Critical care medicine
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Critical care medicine · Apr 1994
Comparative StudyContinuous intra-arterial blood gas and pH monitoring in critically ill patients with severe respiratory failure: a prospective, criterion standard study.
To evaluate the routine clinical performance of a new intra-arterial fiberoptic blood gas sensor that provides continuous PO2, PCO2, and pH monitoring. ⋯ The degree of agreement of intra-arterial blood gas sensor values with conventional blood gas analysis is within an acceptable range for routine clinical purposes. Acute changes in measured values are detected reliably. Continuous intra-arterial blood gas analysis can add substantially to the safety of patients with acute respiratory failure and can reduce blood sampling requirements for blood gas analysis.
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Critical care medicine · Apr 1994
Comparative StudyUse of arterial blood with bedside glucose reflectance meters in an intensive care unit: are they accurate?
To compare blood glucose values obtained from two different sampling sites (arterial catheter and capillary from finger puncture), which were analyzed by a bedside reflectance meter. A sample was also analyzed by standard methods (oxygen electrode oxidation in the laboratory). ⋯ Since arterial whole blood samples give higher glucose results than arterial serum, the use of arterial whole blood in combination with reflectance meters must be recommended with caution. This caution is especially advised if the glucose values obtained with arterial whole blood are used in conjunction with a sliding scale of insulin, which depends on threshold concentrations of glucose. In our hospital, use of arterial whole blood in combination with reflectance meters could have resulted in an incorrect dose of insulin in 31 of 50 patients.
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Critical care medicine · Apr 1994
Comparative StudyInflammatory markers: superior predictors of adverse outcome in blunt trauma patients?
To assess whether variables reflective of early metabolic responses to injury are predictors of outcome in critically ill trauma patients. ⋯ Readily obtainable inflammatory marker measurements may better reflect the summation effects of the early perfusion deficit and tissue injury in the blunt trauma patient compared with conventional measures of injury severity.
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Critical care medicine · Apr 1994
Improvised automatic lung ventilation for unanticipated emergencies.
To design an improvised circuit that can be used to extend the capability of a single ventilator to ventilate two or more patients and that can be assembled from readily available parts in times of unanticipated emergency. ⋯ These two improvised circuits can extend the capability of a standard volume-cycled ventilator to provide automatic ventilation of the lungs in times of disaster.
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Critical care medicine · Apr 1994
Hemodynamic responses to shock in young trauma patients: need for invasive monitoring.
To determine whether early invasive monitoring is necessary in young trauma patients. ⋯ Our data demonstrate that young trauma patients have substantial but clinically occult myocardial depression after shock, and most of these patients require inotropes to optimize and clear circulating lactate. Early invasive monitoring is necessary to precisely define the adequacy of the cardiac response and to individually tailor therapy. Patients who do not optimize and clear their lactate within 24 hrs may not survive.