Critical care medicine
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Critical care medicine · Sep 1997
Dramatic effect on oxygenation in patients with severe acute lung insufficiency treated in the prone position.
To confirm the positive effect of prone positioning on oxygenation in patients with acute lung insufficiency. ⋯ The prone position significantly improves impaired gas exchange due to severe acute lung insufficiency. It is suggested that this treatment is used before more complex modalities.
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Critical care medicine · Sep 1997
GuidelineGuidelines for advanced training for physicians in critical care. American College of Critical Care Medicine of the Society of Critical Care Medicine.
To define the body of knowledge and practical skills required by a physician trained as a specialist in critical care medicine. ⋯ A curriculum was developed that defines the core cognitive and procedural skills that practitioners of critical care should possess on completion of advanced training in this field. Additional cognitive skills required for advanced trainees in pediatric critical care were delineated.
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Critical care medicine · Sep 1997
Comparative StudyAn evaluation of empiric vs. nomogram-based dosing of heparin in an intensive care unit.
To compare the time to achieve therapeutic anticoagulation with heparin using two dosing methods. ⋯ Use of a weight-based heparin dosing nomogram by intensive care unit nursing staff can shorten the time to achieve therapeutic anticoagulation compared with empiric dosing by physicians.
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Critical care medicine · Sep 1997
Pyridoxalated hemoglobin polyoxyethylene conjugate does not restore hypoxic pulmonary vasoconstriction in ovine sepsis.
Hypoxic pulmonary vasoconstriction, a protective mechanism, minimizes perfusion of underventilated lung areas to reduce ventilation-perfusion mismatching. We studied the effects of sepsis on hypoxic pulmonary vasoconstriction and attempted to determine whether hypoxic pulmonary vasoconstriction is influenced by pyridoxalated hemoglobin polyoxyethylene conjugate, a nitric oxide scavenger. ⋯ Hypoxic pulmonary vasoconstriction is blunted during sepsis and there is no adaptation over time. It is not influenced by pyridoxalated hemoglobin polyoxyethylene conjugate. Pyridoxalated hemoglobin polyoxyethylene conjugate reversed hypotension and, with the exception of an increase in pulmonary arterial pressure, had no adverse effects on hemodynamics or oxygenation.