Articles: critical-care.
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Anesteziol Reanimatol · Jul 1990
Comparative Study[Extracorporeal detoxification (hemosorption, plasmapheresis and plasma exchange) in the intensive therapy of hemolytic disorders].
Extracorporeal detoxication techniques (hemosorption, plasmapheresis and plasma exchange) were used in a complex therapy of 55 patients with hemolytic disorders of different etiology. The results of clinical and laboratory studies confirm the efficacy of plasmapheresis. Skin surfaces and mucosa became less icteric, the size of the spleen and liver diminished, the levels of free hemoglobin, bilirubin and circulating immune complexes decreased, blood toxicity reduced. Unlike hemosorption, plasmapheresis and plasma exchange had no unfavourable effects on blood cells.
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Randomized Controlled Trial Clinical Trial
Albumin supplementation in the critically ill. A prospective, randomized trial.
Albumin replacement to correct hypoalbuminemia in critically ill patients has been controversial. This study was a prospective, randomized trial of 25% albumin administration in 40 hypoalbuminemic (serum albumin, less than 25 g/L [2.5 g/dL]), critically ill patients. ⋯ There were also no significant differences in length of hospital stay, intensive care unit stay, ventilator dependence, or tolerance of enteral feeding, despite significant elevations of albumin in the treatment group. The costly use of exogenous albumin as treatment for hypoalbuminemia in this patient population does not appear to be justified.
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Pediatric emergency care · Jun 1990
Critical care interhospital transports: predictability of the need for a pediatrician.
The Children's Hospital of Alabama Critical Care Transport System provides a mobile intensive care unit for interhospital transfer of critically ill pediatric patients. The transport team consists of a pediatrician, a pediatric emergency nurse, and a respiratory therapist. We studied whether it was possible to determine in advance whether it was always necessary for a physician to be on the team. ⋯ Therefore, an accurate prediction of need for a physician was possible in advance. Of the remaining transports in which the determination was significantly changed, 37 (25%) indicated a decrease in actual need for a physician after completion of the transport. There was a significant increase over the prediction in the actual need for a physician in only three cases (2%).