Critical care medicine
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To describe the goals of sedative use in the intensive care unit and review the pharmacology of commonly used sedative drugs as well as to review pertinent publications in the literature concerning the comparative pharmacology of these drugs, with emphasis on outcomes related to sedation and comparative pharmacoeconomics. ⋯ An individualized approach to sedation based on knowledge of drug pharmacology is needed because of confounding variables including concurrent patient illness, depth of sedation, and concomitant use of analgesic agents. (Crit Care Med 2000; 28:854-866)
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Critical care medicine · Mar 2000
Randomized Controlled Trial Comparative Study Clinical TrialA cost-effectiveness analysis of the application of nitric oxide versus oxygen gas for near-term newborns with respiratory failure: results from a Canadian randomized clinical trial.
To conduct a cost-effectiveness analysis of the use of inhaled nitric oxide (NO) vs. oxygen administered to near-term (gestational age > or =34 wks) newborns with severe respiratory illness that were referred for consideration of extracorporeal membrane oxygenation (ECMO). ⋯ The small numbers of patients in the trials precluded significant results. Further, our results have a short-term time horizon (discharge to home or death). Thus, for non-CDH patients, the favorable ratio provides very qualified evidence in favor of NO.
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Critical care medicine · Mar 2000
Comparative StudyEvaluation of a thoracic bioimpedance cardiac output monitor during cardiac catheterization.
To evaluate the accuracy and precision of an advanced thoracic bioimpedance cardiac output monitor by comparing it with conventional thermodilution. ⋯ The correlation between conventional thermodilution and thoracic bioimpedance cardiac output estimates was good and the standard deviation of the differences was lower than that reported for commercially available devices. The system can be used in the cardiac catheterization lab for reliable and continuous noninvasive measurement of cardiac output.
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Critical care medicine · Mar 2000
Clinical Trial Controlled Clinical TrialDetection of capillary protein leakage by indocyanine green and glucose dilutions in septic patients.
To determine whether indocyanine green (ICG) and glucose dilutions can detect generalized capillary protein leakage in septic patients without requiring repeated measurements. ⋯ Our results indicate that overestimation of the PV-ICG can occur in septic patients and, further, suggest that simultaneous measurement of the two distribution volumes would help predict generalized capillary protein leakage in septic patients without repeated measurement.
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Critical care medicine · Mar 2000
Comparative StudyEvidence for the need of bedside accuracy of pulse oximetry in an intensive care unit.
To compare pulse oximetry saturation (Spo2 with arterial blood gas saturation (SaO2) obtained during clinical routine to determine the optimal lowest reliable value of SpO2 in ventilator-dependent patients before setting up a nurse-directed protocol of FIO2 titration. ⋯ In the range of SaO2 tested, regardless of the sensor used, SpO2 overestimated SaO2. Large limits of agreement were found. Based on this result, the authors concluded that before defining a nurse-directed protocol of FIO2 titration with SpO2, the material used daily must be evaluated. A minimum threshold SpO2 value of 96% in both groups I and II is more reliable to ensure SaO2 > or = 90%.