Articles: critical-care.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Apr 1993
Review[Indications for the use of human albumin in anesthesia and intensive care medicine].
The plasmatic albumin concentration (3.5-4.5 g/dl) represents about 60% of the total plasma protein. Only 25-40% of whole albumin belongs to the intravascular pool, the majority is distributed in the interstitial space especially of the skin. Main physiological effects of plasmatic albumin are the control of the plasmatic volume by preservation of the colloid oncotic pressure (COP) and the plasmatic transport including the binding of drugs. ⋯ For prevention of interstitial pulmonary oedema, a COP of 15-20 mmHg should be achieved. Up to now, no clinical study verified a positive effect of albumin substitution regarding outcome or incidence of complications in intensive-care patients. Thus, an albumin therapy to maintain a COP of 15-20 mmHg in intensive-care patients is only recommended if a capillary leak is unlikely and the dose limits of synthetic colloids are attained.(ABSTRACT TRUNCATED AT 250 WORDS)
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The incidence, epidemiology, and pathophysiology of drowning and near-drowning are presented. Particular attention is paid to the neurologic and pulmonary pathophysiology indicators for monitoring and laboratory tests. Special attention to transportation of patients is given, and treatment in the field, emergency department, and pediatric intensive care unit is delineated.