Articles: critical-care.
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Acta Anaesthesiol Belg · Jan 1990
Clinical evaluation of pulse oximetry monitors on critically ill patients.
Four pulse oximeters and two pulse oximeter-capnographs were evaluated on accuracy of measuring oxygen saturation and heartrate for the former and oxygen saturation, heartrate, respiratory rate and capnography for the latter. In the first part of the study four pulse oximeters (Criticare Systems Model 501 +, Ohmeda Biox 3700 Pulse Oximeter, Nellcor Model N 100 and Datex Satlite) were simultaneously studied on 10 ventilated ICU patients. Fifty simultaneous measurements were done for heartrate and oxygen saturation and compared to arterial saturations and ECG heartrates. ⋯ As in the first part of the study all results were accurate within two percent of control values. From those data we can conclude that all examined monitors were fairly accurate compared to simultaneous arterial blood gas analysis and ECG monitoring. The oxicap monitors have the advantage of giving continuous information on two very important parameters of patient monitoring: CO2 and saturation.
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Scand. J. Clin. Lab. Invest. Suppl. · Jan 1990
Case ReportsThe oxygen status of the arterial blood in the critically ill.
In Critical Care medicine the concepts of Oxygen Delivery, Oxygen Consumption and Tissue Oxygenation have become fundamental in clinical practice but measurements of Oxygen Content and O2 Transport variables require invasive procedures that could be dangerous for critically ill patients and trigger a septic process. Derived indices obtained combining data from a Blood Gas Analyzer with the data from a multi-wavelength spectrophotometer and using the Ole Siggaard-Andersen pH/Blood Gas computerised algorithm might be the non-invasive answer. On 115 arterial blood samples from critically ill patients, we measured pH, pCO2, pO2, oxygen saturation, total hemoglobin concentration and fractions of carboxy- and methemoglobin. ⋯ The correlation between p50 calculated by the Ole Sigaard-Andersen algorithm with that derived from classical formula shows the superiority of the findings obtained by means of the new algorithm. In critically ill patients the ODC is usually shifted to the right. The new parameters, pO2uv- and CQ, contain useful informations for clinical practise; but rapid changes in Cardiac Index (CI) and VO2/m2 can be ignored by the new algorithm, if these changes are not associated with a rise in ctO2 or pH and pCO2 changes.(ABSTRACT TRUNCATED AT 400 WORDS)
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Because of a good prenatal care eclampsia has been very seldom. But it is still a severe disease. By means of a case report vital symptoms and possible etiologic mechanisms are discussed. The meaning of an interdisciplinary intensive care and a subtle monitoring has been emphasized.
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Anesteziol Reanimatol · Jan 1990
Comparative Study[The efferent therapy of the critical state due to status asthmaticus].
A total of 200 patients with severe infection-induced bronchial asthma (BA) admitted to hospital with a diagnosis of status asthmaticus (SA) have been subjected to complex examination. It has been demonstrated that SA is a severe combined toxemia that leads to insensitivity of bronchial receptor apparatus to broncholytic effects and requires efferent therapy. 50 out of 130 patients with I to II and III degree SA were resistant to conventional intensive care procedures. ⋯ EHS ensures positive hemodynamic and detoxicating effects, removing "critical" concentration of toxic ligands that block broncholytic adrenoreception. The use of efferent therapeutic techniques in SA makes it possible to reduce the mortality rate, promote the condition arrest, relieve the critical condition, reduce the doses of broncho- and spasmolytics, glucocorticoids, facilitate future drug withdrawal, and reduce the duration of the patients' stay in intensive care units.
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The initial management of multiple trauma must achieve a triple aim: performing the actions required by a vital emergency, preventing as well as possible the complications associated with the initial lesions, and, most importantly, bringing the injured person into hospital in the best possible conditions for emergency surgery. Achieving these aims requires a perfect coordination of medical and nonmedical rescue. A rough initial categorization is important to decide whether additional medical staff is desirable, choose the type of transport planned (by ambulance, helicopter...) as well as the department or hospital due to receive the patient. ⋯ The indications of ventilatory support must be very wide whenever coma or signs of respiratory distress are noted, more so with an associated shock. The indications of aspiration of a gaseous or fluid pleural effusion must also be discussed. Maximal suppression of pain must be kept in mind throughout all these operations.(ABSTRACT TRUNCATED AT 250 WORDS)