Critical care medicine
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Critical care medicine · Oct 1997
Comparative StudySerial electrocardiogram changes in acute tricyclic antidepressant overdoses.
To describe the changes over time of the QRS interval and terminal 40-msec QRS frontal axis (T40-ms) in patients with acute tricyclic antidepressant poisoning, to identify clinical factors and treatment associated with these changes, and to determine if patients with tricyclic antidepressant-related complications (seizures and/or arrhythmias) had differences in such serial electrocardiogram (ECG) changes when compared with patients without complications. ⋯ The conduction abnormalities seen in severe tricyclic antidepressant toxicity vary widely in the time observed for resolution of these abnormalities and sometimes remain persistently abnormal. All ECG parameters were significantly more abnormal in those patients who developed seizures and/or arrhythmias. Clinical improvement occurred both before and during these ECG changes.
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Critical care medicine · Oct 1997
Cerebral blood flow during experimental endotoxemia in volunteers.
To measure cerebral blood flow, cerebral metabolic rate for oxygen, cerebral oxygen delivery, and cerebral vascular resistance during experimental endotoxemia in volunteers. ⋯ A dose of endotoxin sufficient to induce systemic vasodilation in healthy subjects does not influence cerebral blood flow or the cerebral metabolic rate for oxygen.
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Critical care medicine · Oct 1997
Comparative StudyHeat stress increases survival rates in lipopolysaccharide-stimulated rats.
To examine the hypothesis that heat stress applied after the administration of bacterial endotoxin is protective. ⋯ We conclude that heat stress applied after the initiation of endotoxemia can provide protection against an otherwise lethal stimulus and that the mechanism of protection may be related to the attenuation of plasma IL-1 beta concentrations.
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Critical care medicine · Oct 1997
Echocardiographic observations during in hospital cardiopulmonary resuscitation.
To assess echocardiographic observations during in hospital cardiopulmonary resuscitation (CPR) and the utility of this information in the management of cardiac arrest. ⋯ An echocardiographic examination is feasible during CPR and may offer useful information in the management of the individual patients with cardiac arrest. It may depict the proximate cause of cardiac arrest, e.g., pulmonary embolism, cardiac tamponade, or hypovolemia, and signal the return of ventricular contractions in patients with initially absent mechanical activity. The appearance of intracardiac coalescent echo contrast in our patients with unrelenting cardiac arrest was associated with a failed outcome. The role of echocardiographic imaging in the setting of advanced cardiac life support requires further study.
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Critical care medicine · Oct 1997
Tumor necrosis factor-alpha, interleukin-1 beta, and interleukin-6 concentrations in cerebrospinal fluid predict ventriculoperitoneal shunt infection.
To determine the diagnostic value of cerebrospinal fluid tumor necrosis factor (TNF)-alpha, interleukin (IL)-1 beta, and IL-6 released into the cerebrospinal fluid of patients with ventriculoperitoneal shunt infection. ⋯ The presence of cerebrospinal fluid inflammatory cytokines strongly suggests ventriculoperitoneal shunt infection. Detection of these cytokines in the cerebrospinal fluid could be used for earlier diagnosis of bacterial infection.