Critical care medicine
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Critical care medicine · Jan 1996
Single breath CO2 analysis: description and validation of a method.
To evaluate the performance of a newly developed single breath CO2 analysis station in measuring the airway deadspace in a lung model (study 1), and then to quantify the bias and precision of the physiologic deadspace measurement in a surfactant-depleted animal model (study 2). ⋯ Our initial experience with the single breath CO2 analysis station indicates that this device can reliably provide on-line evaluation of the single-breath CO2 waveform. In particular, estimation of the airway and physiologic deadspace under a variety of testing conditions was consistently within 5% of actual values. We feel that with further application and refinement of the technique, single breath CO2 analysis may provide a noninvasive, on-line monitor of changes in pulmonary blood flow.
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Critical care medicine · Jan 1996
Respiratory and cardiac function in children after acute hypoxemic respiratory failure.
To examine the pulmonary and cardiac function of children who survived an episode of acute hypoxemic respiratory failure. ⋯ Although pediatric survivors of acute hypoxemic respiratory failure perceive neither a limitation in lifestyle nor chronic pulmonary morbidity, careful examination of the cardiopulmonary system demonstrates a significant number with abnormal chest radiographs and abnormalities in pulmonary function. These children require careful follow-up and may benefit from use of a bronchodilator.
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Critical care medicine · Jan 1996
Clinical TrialInitial experience with partial liquid ventilation in pediatric patients with the acute respiratory distress syndrome.
Liquid ventilation with perfluorocarbon previously has not been reported in pediatric patients with respiratory failure beyond the neonatal period. We evaluated the technique of partial liquid ventilation in six pediatric patients with the acute respiratory distress syndrome of sufficient severity to require extracorporeal life support (ECLS). ⋯ Perfluorocarbon may be safely administered into the lungs of pediatric patients with severe respiratory failure on ECLS and may be associated with improvement in gas exchange and pulmonary compliance.
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Critical care medicine · Jan 1996
Comparative StudySpirometric versus Fick-derived oxygen consumption: which method is better?
Oxygen consumption (VO2) is often measured in critically ill patients using the Fick equation: VO2 = cardiac output x arterial-venous oxygen content difference. To determine if this method is accurate, it was compared with a spirometric technique. ⋯ The bias between the Fick and spirometrically determined VO2 values was 58 mL/min. The precision (SD of the bias) between the Fick and spirometrically determined Vo2 was 35 mL/min. Fick-derived Vo2 was greater than Vo2 measured spirometrically. The correlation coefficient was 0.90. CONCLUSIONS; Despite all attempts to reduce measurement error, there was an unexplained difference in Fick-derived and spirometrically measured Vo2. Therefore, I feel that the two methods are not interchangeable, and that calculations of Vo2 using the Fick method should be used cautiously when therapeutic maneuvers are based on these data.
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Critical care medicine · Jan 1996
Adrenergic vasopressor agents and mechanical ventilation for the treatment of experimental septic shock.
Vasopressor agents and mechanical ventilation are routine interventions for the treatment of sepsis complicated by hypotension. It was our hypothesis that such treatment singly or in combination increases the duration of survival. ⋯ No benefit or detriment was demonstrated when vasopressor agents were administered to sustain arterial pressure in the course of experimental peritonitis in this murine model of septic shock. This finding contrasted with highly significant prolongation of survival when animals were mechanically ventilated. There was no evidence that routine vasopressor therapy, under these controlled experimental conditions in rats, improved duration of survival.