Critical care medicine
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Critical care medicine · Oct 1999
Comparative Study Clinical TrialMyocardial ischemia and weaning failure in patients with coronary artery disease: an update.
To determine the frequency and effects of weaning-related myocardial ischemia on weaning outcomes in patients with coronary artery disease. ⋯ Electrocardiographic evidence of myocardial ischemia occurs frequently and is associated with significantly increased risk of first-day weaning failure in patients with coronary artery disease.
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Critical care medicine · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of clinical practice guidelines on outcome of infection in patients in the surgical intensive care unit.
In this study, clinical practice guidelines were developed by a multidisciplinary team for patients with infections admitted to a surgical intensive care unit (ICU). ⋯ In this study, the use of clinical practice guidelines for patients who were admitted to the surgical ICU was shown to reduce costs, without adversely affecting patients' outcomes. This study has important implications for the use of clinical practice guidelines for the management of patients with infections who are admitted to surgical ICUs.
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Critical care medicine · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the acute hemodynamic effects of hypertonic or colloid infusions immediately after mitral valve repair.
To determine the acute hemodynamic effect of hypertonic saline and/or colloid solutions as volume resuscitation in postoperative mitral valve repair patients. ⋯ We conclude that in patients who have undergone mitral valve repair, postoperative infusion of hypertonic saline solutions increases left ventricular preload and left ventricular ejection fraction. The use of these hypertonic solutions may be of interest in patients with valvular cardiomyopathy. A titrated dose and a low rate of infusion may substantially improve the safety.
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Critical care medicine · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialA controlled trial of low-molecular-weight heparin (dalteparin) versus unfractionated heparin as anticoagulant during continuous venovenous hemodialysis with filtration.
To compare the efficacy, safety, and cost of fixed-dose low-molecular-weight heparin (dalteparin) with adjusted-dose unfractionated heparin as anticoagulant for continuous hemofiltration. ⋯ Fixed-dose dalteparin provided identical filter life, comparable safety, but increased total daily cost compared with adjusted-dose heparin. Unfractionated heparin remains our anticoagulant of choice for continuous hemofiltration in intensive care.