Critical care medicine
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Critical care medicine · Jan 1993
Iatrogenic complications in adult intensive care units: a prospective two-center study.
a) To evaluate the frequency, types, severity, and morbidity of iatrogenic complications; b) determine associated factors that favor iatrogenic complications; and c) suggest new or more efficient protective measures that may be taken to improve patient safety. ⋯ Major iatrogenic complications were frequent, associated with increased morbidity and mortality rates, related to high or excessive nursing workload, and were often secondary to human errors. To improve patient safety in our ICUs, preventive measures should be targeted primarily on the elderly and the most severely ill patients. Special attention should be given to improving the organization of workload and training, and promoting wider use of noninvasive monitoring.
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Critical care medicine · Jan 1993
Epinephrine as an inotropic agent in septic shock: a dose-profile analysis.
To characterize the acute actions and physiologic dose profile of epinephrine, as a single inotrope, in patients with septic shock. ⋯ Epinephrine increases DO2 in septic shock by increasing cardiac index without an effect on systemic vascular resistance index or PAOP.
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a) To quantify the use of do-not-resuscitate orders in a tertiary care children's hospital; and b) to characterize the circumstances in which such orders are written. ⋯ Do-not-resuscitate orders in pediatric patients are written more often in older than younger hospitalized children who die. Most do-not-resuscitate orders are written for patients who are receiving aggressive medical therapy in the ICU.
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Critical care medicine · Jan 1993
Comparative StudyAcute brain swelling after out-of-hospital cardiac arrest: pathogenesis and outcome.
First, to examine factors that may be related to brain swelling, which was identified by the absence or compression of the lateral and third ventricles and perimesencephalic cisterns on brain computed tomography (CT) scans in the early postresuscitation period in patients who suffered an out-of-hospital cardiac arrest. Second, to characterize the neurologic outcome in those patients in whom cardiac arrest was followed by brain swelling. ⋯ The cause of brain swelling may be related to the development of the metabolic acidosis (possibly lactic acidosis) due to hypoxia before the resuscitation period. Brain swelling may be one of the indicators that predicts a poor neurologic outcome in the patients who suffer an out-of-hospital cardiac arrest.
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Critical care medicine · Jan 1993
Effects of dense, high-volume, artificial surfactant aerosol on a heated exhalation filter system.
To evaluate a supplemental heated filter system during mechanical ventilation with continuous nebulization of an artificial surfactant by a new, high-volume nebulizer. ⋯ The supplemental filter system was able to protect the ventilatory exhalation sensors for approximately 7 hrs at a minute ventilation of 20 L/min. Steam sterilization did not extend the supplemental filter life.