Critical care medicine
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Critical care medicine · Mar 1993
Randomized Controlled Trial Comparative Study Clinical TrialComparison of mask and nasal continuous positive airway pressure after extubation and mechanical ventilation.
To examine the effects of continuous positive airway pressure applied via face masks and nose masks on the change in functional residual capacity and gas exchange. ⋯ The major advantages of continuous positive airway pressure (the improvement of functional residual capacity and oxygen transfer) can also be achieved with nasal continuous positive airway pressure in the postextubation period in patients who have been mechanically ventilated for acute lung injury.
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Critical care medicine · Mar 1993
Randomized Controlled Trial Clinical TrialImproved cardiovascular stability during continuous modes of renal replacement therapy in critically ill patients with acute hepatic and renal failure.
To determine whether continuous modes of renal replacement therapy result in improved cardiovascular stability compared with standard daily intermittent treatment in critically ill patients. ⋯ In critically ill patients, in whom DO2 is impaired, the use of continuous forms of renal replacement therapy is preferred for its improved cardiovascular tolerance compared with daily intermittent machine treatments.
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Critical care medicine · Mar 1993
Enteral nutrition with simultaneous gastric decompression in critically ill patients.
Early enteral nutrition is an important adjunct in the care of critically ill patients. A double-lumen gastrostomy tube with a duodenal extension has been reported to enable early enteral feeding with simultaneous gastroduodenal decompression. We tested the ability of this device to achieve these goals in critically ill patients. ⋯ These data do not support the use of this device for early enteral feeding and simultaneous gastric decompression in critically ill patients.
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Critical care medicine · Mar 1993
Interaction between intrinsic positive end-expiratory pressure and externally applied positive end-expiratory pressure during controlled mechanical ventilation.
To assess the interaction between intrinsic and externally applied positive end-expiratory pressure (intrinsic PEEP and administered PEEP) in mechanically ventilated patients. ⋯ The administration of positive end-expiratory pressure equal to the intrinsic positive end-expiratory pressure causes the almost total disappearance of the intrinsic positive end-expiratory pressure. When the administered positive end-expiratory pressure does not exceed the intrinsic positive end-expiratory pressure, the former is applied almost in its entirety to the patient's external circuit. The administration of positive end-expiratory pressure without prior quantification of the intrinsic positive end-expiratory pressure results in an overestimation of the beneficial effects of the administered positive end-expiratory pressure on the quasi-static compliance.
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Critical care medicine · Mar 1993
The Acute Physiology and Chronic Health Evaluation II classification system is a valid marker for physiologic stress in the critically ill patient.
To compare the Acute Physiology and Chronic Health Evaluation (APACHE II) score with resting energy expenditure obtained from indirect calorimetry to determine whether the APACHE II scoring system is an accurate, objective measure of the degree of critical illness and physiologic stress between groups of patients. ⋯ The APACHE II classification may be a valid marker of physiologic stress as demonstrated by its statistically significant (although weak) relationship with indirect calorimetric measures of energy expenditure associated with varying degrees of critical illness.