Critical care medicine
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Critical care medicine · Aug 1991
Acute Physiology and Chronic Health Evaluation (APACHE II) score and outcome in the surgical intensive care unit: an analysis of multiple intervention and outcome variables in 1,238 patients.
To assess the statistical association of the Acute Physiology and Chronic Health Evaluation (APACHE II) score with multiple intervention and outcome variables in surgical ICU patients. ⋯ The APACHE II score was statistically associated with all the variables examined in our surgical patients, but its predictive power for the individual surgical patient was limited. These findings suggest that the score may be useful for retrospective analyses of large cohorts of patients but should not be used as a triage tool or as a predictor of outcome for the individual patient. Triage decisions should continue to be based on the best available clinical judgment.
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Critical care medicine · Aug 1991
Randomized Controlled Trial Clinical TrialAortic-carotid artery pressure differences and cephalic perfusion pressure during cardiopulmonary resuscitation in humans.
Animal studies have shown an aortic-carotid artery pressure difference during cardiopulmonary resuscitation (CPR), which compromises cerebral perfusion. This pressure difference is most marked with prolonged CPR and can be abolished with administration of high doses of epinephrine. To better understand the mechanism of cerebral blood flow during CPR in humans, we determined the aortic-carotid artery pressure difference, the cephalic perfusion pressure (the carotid artery-jugular vein pressure difference), and thoracic inlet venous "valving" (the central venous-jugular vein pressure difference), while administering standard doses of epinephrine. ⋯ There is no clinically important aortic-carotid artery pressure difference during human CPR using the standard dose of epinephrine, even with prolonged CPR. Despite carotid artery patency and thoracic inlet venous valving, the cephalic perfusion pressure is low during CPR in humans.
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Critical care medicine · Aug 1991
Comparative StudyAccuracy of a mixed venous saturation catheter during acutely induced changes in hematocrit in humans.
To determine the accuracy of in vivo mixed venous hemoglobin saturation (Svo2) measurements with a fiber optic thermodilution catheter during acute changes in hematocrit. ⋯ The accuracy of the studied fiberoptic continuous measuring Svo2 system was not affected by changes in hematocrit or cardiac output. No significant drift in the in vitro Svo2 measurements was observed.
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Critical care medicine · Aug 1991
Cardiothoracic variables measured by bioelectrical impedance in preterm and term neonates.
To report the range of normal values for impedance-derived cardiac output, stroke volume, and the baseline transthoracic impedance in the healthy preterm and term neonate over the weight range generally found in the intensive care nursery. ⋯ These values for transthoracic impedance and transthoracic impedance/cm are the first reported using the standard electrode lead configuration in neonates.
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Critical care medicine · Aug 1991
Gastric mucosal pH as a prognostic index of mortality in critically ill patients.
To determine if measurements of gastric intramucosal pH have prognostic implications regarding ICU mortality. ⋯ Measurements of gastric intramucosal pH on ICU admission, and again 12 hrs later, have a high specificity for predicting patient survival in this ICU patient population (77.8% to 80.6%). Furthermore, given its relative noninvasive nature, tonometrically measured gastric intramucosal pH may be a useful addition to patient monitoring in the ICU.