Articles: critical-care.
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Critical care medicine · Feb 1989
Comparative StudyComparison of hydroxyethyl starch and lactated Ringer's solution on hemodynamics and oxygen transport of critically ill patients in prospective crossover studies.
The cardiopulmonary effects of lactated Ringer's solution (RL) were compared with those of 10% hydroxyethyl starch, hetastarch (HES), given in 44 therapeutic interventions in 15 critically ill patients by crossover design. Each agent was given to each patient at least once; seven patients received each agent twice. ⋯ HES 10% produced significantly increased cardiac index, left and right ventricular stroke work index, CVP, WP, oxygen delivery, oxygen consumption, and reduced pulmonary vascular resistance index (PVRI). RL increased CVP, WP, and PVRI, but did not significantly improve other hemodynamic or oxygen transport variables.
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We evaluated five microprocessor-controlled critical care ventilators from five manufacturers. We rated three units Acceptable and two units Conditionally Acceptable, basing our ratings primarily on performance, safety, monitoring features, specific deficiencies, and ergonomic and human factors design. Because of differences in clinical practice and patient populations, we recommend that purchasing decisions be based on clinical trials conducted on the full range of patients for whom the ventilator will likely be used.
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82 patients treated at a ward of anaesthesiology and resuscitation had 330 renal function tests performed using a computerized programme. While glomerular functions were often preserve or even increased, tubular functions displayed a broad spectrum of disorders. --Nosocomial effects may have a significant role to play there. ⋯ Tubular osmotic diuresis and overflow osmotic diuresis are the most frequent types of diuresis, while lower frequency is seen in water diuresis, mixed water and tubular osmotic diuresis, and mixed overflow and tubular osmotic diuresis. The therapeutical effects of the incidence of overflow osmotic diuresis and wider use of aldosterone antagonists are discussed.