Critical care medicine
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To evaluate in the laboratory a new ventilator with a built-in monitoring function for gas exchange. ⋯ Assuming that limits of agreement for intermethod differences of +/- 20% are clinically acceptable, the VCO2 measurement indicates an acceptable accuracy and precision under controlled ventilation. The respective agreement for the VO2 measurement is lower, but still within the acceptable range. The systematic difference of the VO2 and the VCO2 is mainly influenced by a +8% bias in the inspiratory minute volume measurement, which seems especially susceptible to ventilator settings with inspiratory flow rates of < 50 L/min. An improvement of the minute volume detection would be desirable.
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Critical care medicine · May 1994
Prospective study on the occurrence of withdrawal in critically ill children who receive fentanyl by continuous infusion.
To determine the occurrence of narcotic withdrawal in critically ill children who receive continuous infusions of fentanyl. ⋯ Continuous infusions of fentanyl produce a high occurrence rate of narcotic withdrawal when administered to critically ill children. This effect is both dose- and duration-dependent.
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Critical care medicine · May 1994
Spontaneous gasping increases the ability to resuscitate during experimental cardiopulmonary resuscitation.
To evaluate the effect of spontaneous gasping on cardiorespiratory functions and the ability to resuscitate during experimental cardiac arrest. ⋯ Spontaneous gasping is associated with both pulmonary and hemodynamic effects during cardiac arrest in experimental animals. Spontaneous gasping is biologically useful and is predictive of a more favorable outcome of resuscitative efforts.
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To examine the endogenous erythropoietin response in critically ill children with acute anemia or acute hypoxemia. ⋯ The erythropoietin response to known physiologic stimuli is blunted in critically ill children. This blunted erythropoietin response may result in increased transfusion requirements.
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Critical care medicine · May 1994
ReviewProlonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents: a review of the literature.
To review the reports of prolonged neuromuscular blockade secondary to vecuronium and atracurium administration. To propose mechanisms for prolonged blockade, as well as methods to avoid prolonged blockade. ⋯ Controlled studies assessing the appropriate drug, administration method, use of drug in end-organ dysfunction, and monitoring techniques are unavailable. From the available case reports, length of neuromuscular blockade has been associated with end-organ dysfunction, concomitant drug use, severity of the underlying illness, length of therapy, monitoring techniques used, and perhaps method of drug administration. Steroidally based neuromuscular blocking agents may be particularly hazardous in patients receiving systemic corticosteroids. It is premature to determine the safety of one particular neuromuscular blocking drug in relation to another. Further studies are needed to optimize the use and safety of neuromuscular blocking agents in intensive care unit patients.