Critical care medicine
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Critical care medicine · Mar 1997
Clinical Trial Controlled Clinical TrialDobutamine increases cerebral blood flow velocity and jugular bulb hemoglobin saturation in septic patients.
To evaluate the effects of dobutamine on cerebral hemodynamics in septic patients with stable hemodynamic status. ⋯ These measurements of middle cerebral artery flow velocity and jugular bulb oximetry suggest that dobutamine increases cerebral blood flow but not cerebral VO2 in stable septic patients.
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Critical care medicine · Mar 1997
Randomized Controlled Trial Clinical TrialDouble-blind, randomized study of the effect of cisapride on gastric emptying in critically ill patients.
To investigate the absorption of the gastrokinetic drug, cisapride, and effect of cisapride on gastric emptying in critically ill patients; and to assess the usefulness of clinical signs of gastric emptying. ⋯ Rectal cisapride in the dose given achieved average plasma concentrations similar to those concentrations achieved in healthy subjects after 30 mg of cisapride rectally. There is a large variation in gastric emptying from one day to the next and large numbers of patients are required to determine if cisapride administration improves early gastric emptying in critically ill patients. The volume of gastric aspirate and the presence of bowel sounds do not correlate with gastric emptying.
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Critical care medicine · Mar 1997
Comparative Study Clinical TrialEvaluation of a continuous cardiac output and mixed venous oxygen saturation catheter in critically ill surgical patients.
To evaluate the agreement of continuous cardiac output and mixed venous oxygen saturation measurements, obtained with a modified pulmonary artery catheter, with those values obtained by standard intermittent bolus thermodilution and cooximetry. ⋯ The test catheter adequately measures continuous cardiac output and mixed venous oxygen saturation in the clinical setting. Because intermittent bolus thermodilution is not a true "gold standard" for cardiac output determination, new techniques compared with bolus thermodilution may fail to achieve accuracy expectations. A 9-Fr introducer is recommended, as fiberoptic damage may have occurred when the 8.5-Fr introducer was used.
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Critical care medicine · Mar 1997
Tracheostomy tube occlusion protocol predicts significant tracheal obstruction to air flow in patients requiring prolonged mechanical ventilation.
This study was undertaken to test the hypothesis that a tracheal tube occlusion protocol predicts clinically important obstruction to air flow in patients requiring prolonged mechanical ventilation, making routine bronchoscopy unnecessary. ⋯ A tracheal tube occlusion protocol can predict clinically important obstruction to air flow after prolonged mechanical ventilation.
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Critical care medicine · Mar 1997
Clinical TrialMonitoring interactions between spontaneous respiration and mechanical inflations in preterm neonates.
To determine the value of a new bedside monitor in assessing the interactions between spontaneous respiratory activity and ventilator inflations in preterm infants; and to monitor continuously the degree of patient-ventilator synchrony and the stability of spontaneous respiratory effort during different modes of ventilation and in response to care procedures. ⋯ We describe a new kind of bedside monitor for the Interpretation of respiratory data. Unlike other methods, it is able to give the clinician a continuous measure of patient-ventilator interaction which is easy to interpret. It appears to have wide-spread application in neonatal intensive care nurseries where the babies' own breathing efforts can affect the efficiency of respiration and cause unwanted physiologic instability. The monitor can be used to determine the optimal ventilatory settings to