Critical care medicine
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Critical care medicine · Jan 1999
Long-term outcome and functional health status following intensive care in Hong Kong.
To assess mortality and functional health status of patients at 1 yr following admission to a multidisciplinary intensive care unit (ICU) in Hong Kong. To determine which factors are associated with a poor long-term outcome. ⋯ The SIP scores indicated that the majority of patients who survived to 1 yr after ICU admission enjoyed reasonable functional health status. A poor functional health status at 1 yr did not relate to the severity of the acute illness suffered, but appeared to relate to the prognosis of the underlying disease process.
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Critical care medicine · Jan 1999
A new ventilator improves CO2 removal in newborn lambs with congenital diaphragmatic hernia.
To demonstrate improved ventilation with intratracheal pulmonary ventilation (ITPV) in new-born lambs with congenital diaphragmatic hernia, using a new microprocessor controlled ITPV-specific ventilator. ⋯ ITPV significantly improved CO2 removal in newborn lambs with diaphragmatic hernias without increasing airway pressures or changing oxygenation. Based on these results, we are conducting human clinical trials.
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Critical care medicine · Jan 1999
Aspiration and transtracheal jet ventilation with different pressures and depths of chest compression.
To evaluate aspiration prophylaxis during cardiopulmonary resuscitation (CPR) using transtracheal jet ventilation (TJV) with different pressure-depths of chest compression and chest compression alone without mechanical ventilation. ⋯ Application of TJV during chest compression with different pressures and depths caused no pulmonary aspiration in dogs at frequencies between 600 and 10 cycles/min. The protection against aspiration disappeared if the dogs received only chest compression without TJV. The mechanism of preventing pulmonary aspiration in TJV is thought to be due to forceful unidirectional gas outflow through the larynx and higher airway pressure in the carina than in the upper airway. The airway pressures were not affected by different chest compression pressures and depths because the larynx stayed open during TJV and the air outflow could freely move out without increasing the pressure in the airway.
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Critical care medicine · Jan 1999
Meta Analysis Comparative StudyCrystalloids vs. colloids in fluid resuscitation: a systematic review.
To systematically review the effects of isotonic crystalloids compared with colloids in fluid resuscitation. ⋯ Overall, there is no apparent difference in pulmonary edema, mortality, or length of stay between isotonic crystalloid and colloid resuscitation. Crystalloid resuscitation is associated with a lower mortality in trauma patients. Methodologic limitations preclude any evidence-based clinical recommendations. Larger well-designed randomized trials are needed to achieve sufficient power to detect potentially small differences in treatment effects if they truly exist.