Critical care medicine
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Critical care medicine · Apr 1994
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the hemodynamic and oxygen transport responses to modified fluid gelatin and hetastarch in critically ill patients: a prospective, randomized trial.
To compare the hemodynamic and oxygen transport responses to a rapid (< 10-min) infusion of 500 mL of modified fluid gelatin (group A) or hydroxyethyl starch (group B) in patients suffering from acute hypovolemia. ⋯ There are no significant differences in the hemodynamic responses to hydroxyethyl starch or modified fluid gelatin. The hemodynamic and oxygen transport effects of artificial colloid solutions may not be entirely predictable and should be monitored in critically ill patients.
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Critical care medicine · Apr 1994
Comparative StudyIncreased circulating adhesion molecule concentrations in patients with the systemic inflammatory response syndrome: a prospective cohort study.
To investigate the relationship between the soluble derivatives of endothelial adhesion molecules liberated by activated vascular endothelium and the development of the systemic inflammatory response syndrome and organ dysfunction in septic patients. ⋯ Concentrations of circulating vascular endothelial adhesion molecules, especially soluble E-selectin, are increased in patients with systemic inflammatory response syndrome and these concentrations are more increased in patients with organ dysfunction. High plasma concentrations of soluble E-selectin were closely associated with multiple-organ dysfunction and death. Measurement of adhesion molecules, especially soluble E-selectin, might be used to advantage in the management of patients with sepsis.
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Critical care medicine · Apr 1994
Comparative StudyPulmonary artery catheterization in critically ill patients: a prospective analysis of outcome changes associated with catheter-prompted changes in therapy.
To evaluate physician accuracy in predicting patients' hemodynamic profiles, associated morbidities, rates of change in therapy resulting from catheterization, and the outcome variations associated with such change before the insertion of a pulmonary artery catheter. ⋯ Prompted by assessment of pulmonary artery catheter measurements in patients with circulatory shock who were unresponsive to standard therapeutic measures, a change in therapy for these patients was associated with an improved prognosis, independent of other variables influencing outcome.
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Critical care medicine · Apr 1994
Comparative StudyCirculating interleukin-8 concentrations in patients with multiple organ failure of septic and nonseptic origin.
Interleukin (IL)-8, a pro-inflammatory cytokine, is a potent chemoattractant factor and an activator of neutrophils produced by many cell types after stimulation by IL-1, tumor necrosis factor (TNF), or microbial products such as endotoxins. We investigated whether the presence of measurable IL-8 in plasma was associated with the clinical status of severely ill septic or nonseptic patients susceptible to the development of multiple organ failure. ⋯ In septic patients, high amounts of circulating IL-8 concentrations correlate with fatal outcome, whereas only low plasma concentrations of IL-8 are present in patients with nonseptic, multiple organ failure. This finding suggests that the signals involved in the exacerbation of IL-8 production are different, depending on infectious or noninfectious etiology.
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Critical care medicine · Apr 1994
Comparative StudyUse of pulse oximetry to monitor venous saturation during extracorporeal life support.
To assess the ability of two different pulse oximeters to display continuous venous oxygen saturation through an extracorporeal bypass circuit with a degree of accuracy comparable to direct in-line oximetry. ⋯ In addition to its known clinical usefulness, pulse oximetry may serve as an adequate substitute for in-line oximetry during extracorporeal life support.