Critical care medicine
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Critical care medicine · Feb 1992
Complications of endotracheal intubation and mechanical ventilation in infants and children.
To assess the frequency of complications of endotracheal intubation and mechanical ventilation. ⋯ Complications were related to the duration of intubation and mechanical ventilation.
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To review the physiology of the chloride ion and its relationship to various disease states encountered in the ICU. Special emphasis was paid to the renal handling of chloride and its role in the evaluation of the urine and serum anion gaps. Metabolic acidosis and alkalosis are discussed. ⋯ Measurement of chloride is a valuable tool in the evaluation and treatment of a variety of disorders. Serum chloride is most helpful in assessing both normal and increased anion gap metabolic acidoses, while urine chloride finds utility in the diagnosis of metabolic alkalosis and hyperchloremia metabolic acidosis. The evaluation of any disturbance in chloride homeostasis that defies easy explanation necessitates the measurement of stool electrolytes.
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Critical care medicine · Feb 1992
Comparative StudyAn evaluation of the physical and functional characteristics of resuscitators for use in pediatrics.
To evaluate the physical and functional characteristics of pediatric self-inflating resuscitators. ⋯ While these self-inflating resuscitators met the minimum standards, they are all unable to deliver 100% oxygen. One unit is probably not appropriate in the out-of-hospital setting when ambient temperatures are less than 0 degrees C. Those resuscitators that can be misassembled are dangerous in unskilled hands. In addition, reliance on pop-off valve activation to limit airway pressure is dangerous.
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Critical care medicine · Feb 1992
Patterns of cytokines, plasma endotoxin, plasminogen activator inhibitor, and acute-phase proteins during the treatment of severe sepsis in humans.
To study the patterns of plasma concentrations of endotoxin, tumor necrosis factor-alpha (TNF), interleukin-6 (IL-6), plasminogen activator inhibitor-1, C-reactive protein, and serum amyloid A during the treatment of human sepsis. ⋯ This study confirms previous findings that: a) TNF is a major mediator involved in the pathogenesis of septic shock; b) plasminogen activator inhibitor activity is significantly increased in septic patients and might be involved in the pathogenesis of disseminated intravascular coagulation associated with sepsis; and c) IL-6 is involved in the pathophysiology of septic shock, although further studies are needed to determine whether IL-6 is directly involved in mediating the lethal complications of septic shock or whether it should be considered an "alarm hormone" that reflects endothelial cell injury. Our findings also suggest that the concentrations and trends of these mediators during treatment are valuable for monitoring septic patients.