Critical care medicine
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Critical care medicine · Jan 1996
Multicenter StudySimplified Therapeutic Intervention Scoring System: the TISS-28 items--results from a multicenter study.
To validate a simplified version of the Therapeutic Intervention Scoring System, the TISS-28, and to determine the association of TISS-28 with the time spent on scored and nonscored nursing activities. ⋯ The simplified TISS-28 explains 86% of the variation in TISS-76 and can therefore replace the original version in the clinical practice in the ICU. Per shift, a typical nurse is capable of delivering nursing activities equal to 46 TISS-28 points.
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Critical care medicine · Jan 1996
Respiratory and cardiac function in children after acute hypoxemic respiratory failure.
To examine the pulmonary and cardiac function of children who survived an episode of acute hypoxemic respiratory failure. ⋯ Although pediatric survivors of acute hypoxemic respiratory failure perceive neither a limitation in lifestyle nor chronic pulmonary morbidity, careful examination of the cardiopulmonary system demonstrates a significant number with abnormal chest radiographs and abnormalities in pulmonary function. These children require careful follow-up and may benefit from use of a bronchodilator.
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Critical care medicine · Jan 1996
Comparative StudySpirometric versus Fick-derived oxygen consumption: which method is better?
Oxygen consumption (VO2) is often measured in critically ill patients using the Fick equation: VO2 = cardiac output x arterial-venous oxygen content difference. To determine if this method is accurate, it was compared with a spirometric technique. ⋯ The bias between the Fick and spirometrically determined VO2 values was 58 mL/min. The precision (SD of the bias) between the Fick and spirometrically determined Vo2 was 35 mL/min. Fick-derived Vo2 was greater than Vo2 measured spirometrically. The correlation coefficient was 0.90. CONCLUSIONS; Despite all attempts to reduce measurement error, there was an unexplained difference in Fick-derived and spirometrically measured Vo2. Therefore, I feel that the two methods are not interchangeable, and that calculations of Vo2 using the Fick method should be used cautiously when therapeutic maneuvers are based on these data.
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Critical care medicine · Jan 1996
Cerebral blood flow and carbon dioxide reactivity in neonates during venoarterial extracorporeal life support.
a) To determine if cerebral blood flow is symmetric after internal carotid artery and ipsilateral internal jugular vein ligation in infants during venoarterial extracorporeal life support. b) To determine the cerebral CO2 reactivity (delta cerebral blood flow/delta torr CO2) of neonates during venoarterial extracorporeal life support and its correlation to neurodevelopmental outcome. ⋯ Hemispheric cerebral blood flow was symmetric in infants during early and late venoarterial extracorporeal life support. Some subgroups showed a trend toward decreased right hemispheric cerebral blood flow, but the small number of patients limited interpretation of this finding. CO2 reactivity and cerebral blood flow were highly variable in this population, and were not predictive of short-term neurodevelopmental outcome. Stressed neonates with extremely low cerebral blood flow rates may have relatively normal short-term neurodevelopmental outcome after venoarterial extracorporeal life support.
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Critical care medicine · Jan 1996
Nitric oxide synthase inhibition during experimental sepsis improves renal excretory function in the presence of chronically increased atrial natriuretic peptide.
To test whether renal excretory function decreases after nitric oxide synthase inhibition during experimental hyperdynamic sepsis. ⋯ In this ovine model of experimental hyperdynamic sepsis, renal excretory function decreases in the presence of chronically increased concentrations of atrial natriuretic peptide. Administration of the nitric oxide synthase inhibitor, N omega-nitro-L-arginine methyl ester, reverses the vasodilatory state, thereby improving fluid balance and glomerular filtration.