Critical care medicine
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Critical care medicine · Nov 1995
Comparative StudyCytokines and plasminogen activator inhibitor-1 in posttrauma disseminated intravascular coagulation: relationship to multiple organ dysfunction syndrome.
a) To investigate the relationships between tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta), plasminogen activator inhibitor-1, and disseminated intravascular coagulation (DIC); b) to determine the influence of DIC on the mortality rate, adult respiratory distress syndrome (ARDS), and multiple organ dysfunction syndrome; and c) to find a useful prognostic index for outcome. ⋯ In the patients with trauma, DIC is a predictor of ARDS, multiple organ dysfunction syndrome, and death. TNF-alpha and IL-1 beta might be one of the causes of DIC, while plasminogen activator inhibitor-1 may be one of the aggravating factors of ARDS and multiple organ dysfunction syndrome. Plasminogen activator inhibitor-1 is a good predictor of death for posttrauma DIC patients.
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Critical care medicine · Nov 1995
Comparative StudyJugular ligation does not increase intracranial pressure but does increase bihemispheric cerebral blood flow and metabolism.
To answer the following questions: a) Does jugular venous ligation (simulating venovenous extracorporeal life support) alter proximal jugular venous pressure, intracranial pressure, hemispheric cerebral blood flow, or cerebral metabolism? b) Does release of ligation reverse these effects? and c) What are the comparative effects of venous ligation alone vs. venous ligation in combination with arterial ligation? ⋯ Ligation of the right jugular veins alone (venovenous ligation) or jugular veins and right carotid artery (venoarterial ligation) does not increase jugular venous pressures or intracranial pressure. However, this procedure does increase cerebral blood flow and cerebral oxygen consumption. These findings demonstrate that there is adequate decompression of the venous system by the cerebrovascular system and retrograde decompression during extracorporeal life support appears unwarranted.
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Critical care medicine · Nov 1995
Comparative StudyPerfluorocarbon-associated gas exchange improves pulmonary mechanics, oxygenation, ventilation, and allows nitric oxide delivery in the hypoplastic lung congenital diaphragmatic hernia lamb model.
To determine the efficacy of perfluorocarbon-associated gas exchange and the effects of inhaled nitric oxide during perfluorocarbon-associated gas exchange in the congenital diaphragmatic hernia lamb model. ⋯ Perfluorocarbon-associated gas exchange significantly improved gas exchange, dynamic compliance, and tidal volumes. Furthermore, inhaled nitric oxide can be effectively delivered during perfluorocarbon-associated gas exchange to reduce pulmonary hypertension and enhance oxygenation.
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Critical care medicine · Nov 1995
Comparative StudyPrediction of mortality in neonates with congenital diaphragmatic hernia treated with extracorporeal membrane oxygenation.
To determine if data collected by the Extracorporeal Life Support Organization Registry could be used to identify neonates with congenital diaphragmatic hernia who had a > 90% mortality rate, despite the use of extracorporeal membrane oxygenation (ECMO) support. ⋯ Although a number of factors identify neonates with diaphragmatic hernia as being at higher risk of dying despite ECMO support, data currently collected by the neonatal Extracorporeal Life Support Organization Registry do not allow clinicians to effectively discriminate nonsurvivors from survivors.
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Critical care medicine · Oct 1995
Comparative StudyMonitoring of tissue oxygenation in shock: an experimental study in pigs.
To evaluate different methods and markers for assessing adequacy of tissue oxygenation in shock. ⋯ Many conventional markers of tissue hypoxia are useful when assessing general hypoperfusion, whereas intestinal intramucosal pH is the only reliable and clinically useful indicator of inadequate regional intestinal tissue oxygenation.