Critical care medicine
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Critical care medicine · Jul 1998
Comparative StudyA comparison between the Fick method and indirect calorimetry for determining oxygen consumption in patients with fulminant hepatic failure.
To compare the Fick method of determining oxygen consumption (VO2) with a gas exchange method in a group of patients in whom the cardiac output and mixed venous oxygen saturation values were consistently high. ⋯ Under clinical conditions, the agreement between Fick calculations and indirect calorimetry measurements of VO2 in hyperdynamic patients with fulminant hepatic failure was extremely poor. The reproducibility of Fick calculations was less than the reproducibility derived by gas exchange measurements because of the large measurement errors that may occur with the Fick method when the cardiac output is large and the arterial-venous oxygen content difference is small. Fick calculations systematically underestimate gas exchange measurements. The Fick method is inaccurate and unreliable when an estimation of VO2 is required in patients with this hemodynamic pattern.
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Critical care medicine · Jul 1998
Effect of acute-phase and heat-shock stress on apoptosis in intestinal epithelial cells (Caco-2).
a) To determine if the sequence of exposure of intestinal epithelial cells to heat-shock or acute-phase stimuli would affect whether cellular protection or injury would occur; and b) to determine if the effects of a thermally induced heat-shock response can be mimicked by sodium arsenite, a nonthermal inducer of the heat-shock response. ⋯ These results indicate that preinduction of a heat-shock response (arsenite) can protect against cytokine or LPS-induced apoptosis and enterocyte dysfunction, as manifested by the passage of E. coli across an intact enterocyte monolayer. In contrast, the induction of a heat-shock response after exposure to acute-phase response inducers (cytokines and LPS) may result in decreased enterocyte viability, increased apoptosis, and cellular dysfunction.
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Critical care medicine · Jul 1998
Case ReportsProlonged weakness after cisatracurium infusion: a case report.
To present the first documented case report of myopathy persisting for >48 hrs in a patient treated with cisatracurium and concomitant high-dose corticosteroids. ⋯ Clinicians should remember that irrespective of chemical structural, neuromuscular blocking agents might produce prolonged paralysis in predisposed patients.
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Critical care medicine · Jul 1998
Effects of inhaled nitric oxide during permissive hypercapnia in acute respiratory failure in piglets.
To look for the effects of inhaled nitric oxide on oxygenation and pulmonary hemodynamics during acute hypercapnia in acute respiratory failure. ⋯ Acute hypercapnia resulted in a significant increase in pulmonary arterial pressure without influencing oxygenation and cardiac output. Inhaled nitric oxide significantly reduced the pulmonary hypertension induced by acute permissive hypercapnia but did not influence the flow through the pulmonary artery. Inhaled nitric oxide significantly improved oxygenation in this model of acute lung injury during normocapnia and acute hypercapnia.