Journal of critical care
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Journal of critical care · Jun 1994
Review Randomized Controlled Trial Comparative Study Clinical TrialHepatotoxicity related to total parenteral nutrition: comparison of low-lipid and lipid-supplemented solutions.
Because it is unclear whether or not the lipid or carbohydrate component of total parenteral nutrition solutions determines the development of cholestasis during total parenteral nutrition, a prospective randomized clinical trial of a predominantly carbohydrate solution (group I) versus one with isocaloric substitution of 30% nonprotein calories with lipid (group II) was performed. ⋯ With these statistical considerations, we conclude that there was probably no statistically significant difference between the groups for an increase in AST or AP levels during total parenteral nutrition.
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The dose-response relationship of commercially available preparations of methohexital, pentobarbital, phenobarbital, and thiopental and their respective drug-free solutions on granulocyte function was investigated to evaluate whether suppression of neutrophil chemiluminescence is mediated by the barbiturates themselves or by their drug-free solutions. Furthermore, it was assessed whether suppression of chemiluminescence is due to an interaction mainly with neutrophils or to free radical scavenging. ⋯ With the exception of thiopental, barbiturates do not impair oxygen radical production during phagocytosis of neutrophils.
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Journal of critical care · Jun 1994
Clinical TrialUse of a mean systemic filling pressure analogue during the closed-loop control of fluid replacement in continuous hemodiafiltration.
To assess the use and validity of a mean systemic filling pressure analogue (Pmsa) in the closed-loop control of fluid replacement in continuous hemodiafiltration. ⋯ The stability of cardiovascular variables achieved during Pmsa-based fluid replacement of critically ill patients with major fluid losses supports the validity of the use of the Pmsa as a measure of intravascular volume status. Such an analogue may be useful in nondialytic environments. The use of Pmsa as the basis for automated fluid replacement was safe.
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Journal of critical care · Jun 1994
Effect of inhibition of nitric oxide release on the diaphragmatic oxygen delivery-consumption relationship.
In the vascularly isolated resting and contracting (3 Hz) canine hemidiaphragm, the hypothesis that nitric oxide (NO) is an important regulator of diaphragmatic O2 extraction was tested. ⋯ These results indicate that NO release is an important modulator of the tone of diaphragmatic resistance vessels, but it does not appear to regulate the processes by which O2 extraction is enhanced to compensate for decreased O2 delivery.
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Journal of critical care · Jun 1994
The effect of positive end-expiratory pressure on regional pulmonary perfusion during acute lung injury.
To determine whether positive end-expiratory pressure (PEEP) would change the altered regional pulmonary perfusion pattern caused by oleic acid (OA)-induced acute lung injury was the aim of this study. Our hypothesis was that fixed intravascular obstruction would not be affected by PEEP, leaving the perfusion pattern unchanged if this was the principal cause of perfusion redistribution after lung injury. ⋯ The reversibility with PEEP of the perfusion pattern caused by acute lung injury suggests that fixed intravascular obstruction is not the principal determinant of perfusion redistribution after OA-induced injury.