Critical care medicine
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Critical care medicine · Oct 2001
Epidemiology, management, and outcome of severe acute renal failure of critical illness in Australia.
To study the epidemiology, style of management, and outcome of intensive care patients with acute renal failure requiring replacement therapy in Australia. ⋯ In Australia, critical care physicians and nurses manage severe acute renal failure with limited consultative nephrological input. Renal replacement therapy is continuous and outcomes are satisfactory. Our findings support the view that this approach to management of severe acute renal failure is safe.
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Critical care medicine · Oct 2001
Comparative StudyHemolysis in stored red blood cell concentrates: modulation by haptoglobin or ulinastatin, a protease inhibitor.
Polymorphonuclear leukocyte elastase may injure various tissues. The release of polymorphonuclear leukocyte elastase induced by various stimuli was reported to be inhibited by a protease inhibitor, ulinastatin. In stored blood preparations, polymorphonuclear leukocyte elastase increases depending on the storage days as hemolysis increases. We hypothesized that polymorphonuclear leukocyte elastase might be one of the factors inducing hemolysis in stored blood. Haptoglobin binds to free hemoglobin to reduce hemolysis. The purpose of the study was to investigate the effects of ulinastatin on hemolysis in blood preparations in comparison with haptoglobin. ⋯ Adding haptoglobin or ulinastatin to MAP-CRC was useful to suppress hemolysis during storage of the preparation. The polymorphonuclear leukocyte elastase might not be involved in the mechanisms of hemolysis in MAP-CRC stored for 25 days.
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Critical care medicine · Oct 2001
Comparative StudyUse of bispectral electroencephalogram monitoring to assess neurologic status in unsedated, critically ill patients.
To test whether spectral indices derived from the electroencephalogram (EEG), and especially the bispectral index (BIS), can be used as measures of neurologic status in unsedated, critically ill patients. ⋯ BIS provides a reliable index of neurologic status in awake, unsedated, critically ill patients. Further research is needed to determine whether the effects of neurologic status and pharmacologic sedation upon EEG are additive, whether BIS can be used to assess pharmacologic sedation in the critically ill patient population, and whether such objective measures of neurologic status have prognostic value.
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Critical care medicine · Oct 2001
Comparative StudyEffects of arteriovenous extracorporeal therapy on hemodynamic stability, ventilation, and oxygenation in normal lambs.
To evaluate hemodynamic stability and gas exchange in a neonatal animal model of pumpless arteriovenous extracorporeal membrane oxygenation (AV-ECMO) with extracorporeal shunt flow of up to 15% of cardiac output during variable ventilation and oxygenation. ⋯ Healthy lambs are capable of maintaining effective cardiac output in the presence of moderate arteriovenous shunts (15%). AV-ECMO may provide efficient ventilatory support in the neonatal population with hypercapnia. The amount of oxygen delivery with AV-ECMO depends on arterial desaturation.
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Critical care medicine · Oct 2001
Diltiazem to treat sinus tachycardia in critically ill patients: a four-year experience.
To determine whether an intravenous infusion of the calcium channel blocker diltiazem was effective and safe in treating sinus tachycardia in critically ill adult patients with contraindications to beta-blockers or in whom beta-blockers were ineffective. ⋯ Diltiazem was effective in achieving short-term control of heart rate in 56% of the patients, virtually without adverse effects, where beta-blockade was contraindicated or ineffective.