Articles: critical-care.
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Infusionsther Klin Ernahr · Feb 1986
[Reactions of critically ill patients to volume therapy with hydroxyethyl starch (6% HES 450/0.7)].
At 31 critically ill surgical patients who on clinical grounds required fluid therapy, hemodynamic and oxygen transport, responses were measured after volume expansion with 500 ml 6% HES 450/0,7. There were statistically significant increases in cardiac index (CI) from 3,5 +/- 2,1 to maximal values of 4,4 +/- 0,2 (l/min/m2) and in wedge pressure (WP) from 9,3 +/- 0,7 to maximal values of 13,6 +/- 0,8 (mm Hg) and a significant reduction of systemic vascular resistance index (SVRI) from 2018 +/- 128 to 1641 +/- 102 (dynsec/cm5 m2). There were also observed statistically significant maximal increases of left ventricular stroke work index (LVSWI) from 41 +/- 3,1 to 53 +/- 3,2 (gm/m2) of oxygen delivery (DO2) from 489 +/- 24 to 587 +/- 29 (ml/min/m2) and of oxygen consumption (VO2) from 111 +/- 6 to 130 +/- 7 (ml/min/m2) which took place at the time of the maximum CI-increase. Moreover MAP-, CI- and VO2-responses of patients were stratified according to clinical conditions like time of operation, age, prognosis, ARDS, sepsis, hyperdynamic- and blood volume status.
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The use of computer-based care-oriented physiologic evaluation is still in its developmental stage. However, it seems likely that the capability of computer-based applications to critically ill patients are such that quality and cost-effective intensive care can be delivered in a timely and expeditious fashion. This application has a high promise of helping to reduce the mortality and morbidity of the critically ill or injured surgical patient, now and in the future.