Critical care medicine
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Critical care medicine · Oct 2002
Randomized Controlled Trial Clinical TrialAlbumin and furosemide therapy in hypoproteinemic patients with acute lung injury.
Hypoproteinemia, fluid retention, and weight gain are associated with development of acute lung injury and mortality in critically ill patients, without proof of cause and effect. We designed a clinical trial to determine whether diuresis and colloid replacement in hypoproteinemic patients with acute lung injury would improve pulmonary physiology. ⋯ Albumin and furosemide therapy improves fluid balance, oxygenation, and hemodynamics in hypoproteinemic patients with acute lung injury. Determining the effect of this simple therapy on cost, outcomes, and other patient populations requires further study.
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Critical care medicine · Oct 2002
ReviewA review of nerve agent exposure for the critical care physician.
Nerve agents are discussed. The article discusses their properties, routes of exposure, toxicodynamics, targets of toxicity, and treatment. It is concluded that a focused organized approach to the treatment of nerve agents is key to its successful management.
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Critical care medicine · Oct 2002
ReviewMinimally invasive hemodynamic monitoring for the intensivist: current and emerging technology.
To review minimally invasive cardiac output monitoring devices currently available for use in the intensive care unit. ⋯ Emerging noninvasive or minimally invasive means of cardiac output monitoring are based on varied physiologic principles and can be used for following hemodynamic trends. Each of these methods has advantages and disadvantages; it is important for the clinician to understand the strengths and limitations of each device to effectively use the information derived.
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Critical care medicine · Oct 2002
Clinical TrialDoes methylene blue administration to septic shock patients affect vascular permeability and blood volume?
To assess the effects of the inhibition of guanylate cyclase, an enzyme involved in sepsis-related vascular and myocardial dysfunctions, on hemodynamic variables including blood volume and pulmonary vascular permeability during septic shock. ⋯ This study confirmed the acute vasoconstrictive and positive inotropic effects of methylene blue during septic shock. These effects were not associated with changes in blood volume, myocardial diastolic function, or pulmonary vascular permeability assessed by extravascular lung water.
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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.