Critical care medicine
-
Critical care medicine · Apr 1996
Comparative StudyLidocaine attenuates the hypotensive and inflammatory responses to endotoxemia in rabbits.
To assess the effects of lidocaine on the hemodynamic and inflammatory responses to Escherichia coli endotoxemia in rabbits. ⋯ Lidocaine attenuated the hemodynamic and inflammatory responses to endotoxemia in rabbits. Findings suggest that lidocaine administration may prevent the development of hypotension and metabolic acidosis during endotoxemia.
-
To evaluate the training of clinical staff in the use of interhospital transfer guidelines and to examine the underlying decision-making behavior in organizing patient transfers between hospitals. ⋯ Clinical staff can make informed and appropriate decisions by using standardized guidelines when organizing interhospital transfers.
-
Critical care medicine · Apr 1996
Comparative StudyEffect of jet ventilation on heart failure: decreased afterload but negative response in left ventricular end-systolic pressure-volume function.
To examine the mechanism of cardiac assist with systolic jet ventilation, specifically effects on loading conditions and left ventricular pressure-volume function. Both systolic and diastolic jet ventilation were compared in the absence and presence of heart failure. ⋯ Jet ventilation did not decrease stroke volume in failing hearts because of the afterload-reducing benefit (decreased transmural left ventricular end-systolic pressure) of increased intrapleural pressure in dilated ventricles. Moreover, jet ventilation did not have positive effects on myocardial function and had negative effects on left ventricular elastance in the postjet ventilation period in both normal and failing hearts. Cardiac assist by jet ventilation was not cycle specific, suggesting no selective benefit of jet ventilation over conventional positive-pressure ventilation during heart failure. These studies demonstrate a negative inotropy associated with jet ventilation that, during heart failure, may compromise the general benefit of positive-pressure-mediated increases in intrapleural pressure.