Critical care medicine
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Critical care medicine · Oct 1993
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized study of continuous versus intermittent nebulized albuterol for severe status asthmaticus in children.
a) to determine if continuous nebulization of albuterol is more effective than intermittent nebulization in the treatment of children with status asthmaticus and impending respiratory failure; b) to determine the effect of continuous nebulization and intermittent nebulization on duration of hospital stay and bedside respiratory therapy care. ⋯ In children with impending respiratory failure due to status asthmaticus, continuous nebulization of albuterol is safe and results in more rapid clinical improvement than intermittent nebulization. Respiratory therapy required at the bedside and duration of hospital stay were substantially less for patients receiving continuous nebulization of albuterol, which suggests that continuous nebulization of albuterol is more cost effective than intermittent nebulization.
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Critical care medicine · Oct 1993
Comparative StudyPredictability of creatinine clearance estimates in critically ill patients.
a) To evaluate the predictive ability of different creatinine clearance methods as compared with the criterion standard, inulin clearance; and b) to determine which of the predictive methods yields the most accurate estimation of creatinine clearance. ⋯ The utilization of the Cockcroft-Gault equation as used clinically (the lower of ideal or total body weight and the higher of actual serum creatinine or corrected serum creatinine concentration to 1 mg/dL [85 mumol/L]) results in more accurate predictions of glomerular filtration rate in the medical, critically ill patient than urine creatinine clearance measures. If creatinine clearance measures are used, the 30-min collection provided results not different from those results obtained with 24-hr urinary collections.
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Critical care medicine · Oct 1993
Hypertonic saline infusion in hemorrhagic shock treated by military antishock trousers (MAST) in awake sheep.
To determine the effect of military antishock trousers (MAST) combined with hypertonic saline in controlled hemorrhagic shock in an awake sheep model. ⋯ In hemorrhagic shock, the combination of MAST and hypertonic saline increases mean arterial pressure, improves cardiac output and tissue perfusion during the application of MAST, and also prolongs for > 2 hrs the short beneficial effect of hypertonic saline on mean arterial pressure.
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To review the role of tumor necrosis factor (TNF) in the pathogenesis of the septic shock syndrome. ⋯ TNF plays a major role in the pathogenesis of the septic shock syndrome. TNF exerts a range of beneficial and injurious effects that may ultimately lead to organ dysfunction and death. The burst of TNF release after endotoxemia promotes the progression of the shock syndrome even in the absence of further TNF release. New therapies targeted to the attenuation of TNF may hold promise for the management of patients with septic shock syndrome.