Critical care medicine
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Critical care medicine · Sep 1998
Cost of extracorporeal life support in pediatric patients with acute respiratory failure.
To determine the impact of extracorporeal life support (ECLS) on mortality in pediatric patients with acute hypoxemic respiratory failure (AHRF) at our institution; and to calculate the hospital charges associated with the use of ECLS. ⋯ ECLS for the pediatric patient with AHRF is done at a considerable cost. However, ECLS affects survival favorably, and compares favorably when considering cost/life-year calculations. The data presented in this study may serve as a benchmark for comparison with newer therapies (i.e., liquid ventilation, nitric oxide). These data also provide a framework for cost-based analyses at other ECLS institutions.
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Critical care medicine · Sep 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of oxygen cost of breathing with pressure-support ventilation and biphasic intermittent positive airway pressure ventilation.
To assess the oxygen cost of breathing with either pressure-support ventilation (PSV) or biphasic intermittent positive airway pressure ventilation (BIPAP). ⋯ Pressure support ventilation and BIPAP are both used for weaning patients gradually from the ventilator. BIPAP may be advantageous in patients not breathing sufficiently with PSV, since no patient effort is necessary with use of this ventilatory mode.
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Critical care medicine · Sep 1998
Randomized Controlled Trial Clinical TrialN(G)-monomethyl-L-arginine improves survival in a pig model of abdominal sepsis.
To test the effect of a continuous infusion of the nitric oxide synthase inhibitor N(G)-monomethyl-L-arginine (L-NMMA) on survival rate and hemodynamics in a pig model of endogenous peritoneal live bacterial sepsis. ⋯ In this porcine model of peritoneal sepsis, infusion of L-NMMA increased survival rate and maintained mean arterial pressure without worsening tissue oxygenation. Coronary blood flow, cardiac index, systemic vascular resistance, and urine production were well maintained during L-NMMA treatment.
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Critical care medicine · Sep 1998
Validation of a hand-held lactate device in determination of blood lactate in critically injured patients.
Admission blood lactate is an accurate predictor of injury severity and mortality in trauma patients. The purpose of this study was to evaluate a portable lactate analyzer in a clinical setting by patient care staff. ⋯ Good correlation with a low SEM was obtained over a wide range of clinically relevant lactate values. Use of point of care lactate analysis will decrease analytic time, making an important diagnostic parameter immediately available in the critical care setting.
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Critical care medicine · Sep 1998
Relationship of brain tissue PO2 to outcome after severe head injury.
To determine thresholds of brain tissue PO2 (PbtO2) that are critical for survival after severe head injury. ⋯ Analysis of the PbtO2 monitoring data suggested that the likelihood of death increased with increasing duration of time at or below a PbtO2 of 15 torr (2.0 kPa) or with the occurrence of any PbtO2 values of < or =6 torr (< or =0.8 kPa).