Critical care medicine
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Critical care medicine · Oct 1994
Adult respiratory distress syndrome associated with epidural fentanyl infusion.
To determine the cause of unexplained postoperative adult respiratory distress syndrome (ARDS). ⋯ Based on these findings, as well as a prior history of fentanyl theft at our institution, we conclude that tampering with fentanyl infusate was responsible for the ARDS epidemic that we observed.
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Critical care medicine · Oct 1994
Clinical Trial Controlled Clinical TrialCrystalloid infusion increases plasma hyaluronan.
To investigate the changes in plasma hyaluronan concentrations after intravenous infusion of crystalloid solution in healthy subjects. ⋯ Infusion of crystalloid solution increases plasma hyaluronan, probably through a washout of interstitial hyaluronan by way of increased lymph flow. The consequences of the interstitial loss of hyaluronan on tissue function are unknown.
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Critical care medicine · Oct 1994
Case ReportsIncreased resistance of hygroscopic condenser humidifiers when using a closed circuit suction system.
To examine a hygroscopic condenser after clinical use and to describe the interaction of a hygroscopic condenser and a closed circuit suction system used simultaneously. ⋯ Clinical use of a hygroscopic condenser alone is not associated with a significant increase in peak inflation pressure. We caution the use of a hygroscopic condenser and a closed circuit suction system simultaneously, as an increase in hygroscopic condenser resistance may develop and may be poorly tolerated in patients with marginal ventilatory reserve.
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Critical care medicine · Oct 1994
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialSafety and efficacy of intravenous Carbicarb in patients undergoing surgery: comparison with sodium bicarbonate in the treatment of mild metabolic acidosis. SPI Research Group. Study of Perioperative Ischemia.
To compare the safety and efficacy of intravenous Carbicarb with intravenous sodium bicarbonate in well-oxygenated patients who developed metabolic acidosis while undergoing major surgery. Carbicarb is an equimolar solution of sodium bicarbonate and sodium carbonate (Na2CO3). It does not undergo significant breakdown to CO2 and H2O, nor does it increase CO2 concentrations to the same extent as does pure sodium bicarbonate. Because of these characteristics, Carbicarb may be a more suitable agent than bicarbonate in the treatment of metabolic acidosis. ⋯ Carbicarb corrects metabolic acidosis as well as sodium bicarbonate. However, the potential therapeutic advantage of Carbicarb remains to be determined, especially in patients with more severe metabolic acidosis.
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Critical care medicine · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialRacemic versus l-epinephrine aerosol in the treatment of postextubation laryngeal edema: results from a prospective, randomized, double-blind study.
To determine whether any advantage exists using racemic epinephrine instead of the more potent and less expensive levo(1)-epinephrine in the treatment of postextubation laryngeal edema. ⋯ These data suggest that aerosolized l-epinephrine is as effective as aerosolized racemic epinephrine in the treatment of postextubation laryngeal edema without additional adverse side effects. When dosed appropriately, l-epinephrine is a less expensive and more widely available alternative to racemic epinephrine for the treatment of postextubation laryngeal edema.