Critical care medicine
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Critical care medicine · Jul 1991
Lung fluid dynamics and supply dependency of oxygen uptake during experimental endotoxic shock and volume resuscitation.
We studied the effect of volume resuscitation on lung fluid balance and systemic oxygen extraction during septic shock in eight anesthetized dogs. Sepsis was induced using a 2-hr continuous infusion of Escherichia coli endotoxin at 0.25 micrograms/min.kg. Relationships between oxygen uptake (VO2) and oxygen supply (DO2) were performed acutely during stepwise controlled decrements in cardiac output by progressive inflation of an intracardiac balloon. At each stage, DO2 and corresponding VO2 were measured independently and the individual critical DO2 level was referred to as the point below which the relationship held. The slope of such a constructed relationship was defined as the maximal oxygen extraction ratio. Lung fluid balance was assessed by measurements of extravascular lung water. All values were studied at baseline, after endotoxin insult, and after reversing hypotension by a 10% dextran infusion. ⋯ These data suggest that volume loading may reverse endotoxin-induced peripheral perfusion abnormalities. However, substantial pulmonary edema may occur, possibly jeopardizing the beneficial effects of fluid expansion.
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Critical care medicine · Jun 1991
Comparative StudyCore temperature measurement in the intensive care unit.
To compare three devices that measure core body temperature at the bedside in ICU patients. ⋯ Pulmonary artery thermistor catheters and bladder thermistor catheters appear to give consistent, highly reliable bedside measurements of core body temperature in ICU patients. The currently available device that measures core body temperature from the tympanic membrane appears to give erroneously high readings, and should be used with caution.
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To evaluate the role of amino acid profiles in septic encephalopathy. ⋯ Plasma amino acid profiles appear to be important in septic encephalopathy and the severity of septic disease.