Critical care medicine
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Critical care medicine · Dec 1993
Comparative StudyControl and variability of gastric pH in critically ill children.
To determine the effect of illness severity and acute central nervous system injury on the control and variability of gastric pH in pediatric intensive care unit (ICU) patients receiving ranitidine. ⋯ a) Continuous infusion of ranitidine decreases variability of gastric pH in pediatric ICU patients; b) gastric pH variability may make intermittent monitoring of gastric pH inaccurate; c) children with acute central nervous system injury or PRISM scores of > or = 20 have poor control of gastric pH; d) type of injury and PRISM scores predict response to ranitidine therapy.
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Critical care medicine · Dec 1993
Prognostic and clinical relevance of pupillary responses, intracranial pressure monitoring, and brainstem auditory evoked potentials in comatose patients with acute supratentorial mass lesions.
To test the hypothesis that the clinical condition and outcome in patients with acute supratentorial mass lesions can be assessed by determination of pupillary abnormalities, measurement of intracranial pressure, and results of brainstem auditory evoked potentials. ⋯ Pupillary abnormalities may serve as a reliable parameter, which may even be superior to brainstem auditory evoked potential testing and intracranial pressure monitoring for prediction of outcome in comatose individuals with supratentorial mass lesions. Brainstem auditory evoked potentials can be used to support the clinical relevance of abnormal pupillary status and increased intracranial pressure but are of no prognostic value. Increased intracranial pressure is associated with abnormalities in pupillary status and brainstem auditory evoked potentials. Examination for pupillary abnormalities in combination with intracranial pressure monitoring and brainstem auditory evoked potential testing seems to be a useful strategy in managing patients with supratentorial mass lesions in critical care units.
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Critical care medicine · Dec 1993
Comparative StudyRelationship of burn-induced lung lipid peroxidation on the degree of injury after smoke inhalation and a body burn.
We compared the effect of a modest smoke inhalation injury, a burn injury alone, and a smoke inhalation injury plus a body burn, on the degree of lung oxidant-induced lipid peroxidation and lung injury. ⋯ We conclude that alveolar capillary permeability is not increased early after a moderate smoke injury or smoke injury with burn. Lipid peroxidation is not increased in large airway or lung parenchyma with early after-smoke exposure. The addition of a burn significantly increases lung parenchymal lipid peroxidation, but the oxidant changes do not correspond with the degree of early lung dysfunction.
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Critical care medicine · Dec 1993
A novel leukotriene B4-receptor antagonist in endotoxin shock: a prospective, controlled trial in a porcine model.
To evaluate the hypothesis that treatment with LY255283, a novel leukotriene B4-receptor antagonist, is beneficial in an animal model of the adult respiratory distress syndrome induced by endotoxin. ⋯ These data suggest that leukotriene B4 may be an important mediator of acute lung injury in this porcine model of septic shock and acute lung injury. Further studies to assess the specificity of LY255283 as a leukotriene B4 antagonist are necessary in order to exclude the possibility that the beneficial effects of this compound are due to pharmacologic actions other than the blockade of LTB4 receptors.