Critical care medicine
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Critical care medicine · Jul 1996
Randomized Controlled Trial Clinical TrialRenal hemodynamics during norepinephrine and low-dose dopamine infusions in man.
To characterize the effects of pressor doses of norepinephrine and low-dose dopamine (3 micrograms/kg/min) on renal hemodynamics in man, as well as to determine the clinical relevance of combining dopamine with norepinephrine. ⋯ The addition of dopamine (3 micrograms/kg/min) to pressor doses of norepinephrine normalized renal blood flow in healthy volunteers. These hemodynamic changes were not reflected in urine output and glomerular filtration rate; hence, these monitoring parameters may be unreliable indicators of renal function in the setting of vasopressor therapy. In addition, systemic effects were observed with dopamine (3 micrograms/kg/min), as indicated by a decrease in MAP.
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Critical care medicine · Jul 1996
Comparative StudyEvaluation of complete blood count results from a new, on-site hemocytometer compared with a laboratory-based hemocytometer.
To compare point-of-care results obtained from an on-site hemocytometer with values provided by an institutional laboratory instrument. ⋯ On-site hemoglobin concentration, hematocrit, white blood cell count, red blood cell count, red cell distribution width, and platelet count values compare well with those results obtained from the laboratory. The MD 16 hemocytometer (Coulter Electronics) provides on-site hematologic results that can provide an accurate and rapid quantitative assessment of platelets, and red and white blood cells. Rapid access to information obtained from this type of system may be clinically useful, especially in critically ill patients.
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Critical care medicine · Jul 1996
Mediastinal tube placement in children with pneumomediastinum: hemodynamic changes and description of technique.
To describe the technique, hemodynamic response, and complication rate after the insertion of a percutaneous mediastinal tube for drainage of pneumomediastinum. ⋯ These findings suggest that hemodynamic compromise commonly accompanies pneumomediastinum in children. Decompression of the mediastinal space and drainage of the pneumomediastinum, using this simple bedside technique for continuous drainage, can be performed rapidly and safely in children, resulting in immediate hemodynamic improvement, and allowing for continuous drainage.
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Critical care medicine · Jul 1996
Comparative StudyCerebral effects of resuscitation with hypertonic saline and a new low-sodium hypertonic fluid in hemorrhagic shock and head injury.
A 2400-mOsm/L hypertonic solution (isosal) with a lower sodium content, compared with conventional 7.5% hypertonic saline, was formulated using a mixture of sodium chloride, glucose, and mixed amino acids. This solution was developed to minimize hypernatremia during resuscitation. We assessed the effects of isosal on hemodynamics, brain edema, and plasma sodium concentration after head injury associated with hemorrhagic shock. DESIGN. Prospective, randomized laboratory study. ⋯ After combined head injury and shock, isosal and 7.5% hypertonic saline have similar effects on hemodynamics and intracranial pressure. Hypertonic saline induces a greater degree of brain dehydration; isosal resuscitation results in smaller increases in plasma sodium.
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Critical care medicine · Jul 1996
Cost accounting of adult intensive care: methods and human and capital inputs.
To cost adult intensive care by determining inputs to production, resource consumption per patient, and total cost per intensive care unit (ICU) stay. ⋯ In order to develop strategies aimed at cost containment, it is first necessary to undertake a thorough examination of cost drivers. This detailed cost-accounting study determined inputs to production, resources consumed by individual patients, and costs incurred during ICU stay.