Critical care medicine
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Critical care medicine · Jun 1999
Does splanchnic ischemia occur in isolated neurotrauma? A prospective observational study.
To characterize the incidence and severity of splanchnic ischemia, as defined by gastric tonometry, in patients with isolated severe head injury and to examine the relationship between cerebral hemodynamics and splanchnic ischemia. ⋯ Splanchnic ischemia (intramucosal pH, <7.3) occurs commonly in isolated neurotrauma, with a statistically nonsignificant trend toward development of mucosal ischemia with decreased cerebral perfusion.
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To assess the subjective health status, quality of life, and functional ability of patients whose intensive care stay was prolonged and to compare their quality of life with that of the general population. ⋯ The quality of life of survivors after a prolonged intensive care stay is fairly good, although not comparable with that of the general population. The psychosocial aspects of the quality of life are restored more rapidly than physical performance.
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Critical care medicine · Jun 1999
Low systemic vascular resistance state in patients undergoing cardiopulmonary bypass.
To determine the prevalence, hemodynamic characteristics, and risk factors for the low systemic vascular resistance (SVR) state in patients who have undergone cardiopulmonary bypass. ⋯ Low SVR, a probable manifestation of systemic inflammatory response syndrome, is common in patients after cardiopulmonary bypass. These patients may respond better to a vasopressor to restore vascular tone than to volume loading to further increase cardiac index.
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Critical care medicine · Jun 1999
Prognosis of pediatric bone marrow transplant recipients requiring mechanical ventilation.
To assess the prognosis of pediatric bone marrow transplant recipients requiring mechanical ventilation and to identify risk factors for mortality. ⋯ The observed prognosis is improved over previous reports. Early initiation of aggressive intensive care treatment is warranted in this patient group. Decisions regarding intensity of treatment must be based on aspects of the acute illness rather than on the primary conditions.
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Critical care medicine · Jun 1999
Hypernatremia in the intensive care unit: an indicator of quality of care?
To assess the frequency of hypernatremia in patients who were admitted to an intensive care unit (ICU) and to determine the correlation of hypernatremia with the clinical outcomes, durations of the patients' stays in the ICU, and other clinical variables. ⋯ Despite frequent measurement of sodium levels in patients in the ICU, hypernatremia is a relatively common occurrence. Initial treatment of hypernatremia is often inadequate, and sometimes treatment is delayed. The development of hypernatremia is associated with adverse outcomes for patients developing hypernatremia in the ICU. Hypernatremia could potentially be used as an indicator of quality of care in the medical ICU.