Critical care medicine
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Critical care medicine · Jun 1993
Multicenter StudyPostoperative utilization of critical care services by cardiac surgery: a multicenter study in the Canadian healthcare system.
To describe patterns of critical care services used after cardiac surgery and to evaluate whether variations in the process of care influence outcome. ⋯ Significant differences exist among hospitals in the same healthcare system in the utilization of critical care services for cardiac surgery. In spite of these differences, for similar patient "input," the outcome (mortality and hospital lengths of stay) appeared similar. Assessments of utilization of critical care must focus on more detailed specific issues than unit length of stay, and must include factors such as availability of intermediate care areas, the unit management system, chronic health status, and the operative procedures performed, if a utilization management process is to effect improved resource use in critical care.
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Critical care medicine · Jun 1993
Comparative StudySimultaneous radial, femoral, and aortic arterial pressures during human cardiopulmonary resuscitation.
To examine the validity of interchanging arterial sites and their responses to graded doses of epinephrine during human cardiopulmonary resuscitation (CPR). ⋯ Radial artery relaxation-phase pressure, although statistically higher, correlated with aortic relaxation-phase pressure. Femoral artery relaxation-phase pressure was not statistically different from aortic relaxation-phase pressure. Aortic pressure was statistically higher and had a lower correlation with radial artery pressures during compression phase. The aortic to radial artery and aortic to femoral artery compression-phase gradients abated with increasing doses of epinephrine therapy. Caution must be used when substituting compression-phase pressure obtained at radial or femoral artery sites for aortic pressure during human CPR. Coronary artery perfusion pressures obtained with radial and femoral arteries correlate with aortic pressure when measuring the response to vasopressor therapy during CPR when an interpretable waveform exists.
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Critical care medicine · Jun 1993
Randomized Controlled Trial Clinical TrialA randomized, controlled trial of aminophylline in ventilatory weaning of premature infants.
To determine whether maximal inspiratory force predicts successful neonatal extubation, and whether aminophylline affects maximal inspiratory force or the success rate of extubation. ⋯ Aminophylline is an effective prophylaxis for postextubation apnea in the preterm infant but does not affect maximal inspiratory force or increase the success rate of extubation in this patient population.
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Critical care medicine · Jun 1993
Effects of accidental trauma on cytokine and endotoxin production.
To determine the effects of accidental injury of varying severity on interleukin (IL)-1 alpha, IL-6, IL-8, tumor necrosis factor-alpha (TNF-alpha), and endotoxin release. ⋯ These results demonstrate that severe injury produces rapid, large increases in circulating concentrations of IL-6 and IL-8 that may contribute to the frequent development of the adult respiratory distress syndrome and multiple organ system failure in this clinical setting.
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Critical care medicine · Jun 1993
Relationship between postoperative anemia and cardiac morbidity in high-risk vascular patients in the intensive care unit.
To determine if postoperative anemia is associated with postoperative myocardial ischemia and morbid cardiac events ⋯ This study suggests that postoperative anemia may play a role in postoperative myocardial ischemia and cardiac morbidity.