Critical care medicine
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Critical care medicine · Mar 1995
Clinical Trial Controlled Clinical TrialMedical effectiveness of esophageal balloon pressure manometry in weaning patients from mechanical ventilation.
To determine the efficacy of a new respiratory monitor, which uses esophageal balloons, in aiding clinicians attempting to wean patients from mechanical ventilation. ⋯ The respiratory monitor, using esophageal balloon technology, is effective in that it can provide the clinician with data that can result in more aggressive weaning from mechanical ventilation without an increase in patient intolerance. The duration of mechanical ventilation can be shortened when these data are applied via a rigidly controlled weaning strategy.
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Critical care medicine · Mar 1995
Clinical Trial Controlled Clinical TrialDecreased splanchnic perfusion measured by duplex ultrasound in humans undergoing small volume hemorrhage.
To quantitate duplex Doppler measurements of splanchnic perfusion to determine if these measurements are reproducible in euvolemic humans and if such measurements are sensitive to mild degrees of systemic hypovolemia. ⋯ Noninvasive duplex Doppler measurements of splanchnic peak systolic velocity, time averaged velocity, and estimated blood flow are reproducible and sensitive to small changes in intravascular volume. These data suggest a potential clinical role for duplex imaging in the treatment of critically ill patients to guide therapy to optimize splanchnic perfusion.
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Critical care medicine · Mar 1995
Multicenter StudySurvey of critical care management of comatose, head-injured patients in the United States.
This survey was designed to study current practices in the monitoring and treatment of patients with severe head injury in the United States. ⋯ The survey data indicate that there is a considerable variation in the management of patients with severe head injury in the United States. The establishment of guidelines for the management of head injury based on available scientific data and moderated by practical and financial considerations may lead to improvement in the standard of care.
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Critical care medicine · Mar 1995
Clinical TrialMaternal and fetal colloid osmotic pressure following fluid expansion during cesarean section.
To characterize the changes in colloid osmotic pressure during delivery and to determine the relationship between maternal and fetal colloid osmotic pressures. ⋯ The reduction in maternal colloid osmotic pressure during delivery is, in part, related to intravenous fluid expansion and the amount of vasopressor administered. Despite the significant fluctuations in maternal colloid osmotic pressure, the placenta and fetus possess the capability to alter colloid osmotic pressure.
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Critical care medicine · Mar 1995
Comparative Study Clinical TrialA technique revisited: hemodynamic comparison of closed- and open-chest cardiac massage during human cardiopulmonary resuscitation.
To compare the hemodynamics of closed-chest cardiac massage vs. open-chest cardiac massage in patients resuscitated from cardiac arrest that occurred outside of the hospital. ⋯ Open-chest cardiac massage is superior to closed-chest cardiac massage in providing relaxation-phase and compression-phase pressure gradients during cardiac arrest in patients failing current ACLS protocols. During open-chest cardiac massage, all patients exceeded the minimum coronary perfusion pressure of 15 mm Hg, which is recommended to obtain a return of spontaneous circulation. Further outcome studies are needed to determine the timeliness and appropriate indications for open-chest cardiac massage.