Critical care medicine
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Critical care medicine · Jun 1988
Comparative StudyDeleterious effects of stroma-free hemoglobin used as resuscitative fluid for rats with ischemic intestinal shock.
This study examined the effect of modified stroma-free Hgb solution (SFHS) as a resuscitative fluid for rats in an ischemic intestinal shock model. The experiments compared the effect of SFHS with two other resuscitative fluids: lactated Ringer's solution (RL) and 3% albumin in RL. The control group received no fluids. ⋯ Hct was used to estimate changes in intravascular volume. All control animals became hemoconcentrated and exhibited a 50% loss in plasma volume. The failure of SFHS to improve significantly the survival in rats compared to the controls is surprising in view of the fact that the SFHS had the same oncotic pressure as the albumin-containing solution and identical volumes were administered.
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Critical care medicine · Jun 1988
Incidence and morbidity of extubation failure in surgical intensive care patients.
The rate of extubation failure (reintubation rate) was determined for 700 consecutive extubations in surgical patients admitted to one of two ICUs. Patients were weaned in a standardized fashion and extubated using a standardized gas exchange and mechanics criteria. Of 400 extubations in the general surgical ICU, there were 22 reintubations in 20 patients. ⋯ In no group studied were any predictors of extubation failure detected. We conclude that the incidence, reasons for, and outcome of reintubations in surgical ICU patients varies dramatically depending on the underlying disease process. Overall failure rate was 4%.
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We conducted a prospective study of CPR in our hospital in order to learn more of the factors influencing outcome. In a 7-month period, 71 patients underwent CPR. ⋯ Factors associated with a successful outcome included occurrence of cardiopulmonary arrest within 24 h of hospitalization, short duration of CPR, and the absence of cardiogenic shock, sepsis, acute renal failure, cancer, and pneumonia. Factors which did not influence outcome included the patients' age, sex, location in hospital during the arrest (general ward vs. intensive cardiac care unit), time of day of the arrest, or the participation of senior physicians or anesthesiologists in the resuscitation.
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Critical care medicine · Jun 1988
Case ReportsAmniotic fluid embolism associated with castor oil ingestion.
We report a case of an amniotic fluid embolism (AFE) causing a cardiorespiratory arrest associated temporally with ingestion of castor oil in a full-term normal pregnancy. Risk factors usually associated with AFE were not found in this patient.