Critical care medicine
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Critical care medicine · Feb 2009
Randomized Controlled TrialArrhythmias and heart rate variability during and after therapeutic hypothermia for cardiac arrest.
To evaluate the effects of therapeutic hypothermia (HT) of 33 degrees C after cardiac arrest (CA) on cardiac arrhythmias, heart rate variability (HRV), and their prognostic value. ⋯ The use of therapeutic HT of 33 degrees C for 24 hours after CA was not associated with an increase in clinically significant arrhythmias. Preserved 24 to 48-hour HRV may be a predictor of favorable outcome in patients with CA treated with HT.
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Critical care medicine · Feb 2009
Randomized Controlled Trial Comparative StudyPerioperative volume replacement in children undergoing cardiac surgery: albumin versus hydroxyethyl starch 130/0.4.
To compare 4% albumin with 6% hydroxyethyl starch (HES) 130/0.4 in terms of perioperative blood loss and intraoperative fluid requirements in children undergoing cardiac surgery. ⋯ In children undergoing cardiac surgery, 6% HES 130/0.4 may represent an interesting alternative to 4% albumin for intraoperative fluid volume replacement because of its lower cost.
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Critical care medicine · Feb 2009
ReviewPrinciples of electrical impedance tomography and its clinical application.
This review outlines the basic principle, in addition to validated and upcoming clinical use of electrical impedance tomography (EIT). EIT generates functional tomograms of the thorax for detection of changes in regional lung aeration. These images allow an intraindividual comparison of changes in regional lung function. Specifically, EIT aims to optimize ventilation therapy in patients with acute lung failure. ⋯ Potential applications in the future as well as limitations of EIT technology are described. In summary, EIT is a promising functional tomography technology on the verge of its clinical application.
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Critical care medicine · Feb 2009
Novel and conventional serum biomarkers predicting acute kidney injury in adult cardiac surgery--a prospective cohort study.
To compare the value of novel with conventional serum biomarkers in the prediction of acute kidney injury (AKI) in adult cardiac surgical patients according to preoperative renal function. ⋯ Early postoperative measurement of plasma NGAL was of good value in identifying patients who developed AKI after adult cardiac surgery. Plasma NGAL and serum cystatin C were superior to conventional biomarkers in the prediction of AKI and were also of prognostic value in this setting.
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Critical care medicine · Feb 2009
Comparative StudyThe vasopressin and copeptin response to infection, severe sepsis, and septic shock.
To compare the course of arginine vasopressin (AVP) and copeptin plasma concentrations between patients with infection, severe sepsis, and septic shock. ⋯ Severe sepsis induced a stronger AVP response than infection without systemic inflammation. However, the lack of a difference in AVP plasma concentrations between patients with and without shock indicates that the AVP system does not function normally in severe sepsis. Our data support the hypothesis that impaired AVP response is at least partially responsible for the failure to restore vascular tone in septic shock.