Critical care medicine
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Critical care medicine · Jul 1997
BLEED: a classification tool to predict outcomes in patients with acute upper and lower gastrointestinal hemorrhage.
To develop an outcome prediction tool (BLEED: ongoing bleeding, low systolic blood pressure, elevated prothrombin time, erratic mental status, unstable comorbid disease) for clinical use in patients with either acute upper or acute lower gastrointestinal (GI) hemorrhage. ⋯ The BLEED classification, applied at initial emergency department evaluation and before admission, predicts hospital outcomes for patients with acute upper or lower GI hemorrhage. This outcome prediction tool also identified variations in intensive care utilization between two hospitals.
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Critical care medicine · Jul 1997
Extracorporeal circulation increases nitric oxide-induced methemoglobinemia in vivo and in vitro.
Methemoglobinemia is a well-known side effect of nitric oxide inhalation. We tested the hypothesis whether cardiopulmonary bypass increases methemoglobin formation by nitric oxide. ⋯ Cardiopulmonary bypass is an important risk factor for methemoglobinemia when inhaled nitric oxide is applied. This risk is not secondary to diminished concentrations of energetic substrates.
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Critical care medicine · Jul 1997
Inotropic treatment and intestinal mucosal tissue oxygenation in a model of porcine endotoxemia.
To evaluate the dose-related effects of dopamine, dopexamine, and dobutamine on intestinal mucosal tissue oxygenation following short-time infusion of Escherichia coli lipopolysaccharide, which has previously been shown to decrease mucosal tissue oxygenation by 60% of control values. ⋯ In this model of porcine endotoxemia, dopamine and, to a lesser extent, dopexamine increase intestinal mucosal tissue oxygenation. Of all three inotropes used, dobutamine has the most pronounced effect on systemic oxygen delivery, but it does not improve mucosal tissue oxygenation. Selective vasodilation within the intestinal mucosa, mediated mainly by dopamine-1 receptors, seems to explain the observed intestinal mucosal effect of dopamine and dopexamine.
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Critical care medicine · Jul 1997
Experimental fat embolism induces urine 2,3-dinor-6-ketoprostaglandin F1alpha and 11-dehydrothromboxane B2 excretion in pigs.
To evaluate the in vivo production of prostacyclin and thromboxane A2 during the initial phase of experimental fat embolism as assessed, respectively, by determinations of urine 2,3-dinor-6-ketoprostaglandin F1alpha and 11-dehydrothromboxane B2 excretion. ⋯ Pulmonary hypertension, increased pulmonary vascular tone, and increased pulmonary shunt are hallmarks of the present fat embolism model. These hemodynamic responses may, at least partly, be related to the changed balance between prostacyclin and thromboxane A2 production.
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Critical care medicine · Jul 1997
Partial liquid ventilation: a comparison using conventional and high-frequency techniques in an animal model of acute respiratory failure.
To test the hypothesis that high-frequency ventilation (HFV), when compared with conventional techniques, enhances respiratory gas exchange during partial liquid ventilation (PLV). ⋯ Gas exchange was not enhanced during PLV-HFV. Application of HFV with PLV provides no clear acute physiologic advantages to PLV using more conventional techniques.