Critical care medicine
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Critical care medicine · Aug 1984
Adult respiratory distress syndrome: hospital charges and outcome according to underlying disease.
We reviewed the hospital charges, underlying diagnoses, and hospital outcomes in 39 patients with adult respiratory distress syndrome (ARDS) admitted to the respiratory ICU of a university hospital between July 1979 and June 1981. Charges per patient ranged from $9263 to $187,893 with a median of $52,894. Median ICU charges were $2430/day. ⋯ Only 1 of 27 patients with underlying hematologic/oncologic diseases survived, compared to 6 of 12 patients with other underlying diseases. Charges and outcomes in this study reflect the underlying patient population and philosophy of care at the study institution. Considering the high costs and poor outcomes in ARDS patients with underlying hematologic/oncologic problems, we recommend that the appropriateness of aggressive treatment be reconsidered.
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Critical care medicine · Aug 1984
Renal hypoxia and lactate metabolism in hemorrhagic shock in dogs.
Central and renal hemodynamics, renal cortical and medullary oxygen tension, and renal lactate metabolism were investigated in hemorrhagic shock in dogs. During graded hemorrhage, renal tissue PO2 decreased in parallel with renal blood flow, whereas renal lactate uptake remained virtually unchanged. ⋯ Reinfusion of shed blood increased renal tissue PO2 above its preshock value but did not restore baseline renal oxygen consumption and lactate uptake levels. These results suggest that renal lactate utilization is not limited by oxygen delivery under moderate hemorrhagic hypotension but decreases linearly with renal tissue PO2 during shock.
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Critical care medicine · Jul 1984
Case ReportsCardiac tamponade associated with a multilumen central venous catheter.
Two patients experienced cardiac tamponade after catheterization with a multilumen central venous catheter. The authors review the problem, including recommendations for central line placement to decrease the incidence of this potentially lethal complication.