Critical care medicine
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Critical care medicine · Jan 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialAdministration of the nitric oxide synthase inhibitor NG-methyl-L-arginine hydrochloride (546C88) by intravenous infusion for up to 72 hours can promote the resolution of shock in patients with severe sepsis: results of a randomized, double-blind, placebo-controlled multicenter study (study no. 144-002).
To assess the safety and efficacy of the nitric oxide synthase inhibitor 546C88 in patients with septic shock. The predefined primary efficacy objective was resolution of shock, defined as a mean arterial pressure > or =70 mm Hg in the absence of both conventional vasopressors and study drug, determined at the end of the 72-hr treatment period. ⋯ In this study, treatment with the nitric oxide synthase inhibitor 546C88 promoted the resolution of shock in patients with severe sepsis. This was associated with an acceptable overall safety profile.
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Critical care medicine · Jan 2004
Comparative StudyComplicated acute myocardial infarction requiring mechanical ventilation in the intensive care unit: prognostic factors of clinical outcome in a series of 157 patients.
To determine prognostic factors associated with death in patients with complicated acute myocardial infarction requiring mechanical ventilation. ⋯ We confirmed the high mortality rate of patients admitted to an intensive care unit with acute myocardial infarction requiring mechanical ventilation. In these patients, the main risk factors for death found, namely high APACHE II, early development of acute renal failure, and low resting left ventricular function, reflected the severity of the myocardial infarction.
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Critical care medicine · Jan 2004
Comparative StudyAssessment of the development of choked flow during total liquid ventilation.
The flow rate of a liquid drainage from the lungs is limited because of the elastic nature of the airways. This study was designed to clarify the relationship between intrapulmonary liquid volume and the development of the flow limitation or choked flow phenomenon as a function of expiratory flow rate during total liquid ventilation with perflubron. ⋯ From these data, we conclude that choked flow occurs at intratracheal pressure of less than -20 mm Hg, that Vch is stable for the first 40 mins after the animals are killed, and that Vch is a function of flow rate and initial volume.
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Critical care medicine · Jan 2004
Comparative StudyEffect of core body temperature on ventilator-induced lung injury.
Ventilator-induced lung injury is a risk in patients requiring elevated ventilatory support pressures. We hypothesized that thermal stress modulates the development of ventilator-induced lung injury. ⋯ In two studies of ventilator-induced lung injury in rabbits, maintaining hyperthermia compared with hypothermia augmented the development of lung injury. Similar results from both the in vivo and isolated, perfused lung studies suggest that the observed effects were not due to cardiovascular factors or consequences of heating nonpulmonary organs.