Critical care medicine
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Critical care medicine · Mar 2000
Randomized Controlled Trial Comparative Study Clinical TrialEffects of the phosphodiesterase III inhibitors olprinone, milrinone, and amrinone on hepatosplanchnic oxygen metabolism.
To measure the hepatic venous oxygen saturation in patients after cardiac surgery and to compare the effects of olprinone (OLP), a newly synthesized phosphodiesterase III inhibitor, with those of milrinone (MIL) and amrinone (AMR) on hepatosplanchnic oxygen dynamics. Phosphodiesterase III inhibitors are used to improve the hemodynamic state after cardiac surgery. However, the effect of these agents on the hepatosplanchnic circulation has not been investigated thoroughly. ⋯ These results suggest that OLP enhances hepatosplanchnic blood flow and thus may be beneficial in protecting the hepatosplanchnic organs after cardiac surgery.
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Critical care medicine · Mar 2000
Randomized Controlled Trial Clinical TrialResuscitation of critically ill patients based on the results of gastric tonometry: a prospective, randomized, controlled trial.
To determine whether additional therapy aimed at correcting low gastric intramucosal pH (pHi) improves outcome in conventionally resuscitated, critically ill patients. ⋯ The routine use of treatment titrated against pHi in the management of critically ill patients cannot be supported. Failure to improve outcome may be caused by an inability to produce a clinically significant change in pHi or because pHi is simply a marker of disease rather than a factor in the pathogenesis of multiorgan failure.
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Critical care medicine · Mar 2000
Randomized Controlled Trial Clinical TrialIncentive spirometry does not enhance recovery after thoracic surgery.
To investigate the additional effect of incentive spirometry to chest physiotherapy to prevent postoperative pulmonary complications after thoracic surgery for lung and esophageal resections. ⋯ Pulmonary complications after lung and esophagus surgery were relatively low. The addition of IS to PT did not further reduce pulmonary complications or hospital stay. Although we cannot rule out beneficial effects in a subgroup of high-risk patients, routine use of IS after thoracic surgery seems to be ineffective.
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Critical care medicine · Mar 2000
Randomized Controlled Trial Multicenter Study Clinical TrialPhase II multicenter clinical study of the platelet-activating factor receptor antagonist BB-882 in the treatment of sepsis.
To evaluate the safety and efficacy of the platelet-activating factor receptor antagonist BB-882 in the treatment of patients with sepsis. ⋯ Treatment of sepsis with the platelet-activating factor antagonist BB-882 offers no advantage over placebo on survival, hemodynamic status, respiratory function, or organ failure scores.
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Critical care medicine · Mar 2000
Randomized Controlled Trial Multicenter Study Clinical TrialAn immune-enhancing enteral diet reduces mortality rate and episodes of bacteremia in septic intensive care unit patients.
To determine whether early enteral feeding in a septic intensive care unit (ICU) population, using a formula supplemented with arginine, mRNA, and omega-3 fatty acids from fish oil (Impact), improves clinical outcomes, when compared with a common use, high protein enteral feed without these nutrients. ⋯ Immune-enhancing enteral nutrition resulted in a significant reduction in the mortality rate and infection rate in septic patients admitted to the ICU. These reductions were greater for patients with less severe illness.