Critical care medicine
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Critical care medicine · Aug 1998
Multicenter Study Comparative Study Clinical TrialA multicenter evaluation of a new continuous cardiac output pulmonary artery catheter system.
To validate a new system of continuous cardiac output monitoring. ⋯ This continuous cardiac output system provides a reliable estimate of cardiac output for clinical use if applied in conditions similar to this study. The combination of a continuous measure of cardiac output with other continuous physiologic monitoring (arterial and mixed venous oxygen saturation, oxygen consumption, etc.) may provide important information that no single parameter could achieve.
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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
Comparative StudySimplified acute physiology score II for measuring severity of illness in intermediate care units.
To assess the efficacy of the Simplified Acute Physiology Score (SAPS II) in intermediate care units. A number of patients hospitalized in the intensive care unit (ICU) could be hospitalized in alternative structures, intermediate care units, which are equipped to handle their monitoring needs and able to provide adequate treatment at a lower cost. Characterization of the patients relies on the assessment of their severity of illness by severity scores. The efficiency of severity scores has been established in ICU patients, but not in the setting of intermediate care units. ⋯ The SAPS II assessment of severity of illness in patients admitted to an intermediate care unit is reliable. These results will need to be confirmed, using different patient samplings from intermediate care units.
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Critical care medicine · Aug 1998
Multicenter Study Comparative StudyEvaluation of acute physiology and chronic health evaluation III predictions of hospital mortality in an independent database.
To assess the accuracy and validity of Acute Physiology and Chronic Health Evaluation (APACHE) III hospital mortality predictions in an independent sample of U.S. intensive care unit (ICU) admissions. ⋯ APACHE III accurately predicted aggregate hospital mortality in an independent sample of U.S. ICU admissions. Further improvements in calibration can be achieved by more precise disease labeling, improved acquisition and weighting of neurologic abnormalities, adjustments that reflect changes in treatment outcomes over time, and a larger national database.
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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.