Critical care medicine
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Critical care medicine · Jun 1992
Comparative StudyEffect of a human immunoglobulin preparation for intravenous use in a rabbit model of meningococcal endotoxin-induced shock.
Endotoxin shock is mediated by various cytokines, including tumor necrosis factor. Treatment of patients with i.v. immunoglobulin has been shown to reduce the concentration of circulating cytokines. The purpose of this study was to determine the protective effects of immunoglobulin for i.v. use on meningococcal endotoxin-induced shock in a rabbit model. Experimental animals were challenged with i.v. meningococcal endotoxin (lipo-oligosaccharide) 10 micrograms/kg, and treated with either a 2-hr i.v. immunoglobulin infusion (400 mg/kg) or a similar saline infusion that was initiated 30 mins before endotoxin challenge. Control animals were challenged with saline alone. ⋯ In this model of circulatory shock in rabbits, i.v. immunoglobulin: a) does not significantly alter the physiologic responses to endotoxin challenge; b) significantly reduces endotoxin concentrations; c) reduces tumor necrosis factor concentrations, but not significantly; and d) does not improve survival rate.
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Critical care medicine · Jun 1992
Outcome of intensive care of the "oldest-old" critically ill patients.
To determine the short-term and long-term outcome of critically ill "oldest-old" (greater than or equal to 85 yrs) patients. ⋯ These findings suggest that age alone may be an inappropriate criterion for allocation of ICU resources.
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Critical care medicine · Jun 1992
Comparative StudyIndirect calorimetry in mechanically ventilated infants and children: measurement accuracy with absence of audible airleak.
To establish the effect of an audible airleak (around an endotracheal tube) on oxygen consumption (VO2) measurements in pediatric ICU patients. ⋯ These data suggest that if no audible airleak is detected, VO2 determined by indirect calorimetry may be reliably measured in infants and children with a noncuffed endotracheal tube.
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Critical care medicine · Jun 1992
Comparative StudyRelationship between hepatic blood flow and tissue lipid peroxidation in the early postburn period.
To determine the effect of a body burn on effective or nutrient liver blood flow and the relationship between blood flow and oxidant-induced lipid peroxidation. ⋯ Effective liver blood flow is markedly decreased after burn injury, even with apparently adequate volume resuscitation, when using lactated Ringer's solution. Liver lipid peroxidation persists even when effective liver blood flow is maintained, indicating that the oxidant process is not solely related to blood flow. Infusion of the antioxidant deferoxamine during resuscitation not only prevents the lipid peroxidation, most likely by a nonblood-flow-related process, but also results in an increase in blood flow above normal rates, suggesting that postburn liver oxygen needs exceed normal values.