Critical care medicine
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Critical care medicine · Nov 1998
Comparative StudyBlood transfusion and lung function in chronically anemic patients with severe chronic obstructive pulmonary disease.
To study in anemic patients with chronic obstructive pulmonary disease (COPD) whether blood transfusion reduces minute ventilation and work of breathing (WOB). ⋯ We conclude that red blood cell transfusion in anemic patients with COPD leads to a significant reduction of both the minute ventilation and the WOB. In these patients, transfusion may be associated with unloading of the respiratory muscles, but it may also result in mild hypoventilation.
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Critical care medicine · Nov 1998
Comparative StudyApproximate entropy of respiratory rate and tidal volume during weaning from mechanical ventilation.
To determine the effects of respiratory failure on respiratory rate pattern and tidal volume pattern. ⋯ Respiratory failure causes tidal volume patterns to become increasingly irregular, but increasing respiratory rate has no effect on respiratory rate pattern.
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Critical care medicine · Nov 1998
Comparative StudyImproved outcome after severe head injury with a new therapy based on principles for brain volume regulation and preserved microcirculation.
To assess the new "Lund therapy" of posttraumatic brain edema, based on principles for brain-volume regulation and improved microcirculation. ⋯ The low mortality compared with previous outcome studies strongly indicates that this therapy improves outcome for severe head injuries. However, a randomized, controlled study is needed to reach general acceptance of this new therapy.
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To show how hypoalbuminemia lowers the anion gap, which can mask a significant gap acidosis; and to derive a correction factor for it. ⋯ The observed anion gap can be adjusted for the effect of abnormal serum albumin concentrations as follows: adjusted anion gap = observed anion gap + 0.25 x ([normal albumin] [observed albumin]), where albumin concentrations are in g/L; if given in g/dL, the factor is 2.5. This adjustment returns the anion gap to the familiar scale of values that apply when albumin concentration is normal.
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Critical care medicine · Nov 1998
Comparative StudyComparison of self, nurse, and physician assessment of residents rotating through an intensive care unit.
Compare resident evaluations by self, nurses, and attending physicians. ⋯ Self-rating by residents did not correlate to multiple-choice test scores and differed in some criteria with physicians' or nurses' evaluations. We found many similarities and some differences between physicians' and nurses' evaluations of residents. We speculate that different categories of evaluators assess different aspects of performance. Assessment by a varied group of evaluators should be used when attempts to predict future practice are made.