Critical care medicine
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Although it is useful in certain clinical situations for manual resuscitator units to be used with spontaneously ventilating patients, there are few data regarding their performance in these settings. We measured the percent-delivered oxygen from 13 adult manual resuscitator units during simulated spontaneous ventilation in the range of respiratory frequency, tidal volume, and oxygen supply in which manual resuscitator units might be used with patients. We also measured the resistive pressure developed during simulated ventilation and at constant inspiratory flow of 50 L/min. ⋯ Reliable administration of high percent-delivered oxygen to spontaneously ventilating patients, while retaining the capability to manually ventilate them, is best achieved by a manual resuscitator unit with a valve of low resistance, incorporating a disc to prevent air entrainment. We recommend that manufacturers indicate on the product information sheet the degree (and confidence limits) to which their manual resuscitator unit presents resistance and delivers oxygen to a spontaneously ventilating subject.
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Critical care medicine · Nov 1991
Experience with phenylephrine as a component of the pharmacologic support of septic shock.
To evaluate the use of the selective alpha 1-adrenergic receptor agonist phenylephrine in the hemodynamic support of patients with septic shock. ⋯ Treatment with phenylephrine was associated with beneficial hemodynamic effects when used to maintain perfusion, while increasing DO2 and VO2 in patients with septic shock.
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Critical care medicine · Oct 1991
Multicenter Study Clinical TrialAirway pressure release ventilation during acute lung injury: a prospective multicenter trial.
To evaluate the feasibility of airway pressure release ventilation (APRV) in providing ventilatory support to patients with acute lung injury of diverse etiology and mild-to-moderate severity. ⋯ APRV is a feasible alternative to conventional mechanical ventilation for augmentation of alveolar ventilation in patients with acute lung injury of mild-to-moderate severity.
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Critical care medicine · Oct 1991
Acute physiology and chronic health evaluation (APACHE II) scoring in a cardiothoracic intensive care unit.
To evaluate the predictive value of the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in cardiothoracic surgical patients. ⋯ There was a good relationship between the APACHE II score and mortality rate. Low APACHE II scores accurately predicted survival but only very high scores accurately predicted death.