Critical care medicine
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To determine the pharmacokinetics of intravenous phenytoin in critically ill infants and children with acute neurologic injury. ⋯ Based on the average Km and Vmax values of the children enrolled in our study, it appears that children with neurologic injury between the ages of 0.5 and 9 yrs may require dosages of at least 8 to 10 mg/kg/day, and children aged 10 to 16 yrs may require 6 to 8 mg/kg/day to attain therapeutic phenytoin concentrations.
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Critical care medicine · Aug 1995
Multicenter Study Comparative Study Clinical TrialA comparison of severity of illness scoring systems for intensive care unit patients: results of a multicenter, multinational study. The European/North American Severity Study Group.
To compare the performance of three severity of illness scoring systems used commonly for intensive care unit (ICU) patients in a large international data set. The systems analyzed were versions II and III of the Acute Physiology and Chronic Health Evaluation (APACHE) system, versions I and II of the Simplified Acute Physiology Score (SAPS), and versions I and II of the Mortality Probability Model (MPM), computed at admission and after 24 hrs in the ICU. ⋯ The new versions of the severity systems analyzed (APACHE III, SAPS II, MPM II) perform better than their older counterparts (APACHE II, SAPS I, and MPM I). APACHE II, SAPS II, and MPM II show good discrimination and calibration in this international database.
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Critical care medicine · Aug 1995
Meta AnalysisCorticosteroid treatment for sepsis: a critical appraisal and meta-analysis of the literature.
To determine the effect of corticosteroid therapy on morbidity and mortality in patients with sepsis. ⋯ Current evidence provides no support for the use of corticosteroids in patients with sepsis or septic shock, and suggests that their use may be harmful. These trials underscore the need for future methodologically rigorous trials evaluating new immune-modulating therapies in well-defined critically ill patients with overwhelming infection.
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Critical care medicine · Aug 1995
Randomized Controlled Trial Clinical TrialEffect of erythromycin on gastric motility in mechanically ventilated critically ill patients: a double-blind, randomized, placebo-controlled study.
To document the action of erythromycin on gastric emptying and motility in mechanically ventilated patients. ⋯ In mechanically ventilated patients, intravenous erythromycin (200 mg over 30 mins) increases indices of antral motility and accelerates gastric emptying as assessed by the kinetics of acetaminophen absorption.
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Critical care medicine · Aug 1995
Multicenter Study Comparative StudyA comparison of intensive care unit utilization in Alberta and western Massachusetts.
To analyze differences in intensive care unit (ICU) utilization between a Canadian province and a U.S. area. ⋯ Western Massachusetts hospitalized patients are more likely to be treated in an ICU than are similar patients in Alberta. There is no evidence that the greater ICU utilization in western Massachusetts led to a lower hospital mortality rate.