Critical care medicine
-
Critical care medicine · Apr 1997
Comparative StudyEpinephrine and sodium bicarbonate independently and additively increase survival in experimental amitriptyline poisoning.
Cardiac depression is the main adverse effect of severe tricyclic antidepressant poisoning. The aim of this study was to investigate whether treatment with epinephrine or norepinephrine increases survival as compared with standard treatment with sodium bicarbonate in experimental amitriptyline poisoning. ⋯ Both epinephrine and norepinephrine increased the survival rate in tricyclic antidepressant poisoning in rats. Sodium bicarbonate increased the survival rate independent of inotropic drug treatment. Furthermore, epinephrine was superior to norepinephrine when used both with and without sodium bicarbonate, and the most effective treatment was epinephrine plus sodium bicarbonate.
-
Critical care medicine · Apr 1997
Randomized Controlled Trial Clinical TrialRandomized, prospective trial of bilevel versus continuous positive airway pressure in acute pulmonary edema.
To evaluate whether bilevel positive airway pressure, by actively assisting inhalation, more rapidly improves ventilation, acidemia, and dyspnea than continuous positive airway pressure (CPAP) in patients with acute pulmonary edema. ⋯ Bilevel positive airway pressure improves ventilation and vital signs more rapidly than CPAP in patients with acute pulmonary edema. The higher rate of myocardial infarctions associated with the use of bilevel positive airway pressure highlights the need for further studies to clarify its effects on hemodynamics and infarction rates, and to determine optimal pressure settings.
-
Critical care medicine · Apr 1997
Randomized Controlled Trial Clinical TrialA randomized, controlled trial of protocol-directed versus physician-directed weaning from mechanical ventilation.
To compare a practice of protocol-directed weaning from mechanical ventilation implemented by nurses and respiratory therapists with traditional physician-directed weaning. ⋯ Protocol-guided weaning of mechanical ventilation, as performed by nurses and respiratory therapists, is safe and led to extubation more rapidly than physician-directed weaning.
-
Critical care medicine · Apr 1997
Comparative StudyDoes pediatric housestaff experience influence tests ordered for infants in the neonatal intensive care unit?
To assess the relationship between the experience of pediatric housestaff and tests ordered on infants in the neonatal intensive care unit (ICU). ⋯ Interns order significantly more arterial blood gases per infant than junior and senior residents on-call in the neonatal ICU. Additional study is required to see if the experience of housestaff is associated with a broader array of neonatal outcomes, such as morbidity and mortality.