Critical care medicine
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Critical care medicine · Oct 2002
Early immunoneutralization of calcitonin precursors attenuates the adverse physiologic response to sepsis in pigs.
The 116 amino acid prohormone procalcitonin and some of its component peptides (collectively termed calcitonin precursors) are important markers and mediators of sepsis. In this study, we sought to evaluate the effect of immunoneutralization of calcitonin precursors on metabolic and physiologic variables of sepsis in a porcine model. ⋯ These data from a large-animal model with polymicrobial sepsis demonstrate the salutary effect of early immunoneutralization of calcitonin precursors on physiologic and metabolic variables. Immunologic blockade of calcitonin precursors may offer a novel therapeutic approach to human sepsis.
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Critical care medicine · Oct 2002
Comparative StudyLithium dilution cardiac output measurement: a clinical assessment of central venous and peripheral venous indicator injection.
The lithium indicator dilution technique has been shown to measure cardiac output (CO) accurately by using central venous injection of lithium chloride (Li-CCO). This study aimed to compare the measurement of CO by using peripheral venous administration of lithium chloride (Li-PCO) with Li-CCO. ⋯ Li-PCO gives a measurement that agrees well with Li-CCO. Accuracy of Li-PCO is probably improved if a proximal arm vein is used. Li-PCO provides accurate measurements of CO without the risks of pulmonary artery or central venous catheterization.
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Critical care medicine · Oct 2002
Anti-interleukin-8 autoantibodies in patients at risk for acute respiratory distress syndrome.
To test the hypothesis that elevated concentrations of interleukin-8 associated with anti-interleukin-8 autoantibodies (anti-interleukin-8:interleukin-8 complexes) are found in patients at risk for acute respiratory distress syndrome who developed the disease. ⋯ Bronchoalveolar lavage fluid concentration of anti-interleukin-8:interleukin-8 complexes may serve as a marker of disease progression in patients at risk for acute respiratory distress syndrome.
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Critical care medicine · Oct 2002
Prognostic significance of admission cardiac troponin T in patients treated successfully with direct percutaneous interventions for acute ST-segment elevation myocardial infarction.
Cardiac troponin T (cTnT) elevations at admission indicate a high-risk subgroup of patients with acute ST-segment elevation myocardial infarction, possibly due to a higher failure rate of reperfusion therapies. ⋯ Admission cTnT is a strong predictor of future cardiac risk in patients with ST-segment elevation myocardial infarction, despite successful restoration of Thrombolysis in Myocardial Infarction grade 3 coronary flow by direct percutaneous coronary intervention.
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To investigate the effectiveness of capnometry (carbon dioxide monitoring) in verifying gastric placement of a stylet-guided nasogastric tube in intubated, mechanically ventilated patients. ⋯ Capnometry is a safe method for verifying proper feeding tube placement. The first chest roentgeno-gram can be safely eliminated. With this method, less time and money will be expended in feeding tube placement, making capnometry an efficacious new method.