Critical care medicine
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Critical care medicine · Jan 1996
Frequency of variable measurement in 16 pediatric intensive care units: influence on accuracy and potential for bias in severity of illness assessment.
We evaluated: a) whether the frequency of variable measurement could influence the performance of the Pediatric Risk of Mortality (PRISM) score; b) whether measurement frequency of physiologic variables varied between individual pediatric intensive care units (ICUs), and c) if so, how much of this variability could be attributed to institution-level and patient-level factors. ⋯ Although measurement frequency is associated with unit-level factors, their contribution to the overall variability is small and unlikely to influence the accuracy or reliability of the PRISM score. It is unlikely that there are routine biases associated with differences in measurement frequency of PRISM variables within the spectrum of care practices that now exist.
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Critical care medicine · Jan 1996
Adrenergic vasopressor agents and mechanical ventilation for the treatment of experimental septic shock.
Vasopressor agents and mechanical ventilation are routine interventions for the treatment of sepsis complicated by hypotension. It was our hypothesis that such treatment singly or in combination increases the duration of survival. ⋯ No benefit or detriment was demonstrated when vasopressor agents were administered to sustain arterial pressure in the course of experimental peritonitis in this murine model of septic shock. This finding contrasted with highly significant prolongation of survival when animals were mechanically ventilated. There was no evidence that routine vasopressor therapy, under these controlled experimental conditions in rats, improved duration of survival.
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Critical care medicine · Jan 1996
Burn injury alters beta-adrenergic receptor and second messenger function in rat ventricular muscle.
The molecular pharmacologic bases for the attenuated cardiovascular and metabolic responses to catecholamines, after burn injury, have not been elucidated. In the present study, myocardial tissues were used as a model of beta-adrenergic receptors to study burn injury-induced alterations in receptors and in signal transduction. ⋯ The etiology of the decreased responses in the myocardium to exogenous and endogenous beta-adrenergic receptor agonists after burn injury may be attributed to decreased affinity for ligands, and also to impaired receptor-mediated signal transduction and to decreased adenylate cyclase enzyme activity, resulting in decreased basal and stimulated second messenger (cAMP) production.
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Critical care medicine · Jan 1996
Comment Letter Comparative StudyPropofol vs. midazolam for sedation.
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Critical care medicine · Jan 1996
Randomized Controlled Trial Clinical TrialMagnesium repletion and its effect on potassium homeostasis in critically ill adults: results of a double-blind, randomized, controlled trial.
The aims of this study were to evaluate the safety and efficacy of magnesium replacement therapy and to determine its effect on potassium retention in hypokalemic, critically ill patients. ⋯ Magnesium sulfate administered according to the above regimen safety and significantly increases the circulating magnesium concentration. Despite greater urine magnesium losses in the treatment group, this group exhibited significantly better magnesium retention.