Critical care medicine
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Critical care medicine · Apr 1992
Case ReportsIntravenous midazolam for the treatment of refractory status epilepticus.
To determine the usefulness of midazolam as a therapeutic agent for status epilepticus refractory to conventional treatment. ⋯ In this small study, midazolam appears to be an effective and safe alternative to high-dose barbiturate coma for the termination of status epilepticus when conventional agents have failed.
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Critical care medicine · Apr 1992
Comparative StudyComparison of gastric intramucosal pH with measures of oxygen transport and consumption in critically ill patients.
To determine the relationship of tonometrically measured gastric intramucosal pH to clinically accepted indices of systemic oxygenation. ⋯ In this group of patients, death was associated with increased tissue needs for oxygen that were not adequately satisfied by the available levels of oxygen supply. We also conclude that tonometrically measured gastric intramucosal pH is a useful noninvasive adjunct to current methods of monitoring systemic oxygenation.
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Critical care medicine · Apr 1992
Ventilation/perfusion indices do not correlate with the difference between oxygen consumption measured by the Fick principle and metabolic monitoring systems in critically ill patients.
To determine whether the difference between oxygen consumption (VO2) measured by metabolic gas monitoring systems and by the Fick principle is related to venous admixture, deadspace/tidal volume ratio, or alveolar-arterial oxygen tension gradient in critically ill patients. ⋯ If the difference in VO2 measured by metabolic gas monitoring systems and the Fick principle is due to intrapulmonary VO2 then in critically ill patients the ventilation/perfusion indices of venous admixture, deadspace/tidal volume ratio and alveolar-arterial oxygen tension gradient correlate poorly with intrapulmonary VO2.
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Critical care medicine · Apr 1992
Clinical TrialIntestinal platelet trapping after traumatic and septic shock. An early sign of sepsis and multiorgan failure in critically ill patients?
Patients resuscitated after severe traumatic or septic shock were studied with reference to the behavior of radiolabeled platelets in vital organs, the occurrence of sepsis, and multiorgan failure. These findings were compared with findings of patients who had sustained severe head trauma, but had reportedly not been in shock. ⋯ The results indicate that, in patients resuscitated after severe traumatic or septic shock, increased sequestration of platelets in the intestine, as measured by external detection of radioisotope-labeled autologous platelets, may precede clinical signs of sepsis and multiorgan failure and may possibly predict the outcome.
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Critical care medicine · Apr 1992
Generation of anaphylatoxin C3a in plasma and bronchoalveolar lavage fluid in trauma patients at risk for the adult respiratory distress syndrome.
To determine the generation of anaphylatoxin C3a in plasma and bronchoalveolar lavage fluid in trauma patients at risk for the adult respiratory distress syndrome (ARDS). ⋯ The C3a of epithelial lining fluid to plasma ratio was extremely high in patients developing ARDS, but even the non-ARDS group had a ratio greater than 1, indicating that a substantial local complement activation occurs in the lung.