Critical care medicine
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Critical care medicine · Aug 1998
Comparative StudyExogenous surfactant and positive end-expiratory pressure in the treatment of endotoxin-induced lung injury.
To evaluate the efficacy of treating endotoxin-induced lung injury with single dose exogenous surfactant and positive end-expiratory pressure (PEEP). ⋯ We conclude that PEEP plus surfactant treatment of endotoxin-induced lung injury transiently improves oxygenation, but is unable to maintain this salutary effect indefinitely. Thus, repeat bolus dosing of surfactant or bolus treatment followed by continuous aerosol delivery may be necessary for a continuous beneficial effect.
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Critical care medicine · Aug 1998
Editorial CommentEfficacy of buffers in the management of cardiac arrest.
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Critical care medicine · Aug 1998
Multicenter Study Comparative StudyOutcome of intensive care patients in a group of British intensive care units.
To identify priorities for intensive care unit (ICU) intervention and research. ⋯ Early identification of patients at risk, both before admission and after discharge from the ICU, may allow treatment to decrease mortality. Research and resources may be best directed at patients who die, despite a relatively low predicted mortality. Although these patients are a small percentage of the low-risk admissions, they constitute a large number of ICU deaths. Many patients die after discharge from ICU and this mortality may be decreased by minimizing inappropriate early discharge to the ward, by the provision of high-dependency and step-down units, and by continuing advice and follow-up by the ICU team after the patient has been discharged. Intervention before ICU admission and support of patients after discharge from the ICU should be part of the effort to decrease mortality for ICU patients. Inadequate provision of resources for critically ill patients may result in excess intensive care mortality that is not detected with ICU outcome prediction methods.
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Critical care medicine · Aug 1998
Comparative StudyNo difference exists in the alteration of circadian rhythm between patients with and without intensive care unit psychosis.
To determine if a difference exists in the circadian rhythm entrainment between patients with and without intensive care unit (ICU) psychosis. ⋯ Either patients who develop ICU psychosis have an increased sensitivity to an alteration of their circadian rhythm, or ICU psychosis develops independent of circadian rhythm abnormalities.
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Critical care medicine · Aug 1998
Comparative StudyCardiorespiratory effects of manually compressing the rib cage during tidal expiration in mechanically ventilated patients recovering from acute severe asthma.
To determine the cardiorespiratory effects of manual expiratory rib cage compression in mechanically ventilated patients recovering from acute severe asthma; and to extrapolate these findings to emergency asthma management where ventilation cannot be achieved by positive-pressure ventilation. ⋯ The results suggest that manual compression of the rib cage during consecutive tidal expirations would be ineffective in reducing pulmonary hyperinflation during the emergency management of asthma when air flow obstruction is so severe that ventilation cannot be achieved by positive-pressure ventilation.