Critical care medicine
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Critical care medicine · Jul 1995
Comparative StudyEndotoxemia causes ileal mucosal acidosis in the absence of mucosal hypoxia in a normodynamic porcine model of septic shock.
To evaluate the hypothesis that splanchnic ischemia and mucosal hypoxia are responsible for lipopolysaccharide-induced intramucosal acidosis in pigs. ⋯ Mucosal hypoxia is not responsible for lipopolysaccharide-induced mucosal acidosis in this normodynamic pig model of septic shock. A rightward shift of the oxyhemoglobin dissociation curve (the Bohr effect) can explain the increase in mucosal oxygenation observed in endotoxemic pigs.
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Critical care medicine · Jul 1995
Comparative StudyReduced intestinal absorption of arginine during sepsis.
To investigate the effect of sepsis on the intestinal absorption of arginine. ⋯ Experimental sepsis, induced by either cecal ligation and puncture or intraperitoneal injection of lipopolysaccharide, resulted in impaired intestinal amino acid uptake. Impaired intestinal arginine absorption may explain the lack of benefit of enteral, compared with parenteral, arginine therapy on survival from a septic insult.
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Critical care medicine · Jul 1995
Meta AnalysisSteroid controversy in sepsis and septic shock: a meta-analysis.
The use of corticosteroids in patients with sepsis or septic shock has been controversial for many decades. Clinical studies have reported beneficial, as well as negative results. We conducted a meta-analysis to assess the clinical evidence and to evaluate treatment effects in specific subgroups of patients. ⋯ No overall beneficial effect of corticosteroids in patients with septic shock was observed; however, there is some evidence for a positive effect in patients with Gram-negative septicemia.
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Critical care medicine · Jun 1995
Comparative StudyNoninvasive monitoring of end-tidal carbon dioxide tension via nasal cannulas in spontaneously breathing children with profound hypocarbia.
To determine the correlation between end-tidal CO2 and PaCO2 measured via nasal cannulas in spontaneously breathing children with profound hypocarbia (PaCO2 < 30 torr [< 4.0 kPa]). ⋯ End-tidal CO2 measurement by infrared spectroscopy provides an accurate estimation of PaCO2, even during episodes of severe hypocarbia. Its use may limit the need for invasive monitoring and/or repeated arterial blood gas analyses.