Articles: critical-care.
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To assess the hemodynamic effects of manual lung hyperinflation in mechanically ventilated patients and to measure the different inspiratory pressures and tidal volumes generated by different operators. ⋯ Lung hyperinflation is frequently not achieved by the manual technique. Significant changes in cardiac output can occur and appear to be related to the tidal volume rather than pressure generated.
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Neurosurg. Clin. N. Am. · Oct 1994
ReviewIntegrated multimodality monitoring in the neurosurgical intensive care unit.
The selection of variables for continuous monitoring in the neurosurgical intensive care unit is based upon the requirement for constant perfusion and oxygenation of the brain and knowledge of the frequency and prognostic significance of abnormal values. Both arterial and intracranial pressure must be considered in the form of cerebral perfusion pressure. Body temperature and arterial oxygen saturation are essential to monitoring. Measurement of jugular venous oxygen saturation and cerebral blood flow velocity provide information of value in determining the source of raised intracranial pressure, the most appropriate means of treating it, and the safety of therapy.
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The sources of fever and infection in neurosurgical patients in the intensive care unit are varied and complex. Benign postoperative fever due to atelectasis of the lungs or from central nervous system sources are difficult to define. Distinguishing between these "benign" sources and true nosocomial bacterial infections can be a difficult clinical process. Empiric antibiotic regimens are outlined, and some guidelines are proposed for the management of infected catheters.