Journal of critical care
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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.
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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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Journal of critical care · Jun 1994
Implications of a biphasic two-compartment model of constant flow ventilation for the clinical setting.
To investigate the theoretical effects of changing frequency (f), duty cycle (D), or end-inspiratory pause length on the distribution of ventilation and compartmental pressure in a heterogeneous, two compartment pulmonary model inflated by constant flow. ⋯ In a linear, two compartment model of the respiratory system, disparity of compartmental end-expiratory pressures is the primary mechanism by which changes of f, D, or pause alter the distribution of ventilation during inflation with constant flow. Ventilation is less evenly distributed than peak alveolar pressure, and there are limits to the beneficial effects on the distribution of ventilation to be gained from manipulations of machine settings.
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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
Hemodynamic effects following injection of venom from the scorpion Leiurus quinquestriatus.
The present study tested the hypothesis that scorpion sting induces left ventricular (LV) hypokinesia and myocardial ischemia shortly after injection due to reduction of coronary blood flow (CBF) and increased oxygen demand. ⋯ Myocardial ischemia does not occur in this dog model immediately following administration of scorpion venom. There are significant peripheral circulatory effects of the venom, which account for many of the hemodynamic changes.