Critical care medicine
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Critical care medicine · Dec 1997
Comparative StudyComparison of two different pulse oximeters in monitoring preterm infants.
The aim of the study was to test the reliability and variation in the readings of two widely used pulse oximeters in preterm infants. ⋯ We recommend that all neonatal units adopt a policy of using different saturation alarm limits for these two instruments. We further recommend that other pulse oximeters be tested by a methodology similar to the one we present in this paper, before their use in monitoring oxygenation in preterm infants.
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Critical care medicine · Dec 1997
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialProtocol-guided diuretic management: comparison of furosemide by continuous infusion and intermittent bolus.
To evaluate the safety and relative effectiveness of two diuretic protocols in the intensive care unit (ICU). ⋯ Protocol-guided diuretic management, with individualized titration of dosage to defined physiologic endpoints can be readily and safely implemented in the ICU. Both continuous and bolus diuretic regimens appear equally effective in achieving negative fluid balance. Larger studies with a randomized control arm are needed before these protocols can be recommended as routine practice.
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Critical care medicine · Dec 1997
A prospective evaluation of the use of femoral venous catheters in critically ill adults.
To determine the rate of complications following the use of femoral catheters in adults. ⋯ Based on the data from this study, we conclude that femoral vein catheterization with a polyurethane catheter is associated with an 8.5% frequency rate of femoral vein thrombosis. Thrombosis in the popliteal vein or posterior tibial vein is higher (25.7%), but is homolateral to the catheter with only a 2.8% frequency rate. Infectious complications are low and similar to those of other central venous routes. Given the acceptable rate of clinically important complications, femoral venous catheterization offers an attractive alternate site of insertion to the jugular and subclavian veins for central venous access in the critically ill.
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Critical care medicine · Dec 1997
Systemic inflammatory response syndrome and organ dysfunction following gastrointestinal surgery.
Progression from systemic inflammatory response syndrome (SIRS) to sepsis, severe sepsis, and septic shock has been demonstrated in a variety of patients. However, the presence of SIRS alone was not helpful in predicting the development of multiple organ dysfunction syndrome (MODS) since SIRS includes many nonprogressive conditions. This study was conducted to investigate the clinical significance of SIRS in postoperative patients. ⋯ SIRS is a useful criterion for the recognition of postoperative complications and end-organ dysfunctions. Early recovery from SIRS may arrest the progression of organ dysfunction.
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Critical care medicine · Dec 1997
Perflubron decreases inflammatory cytokine production by human alveolar macrophages.
To determine whether inflammatory cytokine production by stimulated human alveolar macrophages is affected by perflubron exposure. ⋯ Exposure of stimulated human alveolar macrophages to perflubron in vitro decreases cytokine production. This observation suggests that perflubron may have anti-inflammatory activity.