Critical care medicine
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Critical care medicine · Dec 1999
Effect of endotracheal suctioning on cerebral oxygenation in traumatic brain-injured patients.
In patients with severe head injuries, brain damage occurs not only from the primary trauma but also secondarily from a reduction in cerebral oxygenation as a result of brain swelling, ischemia, and elevated intracranial pressure (ICP). However, routine interventions designed to maintain oxygenation, such as endotracheal suctioning (ETS), also may negatively affect the cerebrovascular status by increasing the ICP. The purpose of this study was to determine whether ETS influences cerebral oxygenation in patients with traumatic brain injury. ⋯ The increase in jugular venous oxygen tension associated with increases in middle cerebral artery velocity and mean arterial pressure suggests that cerebral oxygen delivery was maintained during ETS. Cerebral changes associated with ETS using the described protocol are consistent with the preservation of cerebral oxygenation.
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Critical care medicine · Dec 1999
Meta AnalysisImmunonutrition in the critically ill: a systematic review of clinical outcome.
To perform a meta-analysis addressing whether enteral nutrition with immune-enhancing feeds benefits critically ill patients after trauma, sepsis, or major surgery. ⋯ The benefits of enteral immunonutrition were most pronounced in surgical patients, although they were present in all groups. The reduction in hospital length of stay and infections has resource implications.
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Critical care medicine · Dec 1999
Comparative StudyRegional pulmonary blood flow during partial liquid ventilation in normal and acute oleic acid-induced lung-injured piglets.
To determine the spatial distribution of pulmonary blood flow in three groups of piglets: partial liquid ventilation in normal piglets, partial liquid ventilation during acute lung injury, and conventional gas ventilation during acute lung injury. ⋯ The spatial distribution of regional pulmonary blood flow is preserved during partial liquid ventilation compared with gas ventilation in oleic acid-induced lung injury.
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Critical care medicine · Dec 1999
Comparative StudyVascular hyporesponsiveness of the renal circulation during endotoxemia in anesthetized pigs.
To compare the vascular reactivity of the renal circulation in control and septic conditions. ⋯ This study shows a hyporesponsiveness of the renal circulation to vasoactive agents during endotoxemia. Vasoconstriction to NE, endothelium-dependent as well as endothelium-independent relaxations are altered during endotoxemia but not abolished, and despite the continuous infusion of endotoxin for 18 hrs, no recovery was observed over time.
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Critical care medicine · Dec 1999
Multicenter Study Clinical Trial Controlled Clinical TrialLong-term follow-up of survivors of acute lung injury: lack of effect of a ventilation strategy to prevent barotrauma.
To determine the effect of a ventilation strategy to prevent barotrauma on long-term outcome in survivors of acute lung injury. ⋯ We found that 1-2 yrs after the onset of their illness, survivors of acute lung injury have reductions in quality of life and exercise tolerance which are similar to patients with chronic diseases. We were unable to show that a limited ventilation strategy improves either long-term pulmonary function or quality of life in survivors of acute lung injury.