Critical care medicine
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Critical care medicine · Jun 2000
ReviewTolerance, withdrawal, and physical dependency after long-term sedation and analgesia of children in the pediatric intensive care unit.
To describe the consequences of the prolonged administration of sedative and analgesic agents to the pediatric intensive care unit (PICU) patient. The problems to be investigated include tolerance, physical dependency, and withdrawal. ⋯ Tolerance, physical dependency, and withdrawal can occur after the prolonged administration of any agent used for sedation and analgesia in the PICU population. Important components in the care of such patients include careful observation to identify the occurrence of withdrawal signs and symptoms. Treatment options after prolonged administration of sedative/analgesic agents include slowly tapering the intravenous administration of these agents or, depending on the drug, switching to subcutaneous or oral administration.
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Critical care medicine · Jun 2000
Comparative Study Clinical TrialUse of transesophageal Doppler ultrasonography in ventilated pediatric patients: derivation of cardiac output.
To ascertain if cardiac output (CO) could be derived from blood flow velocity measured in the descending aorta of ventilated children by transesophageal Doppler ultrasonography (TED) without the need for direct aortic cross sectional area measurement, and to evaluate the ability of TED to follow changes in CO when compared with femoral artery thermodilution. ⋯ TED provides a clinically accurate estimate of CO across the entire pediatric age range and is able to follow changes in CO.
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Critical care medicine · Jun 2000
Comparative StudyAssessment of the performance of five intensive care scoring models within a large Scottish database.
To assess and compare the performance of five severity of illness scoring systems used commonly for intensive care unit (ICU) patients in the United Kingdom. The five models analyzed were versions II and III of the Acute Physiology and Chronic Health Evaluation (APACHE) system, a version of APACHE II using United Kingdom (UK)-derived coefficients (UK APACHE II), version II of the Simplified Acute Physiology Score (SAPS), and version II of the Mortality Probability Model, computed at admission (MPM0) and after 24 hrs in the ICU (MPM24). ⋯ SAPS II demonstrated the best overall performance, but the superior calibration of APACHE II makes it the most appropriate model for comparisons of mortality rates in different ICUs. The significance of the Hosmer-Lemeshow C test in all the models suggest that new logistic regression coefficients should be generated and the systems retested before they could be used with confidence in Scottish ICUs.
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Critical care medicine · Jun 2000
Multiple site analytical evaluation of a portable blood gas/electrolyte analyzer for point of care testing.
To evaluate the analytical performance of the SenDx 100 portable blood gas and electrolyte analyzer (SenDx Medical, Carlsbad, CA). ⋯ The SenDx 100 portable blood gas and electrolyte analyzer is a simple and easy to use analyzer demonstrating acceptable performance compared with reference methods.
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Critical care medicine · Jun 2000
The pathophysiologic and prognostic significance of acidosis in severe adult malaria.
To investigate the pathophysiology and prognostic significance of acidosis in severe adult malaria. ⋯ These results confirm the importance of acidosis in the pathophysiology of severe adult malaria and suggest a multifactorial origin involving tissue hypoxia, liver dysfunction, and impaired renal handling of bicarbonate.