Critical care medicine
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Critical care medicine · May 1994
Protecting the gut and the liver in the critically ill: effects of dopexamine.
To measure the clinical effects of dopexamine on systemic and splanchnic perfusion in critically ill patients. ⋯ Dopexamine improves gastric intramucosal pH, and thus, splanchnic oxygenation. This improvement in gastric intramucosal pH appears to be independent of dopexamine's systemic effects.
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Critical care medicine · May 1994
Comparative StudyIncreased plasma concentrations of soluble tumor necrosis factor receptors in sepsis syndrome: correlation with plasma creatinine values.
Tumor necrosis factor (TNF) is an important mediator in the complex pathophysiology of sepsis syndrome. Although a positive correlation with mortality rate has been demonstrated, TNF has not been found consistently in sepsis. Since prolonged increases in soluble TNF receptor concentrations were demonstrated after endotoxin and TNF administration, we investigated whether the measurement of TNF receptor concentrations could provide a better indicator of disease than plasma TNF and interleukin (IL)-6 concentrations. ⋯ In the population studied, plasma-soluble TNF receptor concentrations correlated with outcome as well as with plasma creatinine concentrations. The data presented suggest that increased plasma-soluble TNF receptor concentrations in patients with sepsis syndrome are merely the result of renal failure complicating sepsis, and are similarly correlated with mortality rate.
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Critical care medicine · May 1994
Comparative StudyNo differences in hemodynamics, ventricular function, and oxygen delivery in septic and nonseptic patients with the adult respiratory distress syndrome.
To determine whether there are differences in hemodynamics, ventricular function, oxygen delivery, and oxygen consumption between septic and nonseptic patients who have the adult respiratory distress syndrome (ARDS). ⋯ Early in the course of ARDS, there were no differences in hemodynamics, ventricular function, and oxygen delivery and consumption between septic and nonseptic patients. Sepsis does not account for the previously reported differences in hemodynamics, ventricular function, and oxygen delivery and oxygen consumption between survivors and non-survivors of ARDS. We speculate that both ARDS and sepsis cause release of mediators which cause similar changes in hemodynamics, ventricular function, and oxygen delivery and consumption.
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Critical care medicine · May 1994
Admissions to a pediatric intensive care unit for status epilepticus: a 10-year experience.
To characterize the etiology, course, and prognosis in children admitted to a pediatric intensive care unit (ICU) for status epilepticus. ⋯ Most cases of status epilepticus were caused by epilepsy, atypical febrile seizure, encephalitis, meningitis, or metabolic disease. The mortality rate during the ICU stay was 6%. The prognosis was good in most surviving cases, more so if the neurologic development of the child was normal before the status epilepticus.
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Critical care medicine · May 1994
Cytokine, complement, and endotoxin profiles associated with the development of the adult respiratory distress syndrome after severe injury.
The adult respiratory distress syndrome (ARDS) is a frequent complication after severe accidental trauma. This study examines the hypothesis that increased systemic concentrations of proinflammatory cytokines, endotoxin, or complement fragments may predict the development of ARDS. ⋯ These results demonstrate that measurements of plasma concentrations of proinflammatory cytokines, endotoxin, or complement fragments are not helpful in predicting the development of ARDS after severe accidental injury.