Critical care medicine
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Critical care medicine · Jun 1997
Case ReportsProlonged extracorporeal life support (ECLS) for varicella pneumonia.
To review the institutional experience of a national tertiary referral center for extracorporeal life support (ECLS) in severe varicella pneumonia. ⋯ Early recognition of imminent pulmonary failure and rapid institution of ECLS are critical in the successful management of severe, life-threatening varicella pneumonia.
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Critical care medicine · Jun 1997
Effect of NG-nitro-L-arginine-methyl-ester on cardiopulmonary function and biosynthesis of cyclooxygenase products during porcine endotoxemia.
To determine if inhibition of nitric oxide synthase with NG-nitro-L-arginine-methyl-ester (L-NAME) potentiates endotoxin-induced cardiopulmonary dysfunction and release of cyclooxygenase products in a porcine model of endotoxemia. ⋯ During endotoxemia, inhibition of nitric oxide synthase with L-NAME may be deleterious to cardiopulmonary function, as evidence by potentiation of endotoxin-induced systemic and pulmonary vasoconstriction, impairment of gas exchange, and enhanced biosynthesis of cyclooxygenase products. Moreover, during endotoxemia, the concomitant inhibition of two important vasodilators (i.e., nitric oxide and prostacyclin) is associated with a potentiated (p < .05) increase in systemic vascular resistance index.
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Critical care medicine · Jun 1997
Effects of intra-aortic balloon occlusion on hemodynamics during, and survival after cardiopulmonary resuscitation in dogs.
To evaluate the effect of balloon occlusion of the proximal descending aorta during cardiopulmonary resuscitation (CPR) on hemodynamics, restoration of spontaneous circulation, and 24-hr survival. ⋯ Balloon occlusion of the proximal descending aorta during experimental CPR improves restoration of spontaneous circulation. Further laboratory and human studies are needed to determine the clinical efficacy of this technique.
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Critical care medicine · Jun 1997
Variation of inhaled nitric oxide concentration with the use of a continuous flow ventilator.
To investigate the homogeneity of nitric oxide concentrations at different ventilator settings in a delivery system using a continuous flow ventilator. ⋯ Mixing a nitrogen/nitric oxide gas mixture 20 cm before the Y-connector results in an increase of the mean nitric oxide concentration with increasing ventilator rates. This phenomenon does not occur with the nitrogen/nitric oxide gas mixture mixed at the inlet of the humidifier, using a ventilator with a throughout constant flow at the inspiratory outlet of the ventilator. The fluctuations of the main ventilator circuit flow result in changing ratios of nitrogen/nitric oxide gas mixture and the ventilator gas flow. We speculate this changing flow ratio produces the increase in mean nitric oxide concentration within the ventilatory circuit. To ensure a constant concentration of nitric oxide by blending a nitrogen/nitric oxide gas mixture in the ventilator circuit of a continuous flow ventilator, the site of injection of the nitrogen/nitric oxide gas mixture should be at the point where ventilator circuit flow fluctuations are minimal.
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Critical care medicine · Jun 1997
Utilization and diagnostic yield of blood cultures in a surgical intensive care unit.
To evaluate the diagnostic yield of blood cultures obtained in a surgical intensive care unit (ICU) and to assess factors potentially influencing yield. ⋯ Blood culture yield in this surgical ICU was relatively low in comparison with other published studies. The data further suggest that concurrent use of systemic antibiotics and inappropriate or excessive culturing may negatively influence blood culture yield.