Critical care medicine
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Critical care medicine · Feb 1995
Effect of tracheal gas insufflation on gas exchange in canine oleic acid-induced lung injury.
To determine the effect of tracheal gas insufflation on gas exchange in oleic acid-induced lung injury in dogs. ⋯ Tracheal gas insufflation augmented alveolar ventilation effectively in the setting of oleic acid-induced lung injury in dogs. When end-expiratory lung volume and tidal volume were kept constant, tracheal gas insufflation did not affect oxygenation.
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Critical care medicine · Feb 1995
Pentafraction for superior resuscitation of the ovine thermal burn.
To determine if a new hydroxyethyl starch, pentafraction, will cause better capillary retention of fluid in thermally burned and nonburned tissues when compared with some currently used volume expanders. ⋯ Pentafraction is as good, or even superior, for volume resuscitation in the burn patients, when compared with pentastarch and plasma. This conclusion is made most evident by the attenuated changes in systemic vascular resistance and cardiac index. Pentafraction decreases the fluid flux and potential subsequent edema significantly in burned tissues and effectively maintains the pulmonary microvascular integrity.
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Critical care medicine · Feb 1995
Respiratory deadspace measurements in neonates with congenital diaphragmatic hernia.
To apply the technique of respiratory deadspace measurement to consecutive infants with congenital diaphragmatic hernia, who were referred to our institution, in order to assess the efficiency of gas exchange. ⋯ Predictors of outcome in infants with congenital diaphragmatic hernia have been complicated and contradictory, particularly in the ECMO era. We demonstrated that the respiratory deadspace can be easily quantified in these infants, and that a physiologic deadspace of > 0.60 is associated with a 15-fold increase in mortality rate. We also demonstrated that in those infants treated with ECMO, the survivors manifested a significant decrease in their deadspace/tidal volume ratio before ECMO decannulation.
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Critical care medicine · Feb 1995
Hypertonic saline-dextran resuscitation from hemorrhagic shock induces transient mixed acidosis.
To evaluate the magnitude and mechanism of potential metabolic acidosis after resuscitation with 7.5% sodium chloride/6% dextran-70. ⋯ Hypertonic saline/dextran caused an immediate, transient acidemia, which was primarily due to a hyperchloremic, hypokalemic, metabolic acidosis with normal anion gap and decreased inorganic strong ion difference, but which was partially due to a mild transient respiratory acidosis. The acidemia was transient because of the offsetting alkalotic effects of decreasing serum protein, normalization of electrolytes, and transient nature of the increase in CO2. Lactic acidosis was not the cause of the acidemia. Over time, the acid-base status appeared to be improved more effectively with hypertonic saline/dextran than with isotonic saline resuscitation.
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Critical care medicine · Feb 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of propofol and midazolam for sedation in intensive care unit patients.
To evaluate the comparative safety and effectiveness of intravenous infusion of propofol or midazolam when used for 12 to 24 hrs of sedation and to evaluate the quality of sedation during stimulation. ⋯ Propofol was as safe and as efficacious as midazolam for continuous intravenous sedation. The quality of sedation was better in the propofol group.