Critical care medicine
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Critical care medicine · Sep 1999
Randomized Controlled Trial Clinical TrialDopexamine reduces the incidence of acute inflammation in the gut mucosa after abdominal surgery in high-risk patients.
To evaluate the effect of dopexamine on the incidence of acute inflammation in the stomach/duodenum in patients undergoing abdominal surgery > or =1.5 hrs with a minimum of one high-risk criterion. ⋯ Dopexamine in doses of 0.5 and 2.0 microg/kg/min affords significant histologic protection to the upper gastrointestinal tract mucosa 72 hrs after operation in high-risk surgical patients undergoing abdominal surgery.
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Critical care medicine · Sep 1999
Multicenter StudyInterobserver variability in data collection of the APACHE II score in teaching and community hospitals.
To examine interobserver reliability of the Acute Physiologic and Chronic Health Evaluation (APACHE) II score and identify major causes of variability in data collection. ⋯ Reliability of data collection varied widely in different components of the APACHE II probability-of-death model. Significant discrepancies in some components suggested a lack of explicit definitions and timing for consistent data collection between institutions or between data collectors. Nonetheless, variability resulting from data collection appears to be randomly distributed, so that comparisons of group means are valid.
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Critical care medicine · Sep 1999
Multicenter StudyAssociation between nurse-physician collaboration and patient outcomes in three intensive care units.
To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome. ⋯ The study offered some support for the importance of physician-nurse collaboration in ICU care delivery, a variable susceptible to intervention and further study.
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Critical care medicine · Sep 1999
Comparative StudyCytokine expression in severe pneumonia: a bronchoalveolar lavage study.
To assess the cytokine expression (tumor necrosis factor-alpha [TNF-alpha], interleukin [IL]-1beta, and IL-6) in severe pneumonia, both locally (in the lungs) and systemically (in blood). ⋯ The present study describes the lung and systemic inflammatory response in severe pneumonia. The lung cytokine expression seems to be independent from the lung bacterial burden in the presence of antibiotic treatment. Because of the limited sample size, we did not find a clear relationship between serum and BAL fluid cytokine levels and outcome.
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Critical care medicine · Sep 1999
Reliability and precision of a new thoracic electrical bioimpedance monitor in a lower body negative pressure model.
To evaluate the reliability and precision of measurement in a new thoracic electrical bioimpedance (TEB) monitor. ⋯ This new monitor appears to overcome many of the signal processing problems encountered with previous devices. The results clearly demonstrate that accurate and reliable measurement of bioimpedance waveforms is possible and suggest that the monitor is capable of generating precise hemodynamic data across a wide spectrum of hemodynamic alterations. However, the evidence also indicates that new algorithms may be needed to more fully explain the multiple factors affecting this waveform.