Critical care medicine
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Critical care medicine · Sep 1994
Multicenter StudyMortality probability models for patients in the intensive care unit for 48 or 72 hours: a prospective, multicenter study.
To develop models in the Mortality Probability Model (MPM II) system to estimate the probability of hospital mortality at 48 and 72 hrs in the intensive care unit (ICU), and to test whether the 24-hr Mortality Probability Model (MPM24), developed for use at 24 hrs in the ICU, can be used on a daily basis beyond 24 hrs. ⋯ Models developed for use among ICU patients at one time period are not transferable without modification to other time periods. The MPM48 and MPM72 calibrated well to their respective time periods, and they are intended for use at specific points in time. The increasing constant terms and associated increase in the probability of hospital mortality exemplify a common clinical adage that if a patient's clinical profile stays the same, he or she is actually getting worse.
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Critical care medicine · Sep 1994
Preoperative stabilization using high-frequency oscillatory ventilation in the management of congenital diaphragmatic hernia.
a) To assess the efficiency of preoperative stabilization with the use of high-frequency oscillatory ventilation in the treatment of congenital diaphragmatic hernia; b) to determine early prognosis factors. ⋯ a) This study demonstrated the efficiency of preoperative stabilization using high-frequency oscillation in the treatment of congenital diaphragmatic hernia. b) An arterial-alveolar oxygen ratio of > or = 0.3 and an oxygenation index of < or = 10 on admission are associated with a rapidly completed surgical procedure and a good outcome.
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Critical care medicine · Sep 1994
Comparative StudyMechanical respiratory system input impedance during high-frequency oscillatory ventilation in rabbits.
To study the mechanical properties of the rabbit respiratory system during high-frequency oscillatory ventilation by means of mechanical respiratory impedance measurement and to characterize the changes in oscillation mechanics of the respiratory system occurring after bilateral vagotomy. ⋯ Mechanical respiratory impedance measurement proved to be a useful method to study the mechanical properties of the respiratory system during high-frequency oscillatory ventilation. The results suggest that vagally mediated reflex changes in respiratory system mechanics are associated with high-frequency oscillatory ventilation, depending on the ventilatory variables that are used.
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Critical care medicine · Sep 1994
Airway pressure measurements during high-frequency positive pressure ventilation in extremely low birth weight neonates.
Evaluation of a modified, computer-controlled, shutter method to determine the complete intrapulmonary pressure course and to ascertain the expiratory time constant for the respiratory system during high-frequency positive pressure ventilation. ⋯ The computer-controlled shutter method is noninvasive and applicable without impairment, even in preterm neonates with birth weights of < 1000 g. This method provides important information to optimize respiratory therapy, particularly knowledge of the individual time constant. To avoid inadvertent positive end-expiratory pressure and gas trapping, expiratory time should be > 4 time constants.