Articles: critical-illness.
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Intensive care medicine · Jan 1993
ReviewEnteral nutrition in the critically ill patient: a critical review of the evidence.
To examine the relationship between enteral nutrition (EN) and infection in the critically ill. ⋯ Evidence from experimental data in critically ill patients suggests that enteral nutrition may have a favourable impact on gastrointestinal immunological function and infectious morbidity.
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Critical care medicine · Jan 1993
Comparative StudyPharmacokinetics of exogenous epinephrine in critically ill children.
This study was designed to determine the steady-state plasma concentrations and clearance rates of epinephrine in critically ill children, to examine if epinephrine pharmacokinetics conform to a linear model, and to compare epinephrine clearance rates with clearance rates of dopamine and dobutamine. ⋯ Epinephrine infusions produce pharmacologic plasma concentrations of epinephrine in critically ill children. The plasma concentration of epinephrine correlates with the infusion rate, suggesting linear pharmacokinetics. Epinephrine clearance rates in critically ill children appear to be lower than the reported clearance rates in healthy adults. The clearance rates of two other inotropic catecholamines, dopamine and dobutamine, are significantly correlated with the clearance rate of epinephrine.
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Randomized Controlled Trial Clinical Trial
Effects of iced and room temperature injectate on cardiac output measurements in critically ill patients with low and high cardiac outputs.
To determine the effect of injectate temperature (iced or room temperature) on cardiac output values in critically ill adults with low and high cardiac outputs. ⋯ Although research is clearly needed to substantiate these findings, we suggest that nurses use iced injectate in patients with low and high cardiac outputs (< or = 3.5 L/min or > or = 8.0 L/min) to ensure accurate measurement of cardiac output.
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A review of nursing research into the impairment of sleep in the critically ill is presented. The author asserts that in order to fully explicate the phenomena from a nursing perspective, research is needed that focuses upon the meaning of the phenomenon to the patient.
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Blood or plasma glucose concentration can be measured accurately and rapidly. However, after a glucose challenge metabolism may modify glucose kinetics, so that glucose has not been used as an indicator for dilution volumetry. To test the hypothesis that the initial distribution volume of glucose (IDVG) reflects cardiac output rather than glucose metabolism in the critically ill, the relationship between IDVG and thermodilution cardiac output was evaluated at 27 points in 13 non-surgical, critically ill patients without congestive heart failure. ⋯ Correlations were obtained between the IDVG and cardiac output (r = 0.89, n = 27, P < 0.001), and between the incremental plasma glucose concentrations three minutes after the injection and the IDVG (r = 0.94, n = 27, P < 0.001). No difference was found between the IDVG with or without continuous insulin infusions. The results indicate that the IDVG reflects cardiac output rather than glucose metabolism in patients without congestive heart failure.