Critical care medicine
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Critical care medicine · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialPrevention of secondary ischemic insults after severe head injury.
The purpose of this study was to compare the effects of two acute-care management strategies on the frequency of jugular venous desaturation and refractory intracranial hypertension and on long-term neurologic outcome in patients with severe head injury. ⋯ Secondary ischemic insults caused by systemic factors after severe head injury can be prevented with a targeted management protocol. However, potential adverse effects of this management strategy may offset these beneficial effects.
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Critical care medicine · Oct 1999
Randomized Controlled Trial Comparative Study Clinical TrialEffect of patient-controlled analgesia on pulmonary complications after coronary artery bypass grafting.
To determine whether treatment with patient-controlled analgesia (PCA) alone or in combination with nonsteroidal anti-inflammatory drugs can prevent postoperative pulmonary complications after cardiac surgery, when compared with conventional nurse-controlled analgesia. ⋯ PCA significantly decreases postoperative pulmonary atelectasis in patients after coronary artery bypass grafting when compared with nurse-controlled analgesia. In addition, patients treated with PCA experienced a higher quality of analgesia. We therefore conclude that treatment with PCA may reduce respiratory complications after coronary artery bypass grafting.
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Critical care medicine · Oct 1999
Comparative Study Clinical Trial Controlled Clinical TrialInhaled nitric oxide does not improve cardiac or pulmonary function in patients with an exacerbation of chronic obstructive pulmonary disease.
To determine whether inhaled nitric oxide (NO) improves right ventricular function in mechanically ventilated patients with severe chronic obstructive pulmonary disease (COPD). ⋯ Inhalation of NO does not seem to improve either right ventricular function or arterial oxygenation in patients with acute respiratory failure caused by acute exacerbation of COPD.
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Critical care medicine · Oct 1999
Comparative Study Clinical Trial Controlled Clinical TrialDopexamine increases splanchnic blood flow but decreases gastric mucosal pH in severe septic patients treated with dobutamine.
To assess the effects of dopexamine on splanchnic blood flow and splanchnic oxygen uptake in septic patients. ⋯ In hemodynamically stable, hyperdynamic septic patients being treated with dobutamine, dopexamine has no selective effect on splanchnic blood flow. In fact, a decreased pHi suggests a harmful effect on gastric mucosal perfusion.
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Critical care medicine · Oct 1999
Comparative StudyTemperature measurement in critically ill orally intubated adults: a comparison of pulmonary artery core, tympanic, and oral methods.
Core temperature measurement using a pulmonary artery (PA) catheter is considered the gold standard for measuring temperatures in critically ill patients. The objective of this study was to compare oral and tympanic temperature measurements (in both the oral and core equivalence modes) against PA core temperature measurements to determine which method was the most accurate and reliable in the absence of a PA catheter. ⋯ Temperature measurement is an important piece of clinical data in a critically ill patient population. We found oral thermometry to be the most accurate and reproducible method when a PA core measurement was not available.