Critical care medicine
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Critical care medicine · Nov 1993
Ventilatory drive and carbon dioxide response in ventilatory failure due to myasthenia gravis and Guillain-Barré syndrome.
To test the hypothesis that either decreased ventilatory drive or decreased CO2 responsiveness accounts for the hypoventilation observed in patients during acute ventilatory failure from myasthenia gravis or Guillain-Barré syndrome. ⋯ These results suggest that ventilatory drive increases during acute hypoventilation, and the ventilatory drive response to CO2 remains intact, even when the minute ventilation response to CO2 is poor. Therefore, a decrease in ventilatory drive or CO2 response is unlikely to account for hypoventilation during ventilatory failure in patients with myasthenia gravis or Guillain-Barré syndrome.
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Critical care medicine · Nov 1993
Comparative Study Clinical TrialRelationship between oxygen uptake and oxygen delivery in septic patients: effects of prostacyclin versus dobutamine.
To compare the effects of prostacyclin (PGI2) and dobutamine on the relationship between oxygen delivery (DO2) and oxygen uptake (VO2) in stable septic patients. ⋯ PGI2 and dobutamine at the doses used have similar effects on oxygen extraction in critically ill, septic patients, but dobutamine increases DO2 more consistently and is better tolerated than prostacyclin.
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Critical care medicine · Nov 1993
Comparative StudyAccurate assessment of right ventricular function in acute respiratory failure.
Since right ventricular ejection fraction is highly dependent on afterload, right ventricular ejection fraction may not reflect right ventricular contractile function in acute respiratory failure. Despite a severe reduction in right ventricular ejection fraction, the right ventricle may be able to generate pressure output that is sufficient enough to maintain an adequate distribution of pulmonary perfusion. We tested this hypothesis by assessing the correlation between the right ventricular ejection fraction and the right ventricular end-systolic pressure-volume relationship, and by assessing the correlations between right ventricular ejection fraction and the physiologic deadspace/tidal volume ratio and between the physiologic deadspace/tidal volume ratio and the right ventricular end-systolic pressure-volume relationship. ⋯ These data suggest that in acute respiratory failure, the right ventricular ejection fraction does not reflect right ventricular performance.