Critical care medicine
-
Critical care medicine · May 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of pressure- and flow-triggered pressure-support ventilation on weaning parameters in patients recovering from acute respiratory failure.
To compare the effects of pressure- and flow-triggered pressure-support ventilation on weaning parameters during recovery from acute respiratory failure. ⋯ The application of either a pressure- or flow-triggered system during pressure-support ventilation with the ventilator did not significantly affect short-term changes in gas exchange, respiratory mechanics, and inspiratory workload in patients recovering from acute respiratory failure of various etiologies without chronic obstructive pulmonary disease.
-
Critical care medicine · May 1997
Multicenter Study Comparative StudyEvaluating laboratory usage in the intensive care unit: patient and institutional characteristics that influence frequency of blood sampling.
To develop a predictive equation to estimate the frequency of blood drawing for intensive care unit (ICU) laboratory tests and to evaluate variations in ICU blood sampling practices after adjusting for patient and institutional factors. ⋯ The ability to adjust for patient and institutional variables and to predict the number of blood samples drawn for laboratory tests can allow ICUs to compare their practices with those of other units. When integrated into a continuous quality improvement process, this information can be used to identify and focus on opportunities for improving blood conservation and reducing excessive diagnostic testing.
-
Critical care medicine · May 1997
Comparative StudyNoninvasive determination of cardiac output in a model of acute lung injury.
To examine the utility of single breath CO2 analysis as a noninvasive measure of cardiac output in a model of acute lung injury. ⋯ Our results indicate that changes in cardiac output can be determined using components of the CO2 expirogram with a high degree of reliability in animals with induced acute lung injury. Specifically, the use of four parameters derived from a plot of expired CO2 concentration vs. expired volume predict changes in cardiac output in adult sheep with induced lung injury with an adjusted coefficient of determination of .80. Prospective application of this technology in the clinical setting with the rapidly changing physiology that is characteristic of the acutely ill patient will be essential in determining the clinical usefulness of single breath CO2 analysis as a noninvasive measure of cardiac output.
-
Critical care medicine · May 1997
Randomized Controlled Trial Clinical TrialFunctional magnesium deficiency in critically ill patients identified using a magnesium-loading test.
To determine the feasibility of the magnesium-loading test in the critically ill and to validate serum ionized magnesium assay using the magnesium-loading test as a reference in this same patient population. ⋯ The magnesium-loading test is feasible and appears to be valid based on its performance during the 3-day evaluation. Using the magnesium-loading test as a reference, serum ionized magnesium appears to be an insensitive biochemical marker of functional hypomagnesemia. Larger cohort studies using the magnesium-loading test will help establish the true prevalence of magnesium deficiency and its associated risk factors in critically ill patients.
-
Critical care medicine · May 1997
Comparative Study Clinical TrialEffects of pentoxifylline on hemodynamics and oxygenation in septic and nonseptic patients.
To evaluate the effects of pentoxifylline on hemodynamics and systemic oxygenation in septic and nonseptic critically ill patients. ⋯ The administration of pentoxifylline to septic patients results in a significant improvement in hemodynamic performance compared with critically ill nonseptic patients. The better hemodynamic state is accompanied by an increase in DO2 and VO2 with unchanged oxygen extraction ratio.