Critical care medicine
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Critical care medicine · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialProspective, randomized comparison of high-frequency oscillatory ventilation and conventional mechanical ventilation in pediatric respiratory failure.
To compare the effectiveness of high-frequency oscillatory ventilation with conventional mechanical ventilation in pediatric patients with respiratory failure. ⋯ Our results indicate that high-frequency oscillatory ventilation, utilizing an aggressive volume recruitment strategy, results in significant improvement in oxygenation compared with a conventional ventilatory strategy designed to limit increases in peak airway pressures. Furthermore, despite the use of higher mean airway pressures, the optimal lung volume strategy used in this study was associated with a lower frequency of barotrauma, as indicated by requirement for supplemental oxygen at 30 days, and improved outcome compared with conventional mechanical ventilation.
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Critical care medicine · Oct 1994
Clinical Trial Controlled Clinical TrialCrystalloid infusion increases plasma hyaluronan.
To investigate the changes in plasma hyaluronan concentrations after intravenous infusion of crystalloid solution in healthy subjects. ⋯ Infusion of crystalloid solution increases plasma hyaluronan, probably through a washout of interstitial hyaluronan by way of increased lymph flow. The consequences of the interstitial loss of hyaluronan on tissue function are unknown.
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Critical care medicine · Oct 1994
Comparative StudyHemodynamic effects of different modes of mechanical ventilation in acute cardiac and pulmonary failure: an experimental study.
To determine the hemodynamic effects of four different modes of mechanical ventilation in an animal model of acute cardiac and pulmonary failure. ⋯ Synchronized high-frequency ventilation improves cardiac performance in control conditions. No hemodynamic difference is present between the four modes of mechanical ventilation in the cardiac and pulmonary failure periods. External negative pressure oscillation combined with pressure support ventilation has moderate hemodynamic advantages over controlled mechanical ventilation and high-frequency oscillation in different clinical settings, but it also results in a deterioration of pulmonary gas exchange during the pulmonary failure period.
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Critical care medicine · Oct 1994
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialSafety and efficacy of intravenous Carbicarb in patients undergoing surgery: comparison with sodium bicarbonate in the treatment of mild metabolic acidosis. SPI Research Group. Study of Perioperative Ischemia.
To compare the safety and efficacy of intravenous Carbicarb with intravenous sodium bicarbonate in well-oxygenated patients who developed metabolic acidosis while undergoing major surgery. Carbicarb is an equimolar solution of sodium bicarbonate and sodium carbonate (Na2CO3). It does not undergo significant breakdown to CO2 and H2O, nor does it increase CO2 concentrations to the same extent as does pure sodium bicarbonate. Because of these characteristics, Carbicarb may be a more suitable agent than bicarbonate in the treatment of metabolic acidosis. ⋯ Carbicarb corrects metabolic acidosis as well as sodium bicarbonate. However, the potential therapeutic advantage of Carbicarb remains to be determined, especially in patients with more severe metabolic acidosis.