Critical care medicine
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Critical care medicine · Apr 1998
Comparative StudyTotal plasma antioxidant capacity is not always decreased in sepsis.
To compare total plasma antioxidant capacity and selected individual antioxidants in patients with varying degrees of severity of sepsis. ⋯ Although total plasma antioxidant capacity is decreased from normal levels in septic patients, an increase in some oxidants contributes to an increased total antioxidant capacity in septic shock patients.
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Critical care medicine · Apr 1998
Clinical TrialProlonged inhibition of nitric oxide synthesis in severe septic shock: a clinical study.
Inhibitors of nitric oxide synthesis have been suggested to be of value in the treatment of hypotension during sepsis. However, earlier clinical reports only describe the initial effects of these nitric oxide inhibitors. This study was designed to examine the effects of the prolonged inhibition of nitric oxide synthesis with N(omega)-nitro-L-arginine methyl ester (L-NAME) in patients with severe septic shock. ⋯ Nitric oxide appears to play a role in cardiovascular derangements during human sepsis. The increased blood pressure and vascular resistance values are sustained during prolonged inhibition of nitric oxide synthesis with L-NAME in patients with severe septic shock, although the hemodynamic changes are most significant in the early stages of L-NAME infusion. The high mortality rate in these patients may suggest that L-NAME has only limited effects on outcome.
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Critical care medicine · Apr 1998
Health-related quality of life and posttraumatic stress disorder in survivors of the acute respiratory distress syndrome.
Despite considerable progress in intensive care management of the acute respiratory distress syndrome (ARDS), little is known about health-related quality of life in long-term survivors. In addition, intensive care treatment can be extremely stressful, and many survivors of ARDS report adverse experiences such as respiratory distress, anxiety, or pain during intensive care unit (ICU) treatment. This study was performed to assess health-related quality of life in survivors of ARDS and to test the hypothesis that adverse experiences during ICU treatment result in posttraumatic stress disorder (PTSD) and negative effects on health-related quality of life. ⋯ Long-term survivors of ARDS describe a good overall health-related quality of life. Major impairments in mental health domains of health-related quality of life are associated with the development of posttraumatic stress disorder and are a possible result of traumatic experiences during ICU therapy.
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Critical care medicine · Apr 1998
Comparative StudyAccuracy of physiologic deadspace measurement in intubated pediatric patients using a metabolic monitor: comparison with the Douglas bag method.
To evaluate the accuracy of physiologic deadspace (VD/VT) measurement, using a metabolic monitor. ⋯ The VD/VT can be measured reliably and accurately in intubated pediatric patients using a metabolic monitor. The metabolic monitor method is a convenient and simple alternative to the standard Douglas bag method.
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Critical care medicine · Apr 1998
The 67gallium-transferrin pulmonary leak index in patients at risk for the acute respiratory distress syndrome.
To determine the occurrence and clinical importance of increased pulmonary microvascular permeability in patients at risk for acute respiratory distress syndrome (ARDS). ⋯ In this small population, 61% of patients at risk for ARDS and with only mild respiratory changes exhibited increased microvascular permeability in the lungs at ICU admission. Increased permeability may be an early marker of acute lung injury and its clinical features, and may be associated with a relatively complicated respiratory course during the first week after admission, even in the absence of progression to ARDS. Finally, increased pulmonary microvascular permeability may be associated with severe underlying disease and ultimate mortality in the ICU.