Articles: critical-care.
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British heart journal · Feb 1992
Randomized Controlled Trial Comparative Study Clinical TrialDetermination of cardiac output by an angle and diameter independent dual beam Doppler technique in critically ill infants.
To compare cardiac output measurements in critically ill infants by the dual beam Doppler and thermodilution techniques. ⋯ The dual beam Doppler technique was shown to have promise for the non-invasive determination of cardiac output in critically ill infants.
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To review the physiology of the chloride ion and its relationship to various disease states encountered in the ICU. Special emphasis was paid to the renal handling of chloride and its role in the evaluation of the urine and serum anion gaps. Metabolic acidosis and alkalosis are discussed. ⋯ Measurement of chloride is a valuable tool in the evaluation and treatment of a variety of disorders. Serum chloride is most helpful in assessing both normal and increased anion gap metabolic acidoses, while urine chloride finds utility in the diagnosis of metabolic alkalosis and hyperchloremia metabolic acidosis. The evaluation of any disturbance in chloride homeostasis that defies easy explanation necessitates the measurement of stool electrolytes.
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Randomized Controlled Trial Clinical Trial
2% propofol for sedation in the intensive care unit. A feasibility study.
A 2% solution of propofol has been compared with the 1% formulation for sedation in patients whose lungs were being mechanically ventilated in an intensive care unit following coronary artery bypass surgery. There were no significant differences in the amount of propofol used in the two groups, the rate of propofol infusion or the number of changes made to the infusion rate to maintain the desired level of sedation. ⋯ The mean heart rates of those receiving 2% propofol were significantly higher throughout the period of the study for no apparent reason. Propofol 2% was found to be safe, easy to administer and a practical alternative to the 1% solution for sedating cardiac surgical patients.
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Elderly patients who enter the critical care setting have special nursing care needs based on the physiologic changes of aging. An overview of the changes of aging associated with the immunologic, cardiovascular, integumentary, musculoskeletal, and renal systems provides the basis for care planning to meet the needs of older adults in the intensive care unit.
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Mayo Clinic proceedings · Feb 1992
Outcome of recipients of bone marrow transplants who require intensive-care unit support.
To determine the outcome and prognostic factors associated with bone marrow transplantation (BMT), we reviewed the clinical course of 35 adult recipients of such a transplant who were admitted to our intensive-care unit (ICU). This constituted 24% of patients who underwent BMT for treatment of hematologic disorders during the study period. The reasons for admission to the ICU were postsurgical care in 5, respiratory failure in 25, shock in 4, and renal failure in 1. ⋯ The APACHE II (acute physiology and chronic health evaluation) prognostic scoring system underestimated mortality and had no correlation with the duration of stay in the ICU or the hospital. Vasopressors, total parenteral nutrition, and transfusion of blood components in the ICU had no influence on the outcome. Open-lung biopsy was helpful in making specific diagnoses, and pulmonary artery catheters were used in most patients to guide therapy but did not improve survival.(ABSTRACT TRUNCATED AT 250 WORDS)