Critical care medicine
-
Critical care medicine · Jan 1998
Comparative StudySerial determinations of cerebral water content by magnetic resonance imaging after an infusion of hypertonic saline.
To determine regional cerebral water content in vivo by magnetic resonance imaging (MRI) after the administration of 7.5% saline in brain-lesioned rabbits. ⋯ The administration of a 7.5% saline solution causes a prompt and substantial decrease in cerebral water content as assessed by spin-echo T2-weighted MRI. Magnetic resonance imaging offers the opportunity for repeated, noninvasive in vivo determinations of cerebral water content.
-
Critical care medicine · Jan 1998
Multicenter StudyConfidence in life-support decisions in the intensive care unit: a survey of healthcare workers. Canadian Critical Care Trials Group.
To examine the relationship between intensive care unit (ICU) healthcare workers' confidence and their decision to withdraw life support. ⋯ While confidence in decisions about withdrawal of life support increases with seniority and authority, consistency of decisions may not. When given standard information, healthcare workers can make contradictory decisions yet still be very confident about the level of care they would administer.
-
Critical care medicine · Jan 1998
Randomized Controlled Trial Comparative Study Clinical TrialArtificial nutrition after major abdominal surgery: impact of route of administration and composition of the diet.
To evaluate the impact of the route of administration of artificial nutrition and the composition of the diet on outcome. ⋯ Early enteral feeding is a suitable alternative to TPN after major abdominal surgery. The use of the enriched diet appears to be more beneficial in malnourished and transfused patients.
-
Critical care medicine · Jan 1998
Comparative Study Clinical Trial Controlled Clinical TrialProcoagulant activity in patients with isolated severe head trauma.
To determine the degree of regional and systemic coagulation activation soon after isolated severe head injury. ⋯ Within 6 hrs after severe isolated head trauma, systemic procoagulant overflow from the traumatized cerebral microvasculature proceeds to the thrombin level and is then inhibited by antithrombin III. Regional and systemic hypercoagulability and increased D-dimer concentrations appear to be common among head trauma patients. Increased procoagulant and consecutive fibrinolytic turnover may, therefore, spark disseminated intravascular coagulation in this patient group.
-
Critical care medicine · Jan 1998
Removal of piperacillin in critically ill patients undergoing continuous venovenous hemofiltration.
Continuous hemofiltration is now widely used in the intensive care unit. Our study aimed to assess the removal of piperacillin under continuous hemofiltration and to define a suitable dosage regimen of administration. ⋯ Piperacillin was not removed to a significant extent during continuous hemofiltration. Further, in the intensive care unit, patients in shock with multiple organ failure such as liver failure might behave differently from patients with stable end-stage renal disease. A 4-g dose of piperacillin twice a day is recommended in such patients.