Critical care medicine
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Critical care medicine · May 1995
Comparative StudySubcutaneous oxygen tension: a useful adjunct in assessment of perfusion status.
Using a new fluorescence-quenching optode which, unlike earlier oximeters, neither consumes oxygen nor generates heat, we sought to determine the effects of hemorrhage and resuscitation on subcutaneous PO2. Additionally, we compared the effects of resuscitation with diaspirin crosslinked hemoglobin, an oxygen-carrying solution, on subcutaneous PO2 to that of traditional resuscitative fluids. We also compared mean arterial pressure and central venous oxygen saturation, indirect indices of perfusion, to subcutaneous PO2, a direct index of perfusion. ⋯ The fluorescence-quenching optode consistently followed changes in subcutaneous PO2 during hemorrhage and after resuscitation. Diaspirin crosslinked hemoglobin performed as well as blood in restoring peripheral perfusion, as measured by subcutaneous PO2, while both of these fluids were superior to either lactated Ringer's solution or albumin. Both whole blood and diaspirin crosslinked hemoglobin restored mean arterial pressure to baseline, although the effect of the latter was of a longer duration. The pressor effect of the crosslinked hemoglobin did not affect peripheral perfusion, as reflected by the values for subcutaneous PO2. Subcutaneous PO2 is a useful adjunct in assessment of the adequacy of peripheral perfusion and may help redefine targets for resuscitation.
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Critical care medicine · May 1995
Editorial Comment ReviewResuscitation following trauma and hemorrhagic shock: is hydroxyethyl starch safe?
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Critical care medicine · May 1995
Comparative StudyContinuous versus bolus thermodilution cardiac output measurements--a comparative study.
To compare the methods for continuous and bolus thermodilution cardiac output measurements. ⋯ Continuous thermodilution cardiac output measurement provided higher accuracy and greater resistance to thermal noise than standard bolus measurements. The correct placement of the catheter is essential for precise measurements.
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Critical care medicine · May 1995
Comparative StudyEffects of hydroxyethyl starch after trauma-hemorrhagic shock: restoration of macrophage integrity and prevention of increased circulating interleukin-6 levels.
To determine the effects of resuscitation with the colloidal solution (hydroxyethyl starch) vs. crystalloid solution on cell-mediated immune functions after trauma-hemorrhage. ⋯ Since the use of lactated Ringer's solution and hydroxyethyl starch after hemorrhage did not adversely affect cell-mediated immune functions, but produced salutary effects on macrophage functions, hydroxyethyl starch is a safe and beneficial resuscitation adjunct.
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Critical care medicine · May 1995
Comparative StudyEffect of combined nitric oxide inhalation and NG-nitro-L-arginine infusion in porcine endotoxin shock.
To evaluate the possible effects of a combination of systemic nitric oxide synthesis inhibition (to increase mean arterial blood pressure) and nitric oxide inhalation (to decrease pulmonary vascular pressure) in porcine endotoxin shock. ⋯ In this model of porcine endotoxin shock, the combination of NG-nitro-L-arginine infusion and nitric oxide inhalation attenuated pulmonary hypertension and improved gas exchange; it also prevented development of further systemic hypotension, but impaired cardiac output and increased systemic and renal vascular resistances to supranormal levels. NG-nitro-L-arginine/nitric oxide did not reduce sympathetic nervous system activation or metabolic acidosis.