Journal of anesthesia
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The purpose of this study was to determine the mortality rate in 527 critically ill patients with multiple organ failure (MOF), treated in our ICU between August, 1986 and January, 1992, and to compare it with the results obtained in a group of patients studied who had been treated between October, 1978 and July, 1986. The relationship between the mortality rate and each type of organ failure and the extent of organ system involvement was also investigated. ⋯ The mortality rate of patients with the failure of two organs in the present study was significantly lower than that found in those in the previous study. Although artificial organ mechanical life support technology other than that for patients with renal failure is still unsatisfactory, these results suggest that the prognosis of patients with MOF is improving.
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Journal of anesthesia · Sep 1994
Effects of dobutamine on the fatigued diaphragm: A comparison with dopamine.
We examined the effects of dopamine (DOA) 10 μg·kg(-1)·min(-1) I. V. and dobutamine (DOB) 10 μg·kg(-1). min(-1) I. V. on the contractility of the fatigued diaphragm in 26 anesthetized, mechanically ventilated dogs. ⋯ In each group, Pdi at both stimuli decreased after the cessation of administration. The integrated diaphragmatic electric activity (Edi) in the two groups did not change at any frequency of stimulation throughout the study. We conclude that DOB in comparison with DOA is more effective in improving the contractility of the fatigued diaphragm.
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Journal of anesthesia · Sep 1994
Differential effects of halothane and enflurane on end-systolic pressure-diameter relationship in anesthetized, mechanically ventilated dogs.
To clarify the difference of negative inotropic effects, we evaluated the effects of 0, 0.5, and 1 MAC halothane and enflurane on systolic performance in anesthetized, mechanically ventilated, vagotomized dogs. Left ventricular myocardial contractility was assessed by the slope of the end-systolic pressure-diameter relationship (EES), which have been reported to be independent of alterations in preload and afterload but sensitive to changes in myocardial contractility. Both anesthetics decreased heart rate and dose-dependently decreased left ventricular systolic pressure. ⋯ TheEES was decreased with increasing concentrations of enflurane. TheEES was significantly larger (P<0.05) with 1 MAC of halothane than with 1 MAC enflurane. These results suggest that halothane preserves myocardial contractility better than enflurane in the presence of fentanyl.