Critical care medicine
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Critical care medicine · Nov 1993
Comparative StudySurvival in the elderly after out-of-hospital cardiac arrest.
To evaluate the survival prognosis for the elderly (> or = 70 yrs of age) after out-of-hospital cardiac arrest in a large urban center, and to identify any specific differences in survival factors relative to those adults < 70 yrs of age. ⋯ Survival chances for the elderly after out-of-hospital cardiac arrest are not bleak, and are reasonable if ventricular fibrillation/tachycardia is the presenting rhythm. Survival determinants are similar for younger and older adults.
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Critical care medicine · Nov 1993
Endotracheal intubation and mechanical ventilation in severe asthma.
To determine the occurrence rate of complications and mortality in patients with severe asthma requiring endotracheal intubation and mechanical ventilation. ⋯ While complications occurred in 45% of patients with severe asthma requiring intubation and mechanical ventilation, the mortality rate was low. We conclude that intubation and mechanical ventilation in patients with life-threatening asthma are safe and beneficial interventions.
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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.
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Critical care medicine · Nov 1993
Modes of death in the pediatric intensive care unit: withdrawal and limitation of supportive care.
To determine the frequency of withdrawal or limitation of supportive care for children dying in a pediatric intensive care unit (ICU). ⋯ In a large, multidisciplinary pediatric ICU, the most common mode of death was active withdrawal of support. In addition, more than half (173/300, 58%) of children dying in the pediatric ICU underwent either active withdrawal or limitation (do-not-resuscitate status) of supportive care.
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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.