Critical care medicine
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Critical care medicine · Apr 1995
Comparative StudyAfrican-American and white patients admitted to the intensive care unit: is there a difference in therapy and outcome?
To evaluate variations in patient characteristics, hospital mortality, intensive care unit (ICU) length of stay, and treatment among African-American and white patients admitted to the ICU. ⋯ After adjusting for variations in patient characteristics at ICU admission, race has no significant effect on hospital survival. The small but statistically significant differences in adjusted ICU length of stay and resource use could indicate undertreatment for African-Americans or overtreatment for whites.
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Critical care medicine · Apr 1995
Randomized Controlled Trial Clinical TrialSubclavian venous catheterization: greater success rate for less experienced operators using ultrasound guidance.
To determine if ultrasound guidance can be safely performed and improve success rates for subclavian venous catheterization performed by less experienced operators. ⋯ Ultrasound guidance improves the success rate of subclavian venous catheterization performed by less experienced operators. There were no major complications in either group. Ultrasound guidance is usually successful in allowing performance of subclavian venous catheterizations when landmark techniques fail.
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Critical care medicine · Apr 1995
Comparative Study Clinical TrialEvaluation of the clinical usefulness of thermodilution volumetric catheters.
To determine if treatment modalities (fluid, inotropes, and blood) would be altered based on preload measurements of right ventricular end-diastolic volume index measured by fast response thermodilution catheter, as compared with pulmonary artery occlusion pressure (PAOP). ⋯ In this small sample of surgical patients with sepsis, adult respiratory distress syndrome, and hemorrhagic shock (n = 13), the additional information derived from right ventricular end-diastolic volume index did not change treatment in 43 of 46 instances. However, patients with increased intra-abdominal pressures may show misleadingly high PAOP despite low preload. These patients clearly benefitted from the additional information derived from ventricular volume measurements. Additionally, clinicians who are reluctant to take off-PEEP PAOP may also find this catheter useful.
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Critical care medicine · Apr 1995
Acute hypoxemic respiratory failure in children following bone marrow transplantation: an outcome and pathologic study.
To describe the pulmonary pathology and clinical outcome in children with acute hypoxemic respiratory failure after bone marrow transplantation. ⋯ The acute mortality rate (88%) for children with acute hypoxemic respiratory failure after bone marrow transplantation is similar to that reported for adults with this combination of conditions. Diffuse alveolar damage, the histologic hallmark of adult respiratory distress syndrome, was present in a minority (33%) of patients. Infectious pneumonia was the most frequent cause of acute hypoxemic respiratory failure in patients who had pathologic tissue available, emphasizing the need for aggressive diagnostic studies and early institution of antifungal and antiviral therapy.
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Critical care medicine · Apr 1995
Effects of temperature on bleeding time and clotting time in normal male and female volunteers.
This study was done to assess the effects of temperature on bleeding time and clotting time in normal male and female volunteers. ⋯ Our data indicate that during surgical procedures, it is important to maintain normothermia to ensure that platelets and clotting proteins function optimally.