Critical care medicine
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Critical care medicine · Jun 1993
Comparative StudySimultaneous radial, femoral, and aortic arterial pressures during human cardiopulmonary resuscitation.
To examine the validity of interchanging arterial sites and their responses to graded doses of epinephrine during human cardiopulmonary resuscitation (CPR). ⋯ Radial artery relaxation-phase pressure, although statistically higher, correlated with aortic relaxation-phase pressure. Femoral artery relaxation-phase pressure was not statistically different from aortic relaxation-phase pressure. Aortic pressure was statistically higher and had a lower correlation with radial artery pressures during compression phase. The aortic to radial artery and aortic to femoral artery compression-phase gradients abated with increasing doses of epinephrine therapy. Caution must be used when substituting compression-phase pressure obtained at radial or femoral artery sites for aortic pressure during human CPR. Coronary artery perfusion pressures obtained with radial and femoral arteries correlate with aortic pressure when measuring the response to vasopressor therapy during CPR when an interpretable waveform exists.
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Critical care medicine · Jun 1993
Randomized Controlled Trial Clinical TrialTreatment of septic shock with a protease inhibitor in a canine model: a prospective, randomized, controlled trial.
To evaluate the efficacy and mechanism of action of a protease inhibitor (ulinastatin) in septic shock. ⋯ Ulinastatin does not have antimicrobial activity, and it does not sufficiently activate phagocytes. It is suggested that the efficacy of this agent in experimental septic shock is due to a mechanism that activates the reticuloendothelial system and septic reactions.
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Critical care medicine · Jun 1993
Practice Guideline GuidelineGuidelines for the transfer of critically ill patients. Guidelines Committee of the American College of Critical Care Medicine; Society of Critical Care Medicine and American Association of Critical-Care Nurses Transfer Guidelines Task Force.
The development of practice guidelines for the conduct of intra- and interhospital transport of the critically ill patient. ⋯ The available data have allowed us to develop an evidence-based practice policy for the intra- and interhospital transport of the critically ill.
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Critical care medicine · Jun 1993
Relationship between postoperative anemia and cardiac morbidity in high-risk vascular patients in the intensive care unit.
To determine if postoperative anemia is associated with postoperative myocardial ischemia and morbid cardiac events ⋯ This study suggests that postoperative anemia may play a role in postoperative myocardial ischemia and cardiac morbidity.
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Critical care medicine · May 1993
Coagulopathy as a predictor of outcome in meningococcal sepsis and the systemic inflammatory response syndrome with purpura.
To identify simple, contemporary predictors of both morbidity and mortality in pediatric patients with purpuric sepsis syndrome in order to provide a basis for future study of innovative interventions. ⋯ We conclude that: a) outcome of pediatric patients with meningococcal sepsis or the systemic inflammatory response syndrome with purpura can be predicted rapidly, more easily, and with overall accuracy superior to classical prognostication strategies by the simple presence or absence of coagulopathy; b) when applied to a contemporary population, classical prognostication strategies lack value for prediction of mortality, yet remain valid for prediction of "poor outcome" (significant morbidity + mortality); c) when evaluating treatment strategies for such patients, the presence of serious coagulopathy may potentially be useful as an index of illness severity.