Critical care medicine
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Critical care medicine · Feb 1998
Comparative StudyColonization of dental plaque: a source of nosocomial infections in intensive care unit patients.
To study the dental status and colonization of dental plaque by aerobic pathogens and their relation with nosocomial infections in intensive care unit (ICU) patients. ⋯ The amount of dental plaque increased during the ICU stay. Colonization of dental plaque was either present on admission or acquired in 40% of patients. A positive dental plaque culture was significantly associated with subsequent nosocomial infections. Dental plaque colonization by aerobic pathogens might be a specific source of nosocomial infection in ICU patients.
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Critical care medicine · Feb 1998
Comparative StudyDiagnostic accuracy of protected specimen brush and bronchoalveolar lavage in nosocomial pneumonia: impact of previous antimicrobial treatments.
To determine whether the diagnostic accuracy of bronchoscopy samples in patients with suspected ventilator-associated pneumonia is affected by prior antibiotic treatment given for a previous infection, and/or by antibiotic treatment recently started to treat suspected ventilator-associated pneumonia. ⋯ After recent introduction of an antibiotic treatment for suspected ventilator-associated pneumonia, protected specimen brush and bronchoalveolar lavage culture thresholds must be decreased to maintain good accuracy. In contrast, current antibiotic treatment prescribed for a prior infectious disease does not modify the diagnostic accuracy of protected specimen brush or bronchoalveolar lavage.
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Critical care medicine · Feb 1998
Randomized Controlled Trial Clinical TrialEffects of low-dose dopamine on renal and systemic hemodynamics during incremental norepinephrine infusion in healthy volunteers.
To assess the effects of low-dose dopamine on norepinephrine-induced renal and systemic vasoconstriction in normotensive healthy subjects. ⋯ In healthy man, norepinephrine causes a large decrease in renal plasma flow but not in glomerular filtration rate. Concomitant dopamine administration prevents this decrease in renal plasma flow, increases sodium excretion, and also attenuates the norepinephrine-induced systemic blood pressure increase. These findings warrant further clinical evaluation of the effect of concomitant low-dose dopamine and norepinephrine administration in critically ill patients.
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Critical care medicine · Feb 1998
Comparative StudyDecomplexification in critical illness and injury: relationship between heart rate variability, severity of illness, and outcome.
To determine if decomplexification of heart rate dynamics occurs in critically ill and injured pediatric patients. We hypothesized that heart rate power spectra, a measure of heart rate dynamics, would inversely correlate with measures of severity of illness and outcome. ⋯ Our data support the hypothesis that measures of heart rate power spectra are inversely related and negatively correlated to severity of illness and outcome in critically ill and injured children. The phenomenon of decomplexification of physiologic dynamics may have important clinical implications in critical illness and injury.
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Critical care medicine · Feb 1998
Comparative StudyHelium versus oxygen for tracheal gas insufflation during mechanical ventilation.
To evaluate and compare the effect of tracheal gas insufflation using two gases with different physical properties, helium and oxygen, as an adjunct to conventional mechanical ventilation in patients with respiratory failure. ⋯ In volume-controlled, mechanically ventilated patients with respiratory failure, tracheal gas insufflation with helium might be suggested as an alternative to oxygen.