Critical care medicine
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Critical care medicine · Jan 1994
Randomized Controlled Trial Clinical TrialSelective decontamination of the digestive tract in multiple trauma patients--is there a role? Results of a prospective, double-blind, randomized trial.
To evaluate the efficacy of the technique of selective decontamination of the digestive tract in preventing the development of secondary infection and its influence on morbidity and mortality rates in multiple trauma patients with chest injuries requiring intermittent positive-pressure ventilation. ⋯ We have been unable to show any benefit from the use of selective decontamination of the digestive tract in the prevention of secondary infections in multiple trauma patients.
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Critical care medicine · Jan 1994
Comparative StudyOxygen Fick and modified carbon dioxide Fick cardiac outputs.
To compare cardiac outputs estimated from the classical oxygen Fick and modified CO2 Fick methods with thermodilution cardiac output. The modified CO2 Fick cardiac output was obtained by replacing the oxygen uptake (VO2) in the Fick equation with the CO2 production (VCO2) divided by either an assumed or measured value of the respiratory exchange ratio or with an independently determined constant (Crit Care Med 1991; 19:1270-1277). ⋯ We conclude from this study that thermodilution cardiac output is more closely related to cardiac output calculated from modified CO2 Fick methods than to oxygen Fick cardiac output. Since cardiac output calculated with the modified CO2 Fick method 3 obviates the difficulties associated with measuring VO2 accurately and requires neither an assumption of nor measurement of the respiratory exchange ratio, method 3 may prove to be clinically useful for continuous cardiac output monitoring via oximetry in ICU patients.
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Critical care medicine · Jan 1994
Comparative StudyDopamine infusion during resuscitation of experimental hemorrhagic shock.
To compare the effects of starting dopamine administration early or late on organ perfusion by measuring tissue oxygen tensions during standard volume resuscitation of hemorrhagic shock. ⋯ Starting dopamine administration early during volume resuscitation in a model of experimental hemorrhagic shock led to higher liver, subcutaneous, and transcutaneous tissue oxygen levels. This finding indicates enhanced tissue oxygen perfusion, especially in the liver.
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Critical care medicine · Jan 1994
Enoximone and acute left ventricular failure during weaning from mechanical ventilation after cardiac surgery.
To evaluate enoximone, a phosphodiesterase III inhibitor, in the treatment of left ventricular failure during the weaning of patients from mechanical ventilation after heart surgery. ⋯ Because of its positive inotropic and vasodilatory properties, enoximone is helpful for respiratory weaning of patients with left ventricular failure after cardiac surgery.