Critical care medicine
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Critical care medicine · Mar 1997
Comparative Study Clinical Trial Controlled Clinical TrialEpinephrine impairs splanchnic perfusion in septic shock.
To assess the effects of epinephrine on splanchnic perfusion and splanchnic oxygen uptake in patients with septic shock. ⋯ We conclude that undesirable splanchnic effects on patients in whom that region is particularly fragile should be considered when using epinephrine for septic shock treatment.
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Critical care medicine · Mar 1997
Randomized Controlled Trial Multicenter Study Clinical TrialParenteral administration of different amounts of branch-chain amino acids in septic patients: clinical and metabolic aspects.
To study the effects of a total parenteral nutrition solution changing branch-chain amino acid concentrations and/or nitrogen supply on protein metabolism, length of stay, and mortality rate; and to evaluate the unique metabolic status of sepsis that leads to a search for specific total parenteral nutrition formulas. ⋯ Our results suggest that the branch-chain amino acids-rich formulas (45%) show a beneficial effect in septic patients.
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Critical care medicine · Mar 1997
Randomized Controlled Trial Clinical TrialDouble-blind, randomized study of the effect of cisapride on gastric emptying in critically ill patients.
To investigate the absorption of the gastrokinetic drug, cisapride, and effect of cisapride on gastric emptying in critically ill patients; and to assess the usefulness of clinical signs of gastric emptying. ⋯ Rectal cisapride in the dose given achieved average plasma concentrations similar to those concentrations achieved in healthy subjects after 30 mg of cisapride rectally. There is a large variation in gastric emptying from one day to the next and large numbers of patients are required to determine if cisapride administration improves early gastric emptying in critically ill patients. The volume of gastric aspirate and the presence of bowel sounds do not correlate with gastric emptying.
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Critical care medicine · Mar 1997
Clinical Trial Controlled Clinical TrialDobutamine increases cerebral blood flow velocity and jugular bulb hemoglobin saturation in septic patients.
To evaluate the effects of dobutamine on cerebral hemodynamics in septic patients with stable hemodynamic status. ⋯ These measurements of middle cerebral artery flow velocity and jugular bulb oximetry suggest that dobutamine increases cerebral blood flow but not cerebral VO2 in stable septic patients.
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Critical care medicine · Mar 1997
Comparative Study Clinical TrialEvaluation of a continuous cardiac output and mixed venous oxygen saturation catheter in critically ill surgical patients.
To evaluate the agreement of continuous cardiac output and mixed venous oxygen saturation measurements, obtained with a modified pulmonary artery catheter, with those values obtained by standard intermittent bolus thermodilution and cooximetry. ⋯ The test catheter adequately measures continuous cardiac output and mixed venous oxygen saturation in the clinical setting. Because intermittent bolus thermodilution is not a true "gold standard" for cardiac output determination, new techniques compared with bolus thermodilution may fail to achieve accuracy expectations. A 9-Fr introducer is recommended, as fiberoptic damage may have occurred when the 8.5-Fr introducer was used.