Critical care medicine
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Critical care medicine · Jun 1992
Comparative StudyColonization of dental plaque by respiratory pathogens in medical intensive care patients.
To assess the prevalence of oral colonization by respiratory pathogens in a group of ICU patients, with specific attention to dental plaque and the oral mucosa. ⋯ These findings suggest that bacteria commonly causing nosocomial pneumonia colonize the dental plaque and oral mucosa of intensive care patients. In many cases, this colonization occurs by large numbers of bacteria. Dental plaque may be an important reservoir of these pathogens in medical ICU patients. Efforts to improve oral hygiene in medical ICU patients could reduce plaque load and possibly reduce oropharyngeal colonization.
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Critical care medicine · Jun 1992
Comparative StudySeptic shock in patients with cirrhosis: hemodynamic and metabolic characteristics and intensive care unit outcome.
To examine the hemodynamic and metabolic characteristics and ICU outcome of septic shock in patients with cirrhosis. ⋯ In patients with cirrhosis, septic shock was characterized by severe liver dysfunction, low blood temperature, marked increases in cardiac index and lactic acidemia, and a 100% ICU mortality rate. These findings should be taken into account if patients with cirrhosis are to be included in controlled studies on septic shock.
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Critical care medicine · Jun 1992
Comparative StudyLung mechanics during and after extracorporeal membrane oxygenation for meconium aspiration syndrome.
To determine whether abnormalities in lung mechanics detected in infants during the acute phase of meconium aspiration syndrome persist after treatment with extracorporeal membrane oxygenation (EMCO). ⋯ We conclude that improvements in the clinical condition and oxygenation, permitting successful decannulation from ECMO, are achieved before clinically important improvements in lung mechanics.
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Critical care medicine · Jun 1992
Cerebral blood flow pattern and autoregulation during open-heart surgery in infants and young children: a transcranial, Doppler ultrasound study.
To elucidate the effect of cardiopulmonary bypass on cerebral perfusion and on the autoregulatory ability of the cerebral vascular bed of infants and young children. ⋯ The finding suggests that cerebral blood flow decreases with decreasing nasopharyngeal temperature. During hypothermic cardiopulmonary bypass, cerebral autoregulation seems to be easily disturbed, especially at low nasopharyngeal temperatures.
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Critical care medicine · Jun 1992
Comparative StudyLack of relationship between the true airway pressure and the pressure displayed with an infant ventilator.
To establish if the pressure indicated in the manometer of an infant ventilator (IV 100B, Sechrist, Anaheim, CA) reflects the true pressure delivered to the proximal airway during mechanical ventilation in the neonatal ICU. ⋯ These data demonstrate that it is impossible to know the true pressure delivered to the proximal airway of a neonate during mechanical ventilation by observing the ventilator pressure manometer. The manometer readings consistently underestimate the true peak inspiratory pressure values and are very unpredictable regarding positive end-expiratory pressure values. These findings support the use of other methods to monitor the proximal airway pressure besides the ventilator's manometer in the neonatal ICU. Furthermore, mean airway pressure should not be calculated from the pressure readings obtained from the tested ventilator's manometer.