Critical care medicine
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Critical care medicine · Oct 1991
Multicenter Study Clinical TrialAirway pressure release ventilation during acute lung injury: a prospective multicenter trial.
To evaluate the feasibility of airway pressure release ventilation (APRV) in providing ventilatory support to patients with acute lung injury of diverse etiology and mild-to-moderate severity. ⋯ APRV is a feasible alternative to conventional mechanical ventilation for augmentation of alveolar ventilation in patients with acute lung injury of mild-to-moderate severity.
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Critical care medicine · Oct 1991
Comparative StudyEffect of associated injuries and blood volume replacement on death, rehabilitation needs, and disability in blunt traumatic brain injury.
To examine the effects of associated injuries on death, disability, rehabilitation needs, and cost in patients with blunt traumatic brain injury. ⋯ In blunt traumatic brain injury, the addition of major visceral or extremity injuries, with need for blood replacement or shock, increases the risk of death, the need for rehabilitation, and the costs of disability.
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Critical care medicine · Oct 1991
Cardiac output from carbon dioxide production and arterial and venous oximetry.
To determine cardiac output from measurements of CO2 production (VCO2), and arterial (SaO2) and mixed venous (SvO2) oxygen saturations, using a modified Fick equation, in which cardiac output = VCO2/[k (SaO2 - SvO2)], where k represents a constant. ⋯ The proposed method for calculating cardiac outputs solely from VCO2 and oximetry saturations yields results that correspond closely to thermodilution determined cardiac outputs. The method is simple and avoids the difficulties in the Fick method associated with accurate VO2 measurement. This approach may be suitable for continuous cardiac output monitoring in critically ill patients.
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Critical care medicine · Oct 1991
Randomized Controlled Trial Comparative Study Clinical TrialReduction of colonization and infection rate during pediatric intensive care by selective decontamination of the digestive tract.
To compare the effects of two different antibiotic regimes on the colonization and infection rates of critically ill pediatric patients. ⋯ Selective oropharyngeal and gastrointestinal decontamination combined with systemic cefotaxime application allows for a significant reduction of the colonization rate with Gram-negative bacteria and yeasts in critically ill pediatric patients undergoing prolonged intensive care. In addition, it significantly reduces the Gram-negative infection rate of the respiratory system. However, this therapeutic approach does not alter ICU length of stay or mortality rate.
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Critical care medicine · Oct 1991
Comparative StudyReduction of duration and cost of mechanical ventilation in an intensive care unit by use of a ventilatory management team.
To test the hypothesis that a formal interdisciplinary team approach to managing ICU patients requiring mechanical ventilation enhances ICU efficiency. ⋯ We conclude that a ventilatory management team, or some component thereof, can significantly and safely expedite the process of "weaning" patients from mechanical ventilatory support in the ICU.