Critical care medicine
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Critical care medicine · Jun 1980
Clinical Trial Controlled Clinical TrialContinuous transcutaneous oxygen monitoring in the critically ill neonate. A controlled clinical trial.
Ten neonates with respiratory distress requiring mechanical ventilation and supplemental oxygen were studied during a continuous 24-h period to determine the value of continuous transcutaneous oxygen (PtcO2) monitoring. All 10 infants were continuously monitored during the study with a Clark-type skin electrode (Litton) and 5 of the 10 also had a catheter-tip oxygen electrode in place in the umbilical artery to measure umbilical artery O2 (PuaO2). The results of these two forms of monitoring were not available for the care of the infant during the study period. ⋯ Correlation between PaO2 and PtcO2 values (r = 0.93) was greater than the correlation between PaO2 and PuaO2 (r = 0.81). PtcO2 = 19.7 +/- 0.74 X PuaO2, and the correlation coefficient between PtcO2 and PuaO2 was 0.64. Continuous oxygen monitoring revealed significantly longer periods of hypoxia than that observed from blood gas estimations alone and its use in the low birth weight infant should result in more rational ventilatory therapy and in fewer episodes of hypoxia.
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Critical care medicine · May 1980
Randomized Controlled Trial Clinical TrialHemodynamic, blood volume, and oxygen transport responses to albumin and hydroxyethyl starch infusions in critically ill postoperative patients.
Hemodynamic, plasma volume, and oxygen transport effects were measured after administration of 500 ml of 5% albumin or 6% hydroxyethyl starch (HES) in hypovolemic postoperative patients using a prospectively randomized crossover design. Both agents produced marked and significant improvement in plasma volume and flow as well as small transient increases in arterial and venous pressures, urine output, colloidal osmotic pressure (COP), and oxygen transport. The authors conclude that HES is a safe, inexpensive, effective plasma expander that has hemodynamic effects similar to those of other colloids. ⋯ Routine vital signs correlated poorly with the preinfusion control hemodynamic values or the changes in blood volume status after volume loading. Normal cardiac output, central venous pressure (CVP), and pulmonary arterial wedge pressure (WP) values are commonly seen in critically ill postoperative patients who, nevertheless, may be hypovolemic. Measurement of changes in these variables after a fluid challenge is a useful way to assess plasma volume status.
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Injury severity scales of proven reliability and validity are essential for the appropriate allocation of therapeutic resources, for prediction of outcome, and for evaluation of the quantity and quality of emergency medical care in differing facilities and over time. Quantitation of injury severity in the field is particularly necessary. ⋯ The Triage Index has been developed with state-of-the-art multivariate statistical techniques, meets the requirements of an interval ranking scale, and has been both validated and assessed for interuser reliability. The Triage Index is proposed as a validated system of early, rapid, noninvasive, accurate patient assessment permitting appropriate matching of trauma victims with available therapeutic resources as a means of reducing mortality and morbidity.