Critical care : the official journal of the Critical Care Forum
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The use of low-dose dobutamine to maintain hemodynamic stability in pulmonary hypertension may have a detrimental effect on gas exchange. The aim of this study was to investigate whether inhaled nitric oxide (INO), dobutamine and a combination of the two have beneficial effects in patients with end-stage airway lung disease and pulmonary hypertension. ⋯ Dobutamine and INO have complementary effects on pulmonary circulation. Their association may be beneficial in the treatment of patients with mild to moderate pulmonary hypertension.
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The attack on the World Trade Center had the potential to overwhelm New York's health services. Sadly, however, the predicted thousands of treatable patients failed to materialize. ⋯ This determination not only exists in politics but also in health care, and as with all attempts to enforce change there needs to be a period of collecting opinions and data. This article introduces nine reviews in Critical Care offering varied health care perspectives of the events of 11 September 2001 from people who were there and from experts in disaster management.
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The World Trade Center attack and collapse is the first time an aircraft has been used as a weapon of mass effect. The scale and magnitude of this manmade disaster can only be compared with a natural catastrophe such as the Armenian earthquake of December 1988. The importance of an incident command system and the Simple Triage and Rapid Treatment, and the need for fixed Casualty Collection Points, is explained.
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Delirium is a sign of deterioration in the homeostasis and physical status of the patient. The objective of our study was to investigate the predisposing factors for delirium in a surgical intensive care unit (ICU) setting. ⋯ We determined that conditions such as respiratory diseases, infections, fever, anemia, hypotension, hypocalcemia, hyponatremia, azotemia, elevated liver enzymes, hyperamylasemia, hyperbilirubinemia and metabolic acidosis were predicting factors for delirium.
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The plasma colloid osmotic pressure (COP) plays a major role in transcapillary fluid balance. There is no information on plasma COP of healthy infants beyond the first post-natal week. The normal COP in healthy adult subjects (25 mmHg) is currently also applied as a reference value for healthy infants. This study was designed to test whether plasma COP values in healthy infants are the same as those in normal adults. ⋯ The data accept the null hypothesis that the COP range in infants younger than 1 year old is similar to those observed in adult subjects. Our observations, compared with previously reported neonatal COP values, suggest that there is a sharp increase in COP within the first months after birth.