Critical care medicine
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Critical care medicine · Mar 1991
Mild hypothermic cardiopulmonary resuscitation improves outcome after prolonged cardiac arrest in dogs.
This study was designed to explore the effect of mild cerebral and systemic hypothermia (34 degrees C) on outcome after prolonged cardiac arrest in dogs. After ventricular fibrillation with no flow of 10 min, and standard external CPR with epinephrine (low flow) from ventricular fibrillation time of 10 to 15 min, defibrillation and restoration of spontaneous normotension were between ventricular fibrillation time of 16 and 20 min. This procedure was followed by controlled ventilation to 20 hr postarrest and intensive care to 72 hr postarrest. In control group 1 (n = 10), core temperature was 37.5 degrees C; in control group 2 (n = 10), cooling was started immediately after restoration of spontaneous normotension; and in group 3 (n = 10), cooling was initiated with start of CPR. Cooling was by clinically feasible methods. ⋯ Mild cerebral hypothermia started during or immediately after external CPR improves neurologic recovery.
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Critical care medicine · Mar 1991
Predictors of postextubation stridor in pediatric trauma patients.
To determine which factors are the best predictors of postextubation stridor in pediatric trauma patients. ⋯ In pediatric trauma patients, mechanism of injury (facial burn vs. other) and absence of an airleak at the time of extubation are the strongest factors predicting postextubation stridor. Patients with one or both risk factors require special attention to airway management.
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Critical care medicine · Mar 1991
Comparative StudyAcute airway injury during high-frequency jet ventilation and high-frequency oscillatory ventilation.
We compared tracheal histologic injury patterns, airway pressure (Paw) requirements, and in vivo and in vitro estimate of airway humidification in 13 adult cats with normal lungs mechanically ventilated for 16 hr. Six animals were treated with high-frequency jet ventilation at 400 breaths/min and seven animals with high-frequency oscillatory ventilation at 900 breaths/min. ⋯ In this animal model, high-frequency ventilation using either jet or oscillation techniques produced similar inflammatory tracheal damage despite differences in Paw exposure and humidity.
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Critical care medicine · Mar 1991
Adequate resuscitation of burn patients may not be measured by urine output and vital signs.
To compare vital sign and urine output monitoring of seriously burned patients with invasive monitoring during early resuscitation. ⋯ The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive cardiorespiratory monitoring may be necessary to optimize resuscitation of seriously burned patients.
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Critical care medicine · Mar 1991
Pulmonary aspiration during emergency endoscopy in patients with upper gastrointestinal hemorrhage.
To evaluate the frequency and significance of aspiration and its clinical importance in patients with upper GI bleeding undergoing esophagogastroduodenoscopy in the ICU. ⋯ Clinically significant aspiration pneumonia frequently complicates esophagogastroduodenoscopy in upper GI bleeding patients and is an important mechanism of esophagogastroduodenoscopy-induced hypoxia.