Critical care medicine
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To evaluate the changes in the anion gap and their relation to hyperlactatemia and alterations in plasma proteins after cardiopulmonary bypass. ⋯ The decrease in anion gap after cardiopulmonary bypass appears to represent a balance between the influences of increased serum chloride and lactate concentrations and reduced plasma protein concentrations. This analysis demonstrates the limitations of the anion gap in the evaluation of a metabolic acidosis after cardiopulmonary bypass.
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Critical care medicine · Jan 1992
Increased morbidity with increased pulmonary albumin flux in sepsis-related adult respiratory distress syndrome.
To determine the feasibility of utilizing a scintigraphic technique to differentiate patients with adult respiratory distress syndrome due to sepsis syndrome from control volunteers and patients with congestive heart failure. Gamma scintigraphy was compared with chest roentgenograms to predict mortality rate and morbidity in adult respiratory distress syndrome (ARDS) patients. ⋯ Gamma scintigraphy successfully differentiated between control volunteers and patients with congestive heart failure with PAOP less than 30 mm Hg from patients with sepsis-induced ARDS. Although all of the patients with a clinical diagnosis of septic ARDS had similar impairments in oxygenation and chest roentgenograms, those patients with a significantly increased pulmonary albumin flux (greater than 2 SD above control mean) had a markedly increased morbidity.
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To determine patients' preferences for intensive care and to evaluate the influence of a recent ICU experience on preferences for future ICU treatment. ⋯ Patients tolerate intensive care well and desire it to restore health. Most patients modify their desire for intensive care if less favorable outcomes are likely. Patients' preferences for intensive care cannot be predicted from demographic features or previous ICU experiences.
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To determine pulmonary mechanical characteristics in neonates after cardiac surgery. ⋯ Increased lung resistance identifies neonates with respiratory failure after cardiac surgery. Pulmonary mechanics testing may be useful in timing withdrawal of mechanical ventilation.