Intensive care medicine
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Intensive care medicine · Dec 2001
Comparative StudyGastric mucosal systemic partial pressure of carbon dioxide (PCO(2)) gradient in experimental endotoxin shock in swine--comparison of two methods.
Clinically applicable methods for continuous monitoring of visceral perfusion/metabolism do not exist. Gastric mucosal end-tidal partial pressure of carbon dioxide (PCO(2)) gradient has been used, but it has limitations, especially in patients with lung injury and increased dead space ventilation. We studied the agreement between gastric mucosal end-tidal (DPCO(2gas)) and gastric mucosal arterial PCO(2) (D((t-a))PCO(2)) gradients, and especially the effect of dead space ventilation (V(d)/V(t) ratio) on the agreement. We hypothesized that DPCO(2gas) can be used as a semi-continuous indicator of mucosal arterial PCO(2) gradient in sepsis. ⋯ DPCO(2gas) is a clinically applicable method for continuous monitoring of visceral perfusion/metabolism. Septic lung injury and increased dead space ventilation decrease the accuracy of the method, but this may not be clinically important.
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Intensive care medicine · Dec 2001
Using the EuroQol-5D to measure changes in quality of life 12 months after discharge from an intensive care unit.
To compare changes in the health-related quality of life (HRQOL) of critical care patients by diagnostic category. ⋯ The degree and direction of change in ICU patients' HRQOL 1 year after discharge depends considerably on diagnostic category. Proxy responses can be reliably used with the EQ-5D when measuring change in HRQOL.
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Intensive care medicine · Dec 2001
CD64 surface expression on neutrophils is transiently upregulated in patients with septic shock.
To clarify the changes in total leukocyte counts, CD64 neutrophil receptor expression and serum granulocyte colony-stimulating factor (G-CSF) concentrations in critically ill patients without infection and sepsis and in patients with septic shock. ⋯ Decreased neutrophil CD64 expression in an acutely ill population with septic shock may reflect the development of a non-responsive state as well as the early downregulation of neutrophil activation prior to the resolution of an ongoing infection.
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Intensive care medicine · Dec 2001
Mask mechanics and leak dynamics during noninvasive pressure support ventilation: a bench study.
To study the mask mechanics and air leak dynamics during noninvasive pressure support ventilation. ⋯ P(mask-fit) and P(mask-occl) can be easily measured in pneumatic cushioned masks and the data obtained may be useful to guide mask fit and inspiratory pressure set during noninvasive positive pressure ventilation.
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(1) To demonstrate that metabolic parameters are better indicators of tissue hypoxia than regional and whole oxygen consumption (VO(2)). (2) To compare intramucosal pH (pHi) in different gastrointestinal segments. ⋯ During hemorrhage, systemic and intestinal VO(2) remained stable. However, hyperlactatemia and intramucosal acidosis evidenced anaerobic metabolism. pHi changes paralleled in the three intestinal segments.