Critical care medicine
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Critical care medicine · Mar 1992
Evaluation of hypoxic brain injury with spinal fluid enzymes, lactate, and pyruvate.
To investigate the prognostic importance in neurologic recovery of the lumbar cerebrospinal fluid (CSF) variables creatine kinase (CK) and brain-type creatine kinase isoenzyme (CK-BB), lactate dehydrogenase (LDH) and its isoenzymes (LDH 1-5), CSF acid phosphatase, beta-D-N-acetylglucosaminidase activity, and CSF lactate, pyruvate, sodium, potassium, and calcium concentrations in patients who experienced cardiac arrest. ⋯ CSF CK, CK-BB, and CSF lactate concentrations reflect a patient's outcome most reliably when measured within 28 to 76 hrs of the cardiac arrest. Similarly, CSF LDH, its isoenzymes 1-3, and CSF acid phosphatase concentrations, when measured at 76 hrs, can be used to monitor the patient's outcome after cardiac arrest. When correlated with Glasgow Coma Scale scores, the closest negative correlation was again seen in CSF CK and CK-BB at 28 and 76 hrs, as well as in LDH, LDH1-3, and acid phosphatase values at 76 hrs. The negative correlation between CSF lactate and Glasgow Coma Scale scores was most distinct at 28 hrs.
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Critical care medicine · Mar 1992
Comparative StudyContinuous measurement of cardiac output by the Fick principle: clinical validation in intensive care.
To compare continuous measurement of cardiac output by the Fick principle with the thermodilution cardiac output technique in hemodynamically unstable patients. ⋯ Continuous measurement of cardiac output by the Fick principle offers a convenient, reproducible method for hemodynamic monitoring of unstable patients. The variation between the two tested thermodilution techniques is likely to reflect relatively rapid dynamic variation of cardiac output, which is filtered in the 1-min average of cardiac output obtained by the continuous Fick technique.
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Critical care medicine · Mar 1992
Effect of epinephrine on the ability of end-tidal carbon dioxide readings to predict initial resuscitation from cardiac arrest.
To determine if the administration of epinephrine changes the partial pressure of end-tidal CO2 during cardiac arrest, as previously reported. Such a change could diminish the demonstrated ability of end-tidal CO2 measurements to predict resuscitation from cardiac arrest. ⋯ Although epinephrine administration may decrease end-tidal CO2 tensions in cardiac arrest, it does so unpredictably in individual patients, and it does not eliminate the predictive value of this measurement.
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Critical care medicine · Mar 1992
Early prediction of successful weaning during pressure support ventilation in chronic obstructive pulmonary disease patients.
The aim of this study was to examine variables for early prediction of successful weaning in chronic obstructive pulmonary disease (COPD) patients during pressure support ventilation weaning. ⋯ This study confirms that conventional weaning criteria are often inadequate in predicting successful weaning of COPD patients, while airway occlusion pressure at 0.1 sec during the first phase of pressure support ventilation weaning can represent a good weaning predictor.
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Critical care medicine · Mar 1992
Attitudes of critical care medicine professionals concerning forgoing life-sustaining treatments. The Society of Critical Care Medicine Ethics Committee.
To evaluate the attitudes of critical care professionals concerning forgoing life-sustaining treatments in critically ill patients. ⋯ Critical care professionals evaluate both the preservation of life and quality of life in their patients. Despite some discomfort in forgoing treatment, the majority of critical care professionals decide to forgo treatment in irreversibly, terminally ill patients.