Articles: critical-illness.
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Critical care medicine · May 1992
Dobutamine pharmacokinetics and pharmacodynamics in pediatric intensive care patients.
To evaluate the pharmacokinetics and pharmacodynamics of dobutamine in critically ill children. ⋯ There was no effect of plasma dobutamine concentration or infusion rate on plasma clearance rate. For this group of patients, over the range of the intravenous doses studied, dobutamine pharmacokinetics followed a first-order kinetic model. Threshold values for dobutamine usually show increases in cardiac output before changes in heart rate. These data demonstrate that dobutamine is an effective inotropic agent in critically ill pediatric patients and has minimal chronotropic action.
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Critical care medicine · Apr 1992
Comparative StudyComparison of gastric intramucosal pH with measures of oxygen transport and consumption in critically ill patients.
To determine the relationship of tonometrically measured gastric intramucosal pH to clinically accepted indices of systemic oxygenation. ⋯ In this group of patients, death was associated with increased tissue needs for oxygen that were not adequately satisfied by the available levels of oxygen supply. We also conclude that tonometrically measured gastric intramucosal pH is a useful noninvasive adjunct to current methods of monitoring systemic oxygenation.
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Critical care medicine · Apr 1992
Ventilation/perfusion indices do not correlate with the difference between oxygen consumption measured by the Fick principle and metabolic monitoring systems in critically ill patients.
To determine whether the difference between oxygen consumption (VO2) measured by metabolic gas monitoring systems and by the Fick principle is related to venous admixture, deadspace/tidal volume ratio, or alveolar-arterial oxygen tension gradient in critically ill patients. ⋯ If the difference in VO2 measured by metabolic gas monitoring systems and the Fick principle is due to intrapulmonary VO2 then in critically ill patients the ventilation/perfusion indices of venous admixture, deadspace/tidal volume ratio and alveolar-arterial oxygen tension gradient correlate poorly with intrapulmonary VO2.
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Surg Gynecol Obstet · Mar 1992
Randomized Controlled Trial Clinical TrialTolerance to enteral tube feeding diets in hypoalbuminemic critically ill, geriatric patients.
Tolerance of elemental (for example, Peptamen [PEP]) or free amino acid (for example, Vivonex TEN [VIV]) tube feeding diets is controversial, especially in the critically ill patient who is hypoalbuminemic. A prospective, randomized trial was conducted to compare differences between feeding PEP (n = 8) or VIV (n = 8) in critically ill, elderly (average age of 66 years) patients. Diets were administered through nasogastric or postpyloric feeding tubes. ⋯ Serum albumin concentrations upon initiation of the diets were 2.3 grams per deciliter in both groups. We conclude that tolerance to the two diets were similar because it was possible to feed enterally either PEP or VIV in critically ill, hypoalbuminemic patients (serum albumin concentrations of less than 2.5 grams per deciliter) successfully, irrespective of diet. Although there were more stools in the VIV group, this did not reduce compliance with the goals.