Critical care medicine
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Critical care medicine · Jun 1994
Comparative Study Clinical Trial Retracted PublicationCardiopulmonary actions of intravenously administered enalaprilat in trauma patients.
To determine the cardiopulmonary actions of the intravenous administration of the angiotensin-converting enzyme inhibitor enalaprilat in hypertensive trauma patients. ⋯ The intravenous administration of enalaprilat successfully decreased blood pressure in most of our patients. Mechanisms other than the renin-angiotensin system also appear to be involved in hypertensive, critically ill patients. Pulmonary function was not altered; right ventricular function, and both oxygen consumption and oxygen delivery improved in the enalaprilat responder group. Thus, the availability of intravenous enalaprilat seems to enlarge our armamentarium for treating hypertension in the critically ill patient.
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Critical care medicine · Jun 1994
Comparative StudyComparison of inspiratory work of breathing between flow-triggered and pressure-triggered demand flow systems in rabbits.
Flow-triggered continuous positive airway pressure decreases the inspiratory work of breathing in adults when compared with pressure-triggered continuous positive airway pressure. However, the effect of flow-triggered continuous positive airway pressure on work of breathing in neonates is not known. Our objective was to determine if flow-triggering was superior to pressure triggering in the presence of narrow endotracheal tubes, such as those tubes used in neonates. ⋯ Flow-triggering is superior to pressure-triggering in the presence of a 3-mm inner diameter endotracheal tube. This difference was not clear with a 4-mm inner diameter endotracheal tube. The size of the endotracheal tube may be the most important variable in evaluating the approach used to ventilate small neonates.
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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 StudyInduction of the heat shock response reduces mortality rate and organ damage in a sepsis-induced acute lung injury model.
To test the hypothesis that induction of heat shock proteins before the onset of sepsis could prevent or reduce organ injury and death in a rat model of intra-abdominal sepsis and sepsis-induced acute lung injury produced by cecal ligation and perforation. ⋯ These data suggest that thermal pretreatment, associated with the synthesis of heat shock proteins, reduces organ damage and enhances animal survival in experimental sepsis-induced acute lung injury. Although the mechanisms by which heat shock proteins exert a protective effect are not well understood, these data raise interesting questions regarding the importance of fever in the protection of the whole organism during bacterial infection.