Critical care medicine
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Critical care medicine · Oct 1999
Comparative StudySuccessful weaning from cardiopulmonary bypass with central venous prostaglandin E1 and left atrial norepinephrine infusion in patients with acute pulmonary hypertension.
Postoperative pulmonary hypertension increases the mortality risk in cardiac surgery. We have used central venous prostaglandin E1 (PGE1) and left atrial norepinephrine (NE) infusion to wean from cardiopulmonary bypass (CPB) patients with refractory postoperative pulmonary hypertension. ⋯ In patients with refractory postoperative pulmonary hypertension, the combined administration of low-dose PGE1 in the right atrium and NE in the left atrium is an effective means to wean patients from cardiopulmonary bypass.
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Critical care medicine · Oct 1999
Comparative StudyDiscrimination of infectious and noninfectious causes of early acute respiratory distress syndrome by procalcitonin.
To test the sepsis marker procalcitonin (PCT) for its applicability to discriminate between septic and nonseptic causes of acute respiratory distress syndrome (ARDS). ⋯ PCT determination in early ARDS could help to discriminate between septic and nonseptic underlying disease.
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Critical care medicine · Oct 1999
Editorial Comment ReviewAn approach to costs in critical care: macro- versus microeconomics.
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Critical care medicine · Oct 1999
Editorial Comment ReviewPhysician variability in limiting life-sustaining treatment.
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Critical care medicine · Oct 1999
Case ReportsVenous air embolism from central venous catheterization: a need for increased physician awareness.
To report a series of patients with clinically diagnosed venous air embolism (VAE) and major sequelae as a complication of the use of central venous catheters (CVCs), to survey health care professionals' practices regarding CVCs, and to implement an educational intervention for optimizing approaches to CVC insertion and removal. ⋯ There is inadequate awareness of VAE as a complication of CVC use. Focused instruction can improve appreciation of this potentially fatal complication and knowledge of its prevention, but the effect declines rapidly. To achieve a more sustained improvement, a more intensive, hands-on, periodic educational program will likely be necessary, as well as reinforcement through enhanced supervision of CVC insertion and removal practices.