Critical care medicine
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Critical care medicine · Feb 1996
Randomized Controlled Trial Clinical TrialEffects of pentoxifylline on circulating cytokine concentrations and hemodynamics in patients with septic shock: results from a double-blind, randomized, placebo-controlled study.
To determine whether a continuous intravenous infusion of pentoxifylline, a methylxanthine derivative, alters the serum cytokine concentrations and/or hemodynamic measurements in patients with septic shock. ⋯ Pentoxifylline is able to decrease serum TNF but not IL-6 or IL-8 serum concentrations during septic shock. Pentoxifylline was well tolerated by all eight patients with no adverse effect. Further studies are needed to determine if pentoxifylline's ability to lower circulating TNF concentration without altering hemodynamics will improve outcome in septic shock.
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Critical care medicine · Feb 1996
Review Case ReportsTreatment modalities for hypertensive patients with intracranial pathology: options and risks.
To review the cerebrovascular pathophysiology of hypertension, and the risks and benefits of antihypertensive therapies in the patient with intracranial ischemic or space-occupying pathology. ⋯ The treatment of acute hypertension in the patient with intracranial ischemic or space-occupying pathology requires an understanding of the pathophysiology of hypertension and determinants of cerebral perfusion pressure. Individual agents should be selected based on their ability to promptly and reliably decrease blood pressure, while considering effects on cerebral blood flow and intracranial pressure.
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Critical care medicine · Feb 1996
ReviewEvidence based critical care medicine; what is it and what can it do for us? Evidence Based Medicine in Critical Care Group.
To describe the philosophy and approach to patient care called evidence based medicine, and to highlight how it can enhance the practice of intensive care. ⋯ Evidence based medicine can complement other foundation disciplines in intensive care. This is the first article in a series entitled "Evidence Based Critical Care Medicine" which will demonstrate how this approach can be used at the bedside.
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Critical care medicine · Feb 1996
Comparative Study Clinical Trial Controlled Clinical TrialAdministration of an antibody to E-selectin in patients with septic shock.
To determine the safety and pharmacokinetics of a murine monoclonal antibody to E-selectin in patients with newly developed septic shock. ⋯ This pilot study indicates that this antibody to E-selectin appears to be safe and may represent a promising form of therapy in septic shock.
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Critical care medicine · Feb 1996
Multicenter StudyThe impact of extracorporeal membrane oxygenation on survival in pediatric patients with acute respiratory failure. Pediatric Critical Care Study Group.
Extracorporeal membrane oxygenation (ECMO) has been used with increasing frequency in the treatment of acute respiratory failure in pediatric patients. Our objective in this study was to test the hypothesis that ECMO improves outcome in pediatric patients with acute respiratory failure. ⋯ The use of ECMO was associated with an improved survival in pediatric patients with respiratory failure. The lack of association of outcome with treatment in the ECMO-capable hospital or with another tertiary technology (i.e. high-frequency ventilation) suggests that ECMO itself was responsible for the improved outcome. Further studies of this procedure are warranted but require broad-based multi-institutional participation to provide sufficient statistical power and sensitivity to demonstrate efficacy.