Critical care medicine
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Critical care medicine · Sep 1991
Comparative StudyRespiratory complications in critically ill medical patients with acute upper gastrointestinal bleeding.
To determine types of respiratory complications encountered in critically ill patients with serious acute upper gastrointestinal (GI) bleeding, and to identify associated risk factors. ⋯ Respiratory complications are common in critically ill medical patients with serious acute upper GI bleeding, and are associated with a poor outcome. Risk factors include advanced liver disease, esophageal site of bleeding, age greater than 70 yrs, and higher APACHE II score.
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Critical care medicine · Sep 1991
Randomized Controlled Trial Comparative Study Clinical TrialTreatment of gram-negative septic shock with an immunoglobulin preparation: a prospective, randomized clinical trial.
To evaluate the effectiveness of a polyclonal immunoglobulin (Ig) preparation containing IgG, IgM, and IgA as an adjunctive therapy for septic shock. ⋯ Administration of a polyclonal immunoglobulin preparation in the early phase of septic shock was associated with significantly improved survival.
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Critical care medicine · Sep 1991
Case Reports Comparative Study"Near miss" death in obstructive sleep apnea: a critical care syndrome.
The objective of this study was to alert critical care physicians to the syndrome of obstructive sleep apnea with respiratory failure ("near miss" death) and to elucidate characteristics that might allow earlier recognition and treatment of such patients. ⋯ Patients with obstructive sleep apnea who have concomitant chronic obstructive pulmonary disease or hypercarbia and hypoxemia are more prone to develop severe respiratory failure and probable death than those patients with apnea alone. The current study shows that recurrent respiratory failure and presumably mortality from this acute complication can be reversed with effective treatment of the obstructive apnea.
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Critical care medicine · Sep 1991
Comparative StudyComparison of disease severity scoring systems in septic shock.
To compare six disease severity scoring systems as predictors of mortality in septic shock when used in the first 24 hrs of diagnosis. The six scoring systems tested were: Multiorgan Failure; the Acute Organ System Failure; the Acute Physiology and Chronic Health Evaluation (APACHE II); the Multisystem Organ Failure scoring system; the Mortality Prediction Model; and the grading of sepsis. ⋯ The Multiorgan Failure scoring system, APACHE II, and the Acute Organ System Failure scoring system, with minor modifications, were found to be useful prognostic tools for patients with septic shock and allowed us to compare the performance and treatment programs of different ICUs.
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To assess the frequency and mortality rates of septic shock in ICU patients and the clinical course of multiple organ failure associated with septic shock. ⋯ Septic shock is a major cause of death in intensive care patients. Refractory hypotension is a main cause of early deaths. Later on, multiple organ failure becomes the primary clinical problem and cause of mortality.