Critical care medicine
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Critical care medicine · Jun 1998
Comparative StudySeptic shock: an analysis of outcomes for patients with onset on hospital wards versus intensive care units.
To determine if early interventions for septic shock were associated with reduced mortality. ⋯ The data suggest that for patients with septic shock on wards, there were clinically important delays in transfer of patients to the ICU, receipt of intravenous fluid boluses, and receipt of inotropic agents. However, the most powerful predictors of mortality were APACHE II scores and bloodstream infection with Candida species.
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Critical care medicine · Jun 1998
Comparative StudyEffects of continuous negative extrathoracic pressure versus positive end-expiratory pressure in acute lung injury patients.
To compare the effects of continuous negative extrathoracic pressure (CNEP) and positive end-expiratory pressure (PEEP) at the same level of transpulmonary pressure. ⋯ In acute lung injury patients, a CNEP of -20 cm H2O has the capability to obtain transpulmonary pressure and lung function improvement similar to a PEEP of 15 cm H2O. CNEP differs from the positive pressure by increasing the venous return and the preload of the heart, and has no negative effects on cardiac performance.
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Critical care medicine · Jun 1998
Comparative StudyMechanical performance of clinically available, neonatal, high-frequency, oscillatory-type ventilators.
To perform a functional evaluation of five different high-frequency, oscillatory-type ventilators that are currently being marketed for neonatal high-frequency oscillation. ⋯ The findings demonstrate large variations in machine performance. The ventilators also differed profoundly in complexity of operation and versatility as neonatal ventilators.
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Critical care medicine · Jun 1998
Prognostic value of gastric intramucosal pH in critically ill children.
To determine the association of tonometrically measured gastric intramucosal pH (pHi) to the occurrence of multiple organ dysfunction syndrome (MODS) and death in critically ill children. ⋯ Our results show that pHi is an independent predictor of mortality in patients admitted to a pediatric ICU. Although no relationship was observed between the risk of MODS and gastric pHi, the univariate difference of 21% vs. 41% is highly suggestive. The pHi determination is a minimally invasive procedure and well tolerated in children of all ages.
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Critical care medicine · Jun 1998
Comparative StudyAccuracy of two pulse oximeters at low arterial hemoglobin-oxygen saturation.
To evaluate the performance of two pulse oximeters in the measurement of arterial hemoglobin saturation in hypoxemic children. ⋯ The performance of the Ohmeda pulse oximeter deteriorated below an SpO2 of 75%. The Hewlett-Packard pulse oximeter performed consistently above and below an SpO2 of 75%. The ability of both pulse oximeters to reliably predict change in SaO2 based on change in pulse oximetry was limited. We recommend measurement of PaO2 or SaO2 for important clinical decisions.