Critical care medicine
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Critical care medicine · Aug 1992
Randomized Controlled Trial Comparative Study Clinical TrialFrequency and prophylaxis of upper gastrointestinal hemorrhage in critically ill children: a prospective study comparing the efficacy of almagate, ranitidine, and sucralfate. The Gastrointestinal Hemorrhage Study Group.
To determine the occurrence of upper gastrointestinal hemorrhage in critically ill children, and the efficacy of prophylaxis with almagate (antacid), ranitidine, and sucralfate. ⋯ Upper gastrointestinal hemorrhage is an important complication in critically ill children. Prophylaxis with almagate, ranitidine, or sucralfate reduces the occurrence rate of clinically important gastrointestinal hemorrhage.
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Critical care medicine · Aug 1992
ReviewVenous air embolism: clinical and experimental considerations.
To examine the existing literature concerning venous air embolism. Causes, pathophysiology, and management are emphasized. ⋯ Venous air embolism is an infrequent complication of invasive diagnostic and therapeutic maneuvers. The cardiovascular, pulmonary, and central nervous systems may all be affected, with severity ranging from no symptoms to immediate cardiovascular collapse. Therapeutic interventions include mechanical measures, such as positioning, withdrawal of air from the right atrium, and measures aimed at reducing bubble size. Hyperbaric oxygen therapy holds some promise in accomplishing the latter, but randomized, controlled trials demonstrating efficacy have yet to be performed.
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Critical care medicine · Aug 1992
Comparative StudyDiltiazem improves resuscitation from experimental ventricular fibrillation in dogs.
To determine the effect of diltiazem on survival immediately after cardiac arrest and cardiopulmonary resuscitation (CPR) in dogs. ⋯ Diltiazem improves the resuscitation from experimentally induced ventricular fibrillation when administered before or early during CPR. This response may have important clinical implications in the treatment of patients undergoing cardiac arrest and CPR.
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Critical care medicine · Aug 1992
Comparative StudyExtracorporeal life support for pediatric respiratory failure.
The purposes of this report are to a) describe the University of Michigan experience with venoarterial or venovenous extracorporeal life support for severe pediatric pulmonary rescue therapy, and b) examine survivors and nonsurvivors for differences that might be useful for examination in future, prospective studies. ⋯ Extracorporeal life support is an effective rescue therapy for pediatric patients with severe respiratory failure (University of Michigan survival rate of 60%).
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Critical care medicine · Aug 1992
Use of adenosine in the management of perioperative arrhythmias in the pediatric cardiac intensive care unit.
To assess the safety, efficacy, and diagnostic usefulness of iv adenosine in treating acute episodes of paroxysmal supraventricular tachycardia in critically ill infants and children with congenital heart disease. ⋯ Adenosine can be used safely and effectively in critically ill infants and children with congenital heart disease and perioperative tachyarrhythmia. More investigation into the "chemical conversion" of paroxysmal supraventricular tachycardias as well as its diagnostic value in this subset of critically ill patients is warranted.