Critical care medicine
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Critical care medicine · Jun 1991
Comparative StudyCore temperature measurement in the intensive care unit.
To compare three devices that measure core body temperature at the bedside in ICU patients. ⋯ Pulmonary artery thermistor catheters and bladder thermistor catheters appear to give consistent, highly reliable bedside measurements of core body temperature in ICU patients. The currently available device that measures core body temperature from the tympanic membrane appears to give erroneously high readings, and should be used with caution.
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Critical care medicine · Jun 1991
Management of hyponatremic seizures in children with hypertonic saline: a safe and effective strategy.
To study efficacy and safety of hypertonic saline administration in the management of hyponatremic seizures. ⋯ Treatment of hyponatremic seizures with routine anticonvulsants may be ineffective and is associated with a considerable incidence of apnea. A rapid increase in the serum sodium concentration by 3 to 5 mmol/L with the use of hypertonic saline is safe and efficacious in managing acute symptomatic hyponatremia.
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To evaluate the role of amino acid profiles in septic encephalopathy. ⋯ Plasma amino acid profiles appear to be important in septic encephalopathy and the severity of septic disease.
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Critical care medicine · Jun 1991
Oxygen delivery-dependent oxygen consumption in acute respiratory failure.
To investigate whether oxygen consumption (VO2) is dependent on oxygen delivery (DO2) in adult respiratory distress syndrome (ARDS) and non-ARDS acute respiratory failure. ⋯ VO2 is dependent on DO2 over a wide range of DO2 values in acute respiratory failure. This dependency phenomenon is much stronger in ARDS than in respiratory failure due to other causes. Due to the abnormal dependency of VO2 on DO2, changes in the oxygenation status may not be reflected by changes in mixed venous oxygen saturation in ARDS.
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Critical care medicine · Jun 1991
Hypertonic saline dextran resuscitation during the initial phase of acute endotoxemia: effect on regional blood flow.
Small-volume resuscitation by means of bolus application of hypertonic saline solutions has been demonstrated to restore central hemodynamics and regional blood flow in severe hemorrhagic and traumatic shock. The aim of this study was to elucidate the potential of this new concept for treatment of profound hypovolemia and microcirculatory deterioration associated with sepsis and endotoxic shock. In a porcine model of acute hyperdynamic endotoxemia (elicited by continuous iv infusion of Salmonella abortus equi endotoxin for 3.5 hrs), small-volume resuscitation applying hypertonic-hyperoncotic solutions was analyzed for its effect on central hemodynamics, oxygen delivery (Do2), and regional blood flow. Fluid therapy was initiated when the pulmonary artery occlusion pressure (PAOP) tended to decrease (at 43 to 52 mins of endotoxemia), and consisted of 4 mL/kg bolus infusion of either 7.2% sodium chloride, 10% dextran, or 10% dextran in 7.2% sodium chloride; thereafter, PAOP was maintained by controlled infusion of 6% dextran-60. In a control group, 6% dextran-60 was given without preinjection of hypertonic-hyperoncotic solutions. ⋯ Small-volume resuscitation by means of hypertonic saline-dextran proved the most effective, and seems to be an attractive supportive therapy to prevent microcirculatory failure in sepsis and endotoxemia.