Critical care medicine
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Critical care medicine · Dec 1999
Comparative StudyComparison of the hemodynamic effects of amrinone in patients who required low-to-moderate-dose and high-dose catecholamines after cardiac valve replacement.
To determine hemodynamic response to amrinone in patients after cardiac surgery, in relation to the postoperative cardiac function, which was indicated by the required doses of catecholamines. ⋯ The inotropic effects of amrinone after cardiac valve replacement may be associated with the postoperative myocardial reserve, which was indicated by the required doses of catecholamines, although a similar vasodilative effect was observed in both groups.
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Critical care medicine · Dec 1999
Oxygenation in status asthmaticus improves during ventilation with helium-oxygen.
To determine the effect of breathing helium-oxygen (HELIOX) mixtures on pulmonary gas exchange during severe asthma. ⋯ MV with HELIOX improves (A-a)gradient in patients with SA. Although this improvement adds little to routine therapy with supplemental oxygen, it does permit reduction in concentration of inspired oxygen to levels that maximize helium concentration and thus permit full benefits of HELIOX on lung mechanics to be realized in even the most severely ill asthmatics.
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Critical care medicine · Dec 1999
Comparative StudyComparison of intravenous and endotracheal epinephrine during cardiopulmonary resuscitation in newborn piglets.
To compare the efficacy of intravenous and endotracheal epinephrine administration, and intravenous administration above and below the diaphragm, during cardiopulmonary resuscitation in newborn piglets. ⋯ During cardiopulmonary resuscitation in newborn piglets, intravenous administration of epinephrine is more efficacious than endotracheal administration. Furthermore, efficacy is similar between femoral venous and right atrial administration.
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Critical care medicine · Dec 1999
Comparative StudyConventional ventilation modes with small pressure amplitudes and high positive end-expiratory pressure levels optimize surfactant therapy.
High-frequency oscillation studies have shown that ventilation at high end-expiratory lung volumes combined with small volume cycles at high rates best preserves exogenous surfactant and gas exchange in lavaged lungs. We investigated whether surfactant composition and gas exchange can also be preserved by conventional modes of mechanical ventilation, which combine high levels of positive end-expiratory pressure (PEEP) with small pressure amplitudes. ⋯ We conclude that exogenous surfactant composition is preserved by conventional modes of mechanical ventilation that use small pressure amplitudes, and adequate oxygenation is maintained by high end-expiratory pressure levels. Effective carbon dioxide removal can be achieved by applying a ventilation mode that creates auto PEEP and not by a mode that applies the same level of PEEP by static PEEP only.