Critical care medicine
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Critical care medicine · Dec 1991
Multicenter Study Clinical Trial Controlled Clinical TrialAcute physiology and chronic health evaluation (APACHE II) and Glasgow coma scores as predictors of outcome from intensive care after cardiac arrest.
a) To examine the accuracy of the Acute Physiology and Chronic Health Evaluation (APACHE II) and the Glasgow Coma Scores as predictors of the outcome of patients following resuscitation from cardiac arrest; b) to study the impact of the components of APACHE II on the prediction. ⋯ The APACHE II scoring system cannot be recommended as a prognostic tool to support clinical judgement in cardiac arrest patients, but by modifying it, a more accurate prediction of poor outcome could be achieved. The Glasgow Coma Score explained to a great extent the predictive power of the APACHE II.
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Critical care medicine · Dec 1991
Amino acid clearances and daily losses in patients with acute renal failure treated by continuous arteriovenous hemodialysis.
To determine daily amino acid and total protein losses in patients with acute renal failure receiving total parenteral nutrition (TPN) during treatment by continuous arteriovenous hemofiltration with hemodialysis (CAVHD). ⋯ These studies confirm that amino acid clearances are relatively high during CAVHD and daily losses should therefore be considered.
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Critical care medicine · Dec 1991
Anatomical variations of internal jugular vein location: impact on central venous access.
To evaluate whether underlying anatomical variations in the position of the internal jugular vein may account for difficulty in obtaining central venous access in individual patients. ⋯ These findings suggest that anatomical variation may partly account for the inability to cannulate the internal jugular vein in certain patients. In these cases, ultrasound examination quickly establishes the position of the internal jugular vein and may allow for easy and rapid access.
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Critical care medicine · Dec 1991
Randomized Controlled Trial Clinical TrialPreoperative lumbar epidural morphine improves postoperative analgesia and ventilatory function after transsternal thymectomy in patients with myasthenia gravis.
To test the hypothesis that preoperative lumbar epidural morphine improves postoperative pain control and ventilatory function after transsternal thymectomy in patients with myasthenia gravis. ⋯ Preoperative lumbar epidural morphine facilitates postoperative analgesia and improves initial postoperative ventilatory performance.
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Critical care medicine · Dec 1991
Safety of bronchoalveolar lavage in the critically ill, mechanically ventilated patient.
To assess complications of bronchoalveolar lavage in the intubated, mechanically ventilated patient. ⋯ We conclude that bronchoalveolar lavage is a well-tolerated procedure in critically ill, mechanically ventilated patients, provided that risk factors for complications are corrected before the procedure and one adheres to procedural guidelines focused on patient safety. Clinically important complications are uncommon. Some patients exhibit deterioration in oxygen after bronchoalveolar lavage; this occurrence cannot be predicted before the procedure.