Critical care medicine
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Critical care medicine · Mar 1998
Brain temperature exceeds systemic temperature in head-injured patients.
To identify the temperature differences in readings taken from the brain, jugular bulb, and core body in head-injured patients. ⋯ Direct measurement of temperature in head-injured patients is a safe procedure. Temperatures in the brain are typically increased over the core body temperature and the jugular bulb temperatures. Jugular vein temperature measurement is not a good measurement of brain temperature since it reflects body, not brain temperature. These findings support the potential importance of monitoring brain temperature and the importance of controlling fever in severely head-injured patients since brain temperature may be higher than expected.
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Critical care medicine · Mar 1998
Utility of chest radiographs after guidewire exchanges of central venous catheters.
To determine whether chest radiographs are warranted after uncomplicated guidewire exchanges of central venous catheters in patients admitted to a Level I trauma intensive care unit. ⋯ Chest radiographs are unwarranted after uncomplicated guidewire exchanges of central venous catheters in hemodynamically stable, monitored patients. Eliminating these radiographs will result in significant cost and time savings without adversely affecting patient outcome.
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Critical care medicine · Mar 1998
Influence of body temperature, with or without sedation, on energy expenditure in severe head-injured patients.
To quantify the effect of body temperature and sepsis on energy expenditure in head-injured patients. ⋯ Sedation had a major effect on energy expenditure. In sedated patients, body temperature was the main determinant of energy expenditure; the anesthetic agent used had little influence on the level of energy expenditure. Sepsis increased energy expenditure independently of fever, probably through hormonal changes.
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Critical care medicine · Mar 1998
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of central venous pressure and common iliac venous pressure in critically ill mechanically ventilated patients.
To investigate the possibility of using common iliac venous pressure (CIVP) as an alternative to superior vena cava pressure (SVCP) in mechanically ventilated, critically ill, adult patients. ⋯ For clinical purposes, CIVP measured by a catheter of 15 to 20 cm placed through the femoral route is interchangeable with SVCP in mechanically ventilated adult patients. This finding provides an alternative route for assessment of central venous pressure when other routes are not appropriate.
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Critical care medicine · Mar 1998
Randomized Controlled Trial Clinical TrialDecreased corticosteroid-binding globulin in burn patients: relationship with interleukin-6 and fat in nutritional support.
To analyze the effect of low-fat nutritional solutions, with or without fish oil, on serum interleukin (IL)-6, and to explore the relationships between IL-6, corticosteroid-binding globulin (CBG; the main cortisol carrier in plasma), and protein metabolism in severely burned adult patients. ⋯ a) Low-fat feeding, with or without fish oil, does not change the early production of IL-6 after burn injury; b) serum IL-6 is negatively correlated with CBG, which supports the hypothesis that this cytokine inhibits hepatic CBG production; and c) IL-6 does not appear to directly influence protein metabolism in burn patients.