Critical care medicine
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Critical care medicine · Mar 1992
Randomized Controlled Trial Comparative Study Clinical TrialUltrasound-facilitated central venous cannulation.
To compare the conventional method for cannulation of the internal jugular vein with the ultrasound-aided technique. ⋯ Ultrasound guidance reduces both the duration of time and the number of punctures required to cannulate the internal jugular vein. The Seldinger technique appears safer for catheterization of the internal jugular vein.
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Critical care medicine · Mar 1992
Evaluation of hypoxic brain injury with spinal fluid enzymes, lactate, and pyruvate.
To investigate the prognostic importance in neurologic recovery of the lumbar cerebrospinal fluid (CSF) variables creatine kinase (CK) and brain-type creatine kinase isoenzyme (CK-BB), lactate dehydrogenase (LDH) and its isoenzymes (LDH 1-5), CSF acid phosphatase, beta-D-N-acetylglucosaminidase activity, and CSF lactate, pyruvate, sodium, potassium, and calcium concentrations in patients who experienced cardiac arrest. ⋯ CSF CK, CK-BB, and CSF lactate concentrations reflect a patient's outcome most reliably when measured within 28 to 76 hrs of the cardiac arrest. Similarly, CSF LDH, its isoenzymes 1-3, and CSF acid phosphatase concentrations, when measured at 76 hrs, can be used to monitor the patient's outcome after cardiac arrest. When correlated with Glasgow Coma Scale scores, the closest negative correlation was again seen in CSF CK and CK-BB at 28 and 76 hrs, as well as in LDH, LDH1-3, and acid phosphatase values at 76 hrs. The negative correlation between CSF lactate and Glasgow Coma Scale scores was most distinct at 28 hrs.
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Critical care medicine · Mar 1992
Comparative StudyComparison of cerebral blood flow by radionuclide cerebral angiography and by microspheres in cats.
Radionuclide cerebral angiography is commonly used as an adjunct to the diagnosis of brain death. Despite its acceptance as a diagnostic tool, it is not clear whether the absence of cerebral blood flow by radionuclide cerebral angiography denotes a complete lack of cerebral blood flow. ⋯ We conclude that the ability of radionuclide cerebral angiography to quantify low cerebral blood flow is poor, and that this technique may not identify severely reduced cerebral blood flow.