Critical care medicine
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Critical care medicine · Jul 1993
Arterial to end-tidal CO2 tension difference after bilateral lung transplantation.
To assess ventilation/perfusion mismatch with high ventilation/perfusion ratios (i.e., alveolar deadspace) and to assess capnography as a noninvasive method of monitoring ventilation after bilateral lung transplantation. ⋯ Our data suggest marked alveolar deadspace ventilation immediately after bilateral lung transplantation. The presence and rapid improvement of this ventilation/perfusion mismatch may reflect the presence of ischemia-reperfusion lung injury and its improvement in the first hours of reperfusion. In five of seven patients, capnography was not a good measure of PaCO2 during the first hours after bilateral lung transplantation.
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Critical care medicine · Jul 1993
Hemodynamic and oxygen transport responses in survivors and nonsurvivors of high-risk surgery.
To describe temporal hemodynamic and oxygen transport patterns in a large series of high-risk surgical patients in order to document physiologic patterns, to develop therapeutic goals for a wide range of surgical conditions, and to propose a mechanistic model for acute postoperative circulatory failure. ⋯ The data indicate that there are increased metabolic requirements after surgical trauma and that the changes in cardiac index and DO2 represent compensatory increases in circulatory functions stimulated by increased metabolic needs. However, these metabolic needs change with age, gender, severity of illness, type of operation, associated medical conditions, duration of shock, complications, organ failure, and outcome.
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Critical care medicine · Jul 1993
Extracorporeal membrane oxygenation for cardiac rescue in children with severe myocardial dysfunction.
To assess the experience and efficacy of extracorporeal membrane oxygenation (ECMO) for cardiac rescue in patients with presumptively lethal cardiac dysfunction at the Children's Hospital of Pittsburgh. ⋯ Patients with severe myocardial dysfunction who fail conventional therapy can be successfully supported with ECMO during the period of myocardial recovery. ECMO can also provide a viable circulatory support system in patients with prolonged cardiac arrest who fail conventional resuscitation techniques. ECMO is also an effective means of support as a mechanical bridge to heart transplantation.
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To investigate left ventricular function by the Langendorff method after successful cardiac resuscitation in rats. ⋯ These studies, therefore, document progressive systolic and diastolic myocardial dysfunction immediately after successful cardiac resuscitation with restoration of spontaneous circulation.
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Critical care medicine · Jul 1993
Intratracheal perfluorocarbon administration combined with mechanical ventilation in experimental respiratory distress syndrome: dose-dependent improvement of gas exchange.
To test the efficacy of intratracheal instillation of a perfluorocarbon, combined with conventional mechanical ventilation, as well as to establish the dose response of this application on pulmonary parameters in adult animals with acute respiratory failure. ⋯ The remarkable improvements in pulmonary parameters suggest that this type of ventilatory support offers an effective and simple method of perfluorocarbon application in acute respiratory failure.