Critical care medicine
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Critical care medicine · Oct 2001
Editorial CommentResearch agenda or (North) American cultural hegemony?
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Critical care medicine · Oct 2001
Multicenter StudySymptoms of anxiety and depression in family members of intensive care unit patients: ethical hypothesis regarding decision-making capacity.
Anxiety and depression may have a major impact on a person's ability to make decisions. Characterization of symptoms that reflect anxiety and depression in family members visiting intensive care patients should be of major relevance to the ethics of involving family members in decision-making, particularly about end-of-life issues. ⋯ More than two-thirds of family members visiting patients in the intensive care unit suffer from symptoms of anxiety or depression. Involvement of anxious or depressed family members in end-of-life decisions should be carefully discussed.
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Critical care medicine · Oct 2001
Randomized Controlled Trial Clinical TrialIntraoperative prostaglandin E1 improves antimicrobial and inflammatory responses in alveolar immune cells.
Anesthesia and surgery decrease antimicrobial and increase proinflammatory functions of alveolar immune cells. Thus, anti-inflammatory agents that do not further suppress antimicrobial functions are required. We tested the hypothesis that intraoperative prostaglandin E1 (PGE1) suppresses proinflammatory responses and prevents the reduction in antimicrobial responses of alveolar immune cells. ⋯ Intraoperative PGE1 not only suppressed proinflammatory responses, but also protected antimicrobial functions of alveolar macrophages, possibly because PGE1 is mostly inactivated in the pulmonary intravascular space. Our results suggest that intraoperative PGE1 protects the pulmonary immune defense in alveolar immune cells.
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Critical care medicine · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialGastric feeding with erythromycin is equivalent to transpyloric feeding in the critically ill.
To determine whether adding erythromycin to a gastric feeding regimen could render it as effective in meeting nutritional needs as transpyloric feeding. ⋯ Gastric feeding with erythromycin as a prokinetic is equivalent to transpyloric feeding in meeting the nutritional goals of the critically ill.
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Critical care medicine · Oct 2001
ReviewHeart failure in pediatric septic shock: utilizing inotropic support.
Septic shock presents a unique challenge in the pediatric patient. Sepsis stimulates the release of inflammatory mediators that can compromise cardiac function. Oxygen extraction abnormalities, diminished responses to adrenergic agonists, and impaired ventricular function often result. After fluid resuscitation and antibiotic therapy, careful cardiovascular assessment is needed to administer appropriate inotropic and vasoactive drugs.