Critical care medicine
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Critical care medicine · Jun 1994
Comparative StudyEpinephrine infusion in sheep: systemic and renal hemodynamic effects.
To evaluate the dose-response effects of graded epinephrine infusions on systemic and renal hemodynamics. ⋯ Using a clinically relevant dose regimen, epinephrine increased mean arterial pressure and cardiac output. Renal blood flow decreased transiently, but returned to baseline within 30 to 60 mins.
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To determine the predictive value of patient monitoring alarms as a warning system in a pediatric intensive care unit (ICU). ⋯ Over 94% of alarm soundings in a pediatric ICU may not be clinically important. Present monitoring systems are poor predictors of untoward events.
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Critical care medicine · Jun 1994
Comparative StudyComparison of pH and carbon dioxide tension values of central venous and intraosseous blood during changes in cardiac output.
To compare the pH and PCO2 values determined from of simultaneously corrected samples of central venous and intraosseous blood during sequential changes in cardiac output. ⋯ Intraosseous blood samples can be obtained without difficulty even during extreme hypovolemia. The pH and PCO2 values of intraosseous and central venous blood samples were similar under all study conditions. Intraosseous blood may be a useful alternative to central venous blood to assess tissue acid-base status during hemorrhagic shock and other low-flow states.
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Critical care medicine · Jun 1994
Timing and predictors of death in pediatric patients with multiple organ system failure.
To describe the timing of onset of organ system failure, multiple organ system failure diagnosis, and the subsequent death in children admitted to a pediatric intensive care unit (ICU). Second, to identify independent risk markers of death in pediatric patients with multiple organ system failure. ⋯ The mortality rate associated with multiple organ system failure in pediatric patients is high. The maximum number of simultaneous organ system failures during pediatric ICU stay, age < or = 12 months, and the PRISM score on the day of admission are independent risk markers of death. Diagnosis of multiple organ system failures, development of maximum number of organ system failures, and deaths occur remarkably early after pediatric ICU admission; the rationale for using prophylactic therapy under such circumstances is unclear.
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Critical care medicine · Jun 1994
Impact of a clinical pharmacist in a multidisciplinary intensive care unit.
To describe the activities of a clinical intensive care unit (ICU) pharmacist and to determine whether pharmacist-initiated consultations lead to changes in drug costs. ⋯ Dedicated ICU pharmacists are crucial healthcare team members in a multidisciplinary ICU. In addition to substantially reducing drug costs, they provide continuity in individualized pharmacotherapeutic care, and serve an important educational function.