Journal of critical care
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Journal of critical care · Dec 1997
Clinical TrialPreliminary clinical trial of an ex vivo arterial blood gas monitor.
The purpose of this study was to test the analytical performance of a new ex vivo arterial blood gas (ABG) monitor based on fiberoptic sensor technology (SensiCath; Optical Sensors, Inc., Minneapolis, MN) when operated by critical care practitioners in intensive care environments. ⋯ A practical ex vivo ABG monitor has been developed that offers accurate data and potential advantages to the critical care practitioner and the critically ill patient over other ABG analysis systems: one 10-minute calibration procedure; 1-minute analysis time; no permanent blood removal from the patient; and a closed arterial monitoring system. Precision performance is comparable to standard laboratory ABG analysis. The ABG monitor offers reliability and ease of use, and the ability of the critical care practitioner (nurse, respiratory therapist, or physician) to obtain accurate ABG analyses as needed at bedside.
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The purpose of this article was to determine the extent to which patients at high risk of hospital death who undergo cardiopulmonary resuscitation (CPR) have previously had their life support preferences addressed and documented. ⋯ Early communication regarding life-support preferences is important in high-risk patients so that inappropriate or unwanted treatment is not implemented. Given that optimal care includes addressing and documenting life-support preferences in high-risk patients early in their hospitalization, this standard was infrequently met.
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Journal of critical care · Dec 1997
Blood interleukin 10 levels parallel the severity of septic shock.
The aim of this study was to investigate the relation between interleukin (IL) 10, tumor necrosis factor alpha (TNF alpha), IL-1, and IL-6 levels in patients with septic shock and relate these cytokine levels to the development of organ failure. ⋯ Although IL-10 has an inhibitory effect on the production of cytokines, it is released together with TNF and IL-6 in patients with septic shock. IL-10 blood levels are directly related to the severity of inflammation and the development of organ failure in septic shock.
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Journal of critical care · Dec 1997
Pressure support ventilation in adult respiratory distress syndrome: short-term effects of a servocontrolled mode.
To assess the short-term effects of pressure support ventilation in adult respiratory distress syndrome (ARDS), we studied 17 patients with moderate to severe ARDS using mandatory rate ventilation (MRV), a servocontrolled mode of PSV having respiratory rate as the targeted parameter. ⋯ We conclude that (1) PSV delivered by MRV may adequately ventilate patients with moderate to severe ARDS, preserving gas exchange and hemodynamics, at least for the short period tested; (2) early and intermediate ARDS respond in a different manner to MRV in terms of breathing pattern, gas exchange, and level of pressure assistance; and (3) patients with early ARDS are those who have an improvement in intrapulmonary oxygenation probably due, at least in part, to alveolar recruitment augmented by active diaphragmatic contraction.
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Journal of critical care · Dec 1997
Randomized Controlled Trial Clinical TrialTreatment with N-acetylcysteine during acute respiratory distress syndrome: a randomized, double-blind, placebo-controlled clinical study.
Intravenous N-acetylcysteine (NAC) has been reported to improve systemic oxygenation and reduce the need for ventilatory support in patients with an acute lung injury. In the more serious form, namely established adult respiratory distress syndrome (ARDS) (PaO2/FIO2 < or = 200 mm Hg), we tested the hypothesis that treatment with intravenous NAC may be beneficial. ⋯ In this relatively small group of patients presenting with an established ARDS subsequent to a variety of underlying diseases, intravenous NAC treatment during 72 hours neither improved systemic oxygenation nor reduced the need for ventilatory support.