Critical care medicine
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Critical care medicine · Apr 1993
Exogenous surfactant therapy increases static lung compliance, and cannot be assessed by measurements of dynamic compliance alone.
To study the immediate effects of exogenous surfactant therapy on blood gases, lung volumes, and lung mechanics in adult rabbits with experimentally induced respiratory distress syndrome. ⋯ The findings indicate that during mechanical ventilation, the effects of surfactant therapy on lung mechanics are best characterized by changes in functional residual capacity and maximum compliance obtained from static pressure-volume curves and not by dynamic compliance.
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Critical care medicine · Apr 1993
Indicator amount, temperature, and intrinsic cardiac output affect thermodilution cardiac output accuracy and reproducibility.
To determine the accuracy and reproducibility of four thermodilution indicators (5-mL room temperature, 10-mL room temperature, 5-mL iced, and 10-mL iced injectates) at clinically relevant flow rates. ⋯ At low cardiac output levels, reduced indicator impairs accuracy but not reproducibility, a phenomenon that is perhaps related to indicator loss. At high cardiac output rates, reduced indicator impairs reproducibility. This phenomenon is probably related to low signal-to-noise ratio. Thermodilution indicator amounts should be tailored to the output range.
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To describe the structure and organization of pediatric intensive care units (ICUs) in the United States. ⋯ Substantial diversity exists in pediatric ICU structure and organization. Determining factors associated with quality of care is important for improving outcomes.
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Critical care medicine · Apr 1993
Adaptation of pressure support ventilation to increasing ventilatory demand during experimental airway obstruction and acute lung injury.
To estimate the changes in the relative amount of ventilatory assistance offered by inspiratory pressure support during changing ventilatory demand with external airway obstruction and with oleic acid-induced acute lung injury. ⋯ A ventilatory rate-dependent adaptation of pressure support to increased ventilatory demand occurs in an experimental setting both during airway obstruction and lung injury. The results of this study confirm an advantage of breath-to-breath inspiratory pressure support over techniques designed to supply a predetermined mechanical minute volume.