Critical care medicine
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Critical care medicine · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialClinical utility of hygroscopic heat and moisture exchangers in intensive care patients.
To compare the degree of bacterial circuit colonization, frequency of ventilator-associated pneumonia (VAP), character of respiratory secretions, rewarming of hypothermic patients, disposable costs, and air flow resistance in intensive care patients ventilated using either a heat and moisture exchanger (HME) or hot water (HW) humidifier circuit. ⋯ Circuits with a bacterial-viral filtering HME are less readily colonized by bacteria. Contamination is a random event. Humidification technique has no influence on the frequency rate of VAP, the effectiveness of rewarming, nor the character of the respiratory secretions. Breathing resistance is generally low and disposable costs are reduced when an HME is used.
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Critical care medicine · Oct 1997
Comparative Study Clinical Trial Controlled Clinical TrialAirway humidification in mechanically ventilated neonates and infants: a comparative study of a heat and moisture exchanger vs. a heated humidifier using a new fast-response capacitive humidity sensor.
To study the efficiency of a heated humidifier and a heat and moisture exchanger in mechanically ventilated neonates and infants. ⋯ Passive airway humidification by a heat and moisture exchanger is effective in mechanically ventilated neonates and infants over a 6-hr period. However, the performance and safety of a heat and moisture exchanger in prolonged mechanical ventilation remain to be proven.
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Critical care medicine · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialPatient-ventilator flow dyssynchrony: flow-limited versus pressure-limited breaths.
Patient-ventilator flow dyssynchrony occurs when ventilator flow delivery is insufficient to meet patient demands. If sufficiently severe, flow dyssynchrony can produce significant imposed loads on ventilatory muscles. Flow dyssynchrony can be improved by increasing ventilator flow delivery. We hypothesized that the variable flow pressure-limited breath would be a better approach for matching patient flow demands than adjusting a set flow on a conventional volume-cycled breath. ⋯ The pressure-limited, variable-flow approach to ventilator gas delivery appears to be more responsive to a vigorous patient effort than a fixed-flow approach.
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Critical care medicine · Oct 1997
Comparative StudyCerebral oxygenation during warming after cardiopulmonary bypass.
To evaluate jugular venous oxygen saturation (SjVO2), measured with a fiberoptic oximetry catheter, and brain tissue oxygen saturation, measured by near-infrared spectroscopy (NIRSO2), as monitors of cerebral oxygenation during cardiopulmonary bypass surgery. ⋯ The study confirms other studies showing that jugular venous desaturation can occur during rewarming after cardiopulmonary bypass surgery. Presently, SjvO2 appears to be a better monitor of cerebral oxygenation than NIRSO2. However, NIRSO2 has promise as a noninvasive monitor of cerebral oxygenation if future developments allow more quantitative measurements of oxygen saturation.
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Critical care medicine · Oct 1997
Clinical TrialDobutamine improves the adequacy of gastric mucosal perfusion in epinephrine-treated septic shock.
To assess the effects of dobutamine at a rate of 5 micrograms/kg/min on hemodynamics and gastric intramucosal acidosis in patients with hyperdynamic septic shock treated with epinephrine. ⋯ The addition of 5 micrograms/kg/min of dobutamine added to epinephrine in hyperdynamic septic shock selectively improved the adequacy of gastric mucosal perfusion without modification in systemic hemodynamics.