Critical care medicine
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Critical care medicine · Jun 1993
Effects of accidental trauma on cytokine and endotoxin production.
To determine the effects of accidental injury of varying severity on interleukin (IL)-1 alpha, IL-6, IL-8, tumor necrosis factor-alpha (TNF-alpha), and endotoxin release. ⋯ These results demonstrate that severe injury produces rapid, large increases in circulating concentrations of IL-6 and IL-8 that may contribute to the frequent development of the adult respiratory distress syndrome and multiple organ system failure in this clinical setting.
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Critical care medicine · Jun 1993
Comparative StudySimultaneous radial, femoral, and aortic arterial pressures during human cardiopulmonary resuscitation.
To examine the validity of interchanging arterial sites and their responses to graded doses of epinephrine during human cardiopulmonary resuscitation (CPR). ⋯ Radial artery relaxation-phase pressure, although statistically higher, correlated with aortic relaxation-phase pressure. Femoral artery relaxation-phase pressure was not statistically different from aortic relaxation-phase pressure. Aortic pressure was statistically higher and had a lower correlation with radial artery pressures during compression phase. The aortic to radial artery and aortic to femoral artery compression-phase gradients abated with increasing doses of epinephrine therapy. Caution must be used when substituting compression-phase pressure obtained at radial or femoral artery sites for aortic pressure during human CPR. Coronary artery perfusion pressures obtained with radial and femoral arteries correlate with aortic pressure when measuring the response to vasopressor therapy during CPR when an interpretable waveform exists.
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Critical care medicine · Jun 1993
Weight changes in critically ill patients evaluated by fluid balances and impedance measurements.
To study simple, rapid, and predictive methods to determine body weight changes in critically ill patients. ⋯ Calculated fluid balances are not predictive for actual weight changes in critically ill patients. Absolute weight measurements are indispensable. Changes in resistance correlated with weight changes in individual patients if weight changes were > 3 kg.
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Critical care medicine · Jun 1993
Randomized Controlled Trial Clinical TrialTreatment of septic shock with a protease inhibitor in a canine model: a prospective, randomized, controlled trial.
To evaluate the efficacy and mechanism of action of a protease inhibitor (ulinastatin) in septic shock. ⋯ Ulinastatin does not have antimicrobial activity, and it does not sufficiently activate phagocytes. It is suggested that the efficacy of this agent in experimental septic shock is due to a mechanism that activates the reticuloendothelial system and septic reactions.