Critical care medicine
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Critical care medicine · Mar 1995
Randomized Controlled Trial Multicenter Study Clinical TrialEarly enteral administration of a formula (Impact) supplemented with arginine, nucleotides, and fish oil in intensive care unit patients: results of a multicenter, prospective, randomized, clinical trial.
To determine if early enteral feeding, in an intensive care unit (ICU) patient population, using a formula supplemented with arginine, dietary nucleotides, and fish oil (Impact), results in a shorter hospital stay and a reduced frequency of infectious complications, when compared with feeding a common use enteral formula (Osmolite.HN). ⋯ Early enteral feeding of the experimental formula was safe and well tolerated in ICU patients. In patients who received the experimental formula, particularly if they were septic on admission to the study, a substantial reduction in hospital length of stay was observed, along with a significant reduction in the frequency of acquired infections.
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Critical care medicine · Mar 1995
Multicenter StudyInflammatory mediators in relation to the development of multiple organ failure in patients after severe blunt trauma.
To evaluate the posttraumatic course of several inflammatory mediators or markers (complement components C3, C3a, terminal complement complex, thromboxane B2, C-reactive protein, elastase, and neopterin) in relation to the development of multiple organ failure and mortality. ⋯ In multiple trauma patients, excessive triggering of the inflammatory cascade-as expressed by complement activation and stimulation of neutrophils producing elastase--plays an important and early role in the development of multiple organ failure.
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Critical care medicine · Mar 1995
Clinical Trial Controlled Clinical TrialMedical effectiveness of esophageal balloon pressure manometry in weaning patients from mechanical ventilation.
To determine the efficacy of a new respiratory monitor, which uses esophageal balloons, in aiding clinicians attempting to wean patients from mechanical ventilation. ⋯ The respiratory monitor, using esophageal balloon technology, is effective in that it can provide the clinician with data that can result in more aggressive weaning from mechanical ventilation without an increase in patient intolerance. The duration of mechanical ventilation can be shortened when these data are applied via a rigidly controlled weaning strategy.
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Critical care medicine · Mar 1995
Multicenter StudySurvey of critical care management of comatose, head-injured patients in the United States.
This survey was designed to study current practices in the monitoring and treatment of patients with severe head injury in the United States. ⋯ The survey data indicate that there is a considerable variation in the management of patients with severe head injury in the United States. The establishment of guidelines for the management of head injury based on available scientific data and moderated by practical and financial considerations may lead to improvement in the standard of care.
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Critical care medicine · Mar 1995
Clinical TrialMaternal and fetal colloid osmotic pressure following fluid expansion during cesarean section.
To characterize the changes in colloid osmotic pressure during delivery and to determine the relationship between maternal and fetal colloid osmotic pressures. ⋯ The reduction in maternal colloid osmotic pressure during delivery is, in part, related to intravenous fluid expansion and the amount of vasopressor administered. Despite the significant fluctuations in maternal colloid osmotic pressure, the placenta and fetus possess the capability to alter colloid osmotic pressure.