Critical care medicine
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Critical care medicine · May 1994
Ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit.
To evaluate the frequency and clinical correlates of ultrafilterable hypomagnesemia in neonates admitted to the neonatal intensive care unit (ICU). ⋯ Ultrafilterable hypomagnesemia is a common finding in neonates admitted to the ICU. Ultrafilterable hypomagnesemia is associated with the need for mechanical ventilation. To our knowledge, this is the first report of ultrafilterable magnesium concentrations in normal and sick neonates.
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Critical care medicine · May 1994
Effect of advanced cardiac life-support training in rural, community hospitals.
To define the effectiveness of training personnel in rural, community hospitals in advanced cardiac life support (ACLS) and the changes that result in the process and quality of care to patients with ischemic heart disease that can be attributed to participation by team members in an ACLS course. ⋯ Training directed to the entire team likely to participate in the provision of ACLS in the community hospital favorably affects the overall practice of ACLS and the survival rate of patients with ischemic heart disease.
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To examine the endogenous erythropoietin response in critically ill children with acute anemia or acute hypoxemia. ⋯ The erythropoietin response to known physiologic stimuli is blunted in critically ill children. This blunted erythropoietin response may result in increased transfusion requirements.
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Critical care medicine · May 1994
ReviewProlonged paralysis in intensive care unit patients after the use of neuromuscular blocking agents: a review of the literature.
To review the reports of prolonged neuromuscular blockade secondary to vecuronium and atracurium administration. To propose mechanisms for prolonged blockade, as well as methods to avoid prolonged blockade. ⋯ Controlled studies assessing the appropriate drug, administration method, use of drug in end-organ dysfunction, and monitoring techniques are unavailable. From the available case reports, length of neuromuscular blockade has been associated with end-organ dysfunction, concomitant drug use, severity of the underlying illness, length of therapy, monitoring techniques used, and perhaps method of drug administration. Steroidally based neuromuscular blocking agents may be particularly hazardous in patients receiving systemic corticosteroids. It is premature to determine the safety of one particular neuromuscular blocking drug in relation to another. Further studies are needed to optimize the use and safety of neuromuscular blocking agents in intensive care unit patients.
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To evaluate in the laboratory a new ventilator with a built-in monitoring function for gas exchange. ⋯ Assuming that limits of agreement for intermethod differences of +/- 20% are clinically acceptable, the VCO2 measurement indicates an acceptable accuracy and precision under controlled ventilation. The respective agreement for the VO2 measurement is lower, but still within the acceptable range. The systematic difference of the VO2 and the VCO2 is mainly influenced by a +8% bias in the inspiratory minute volume measurement, which seems especially susceptible to ventilator settings with inspiratory flow rates of < 50 L/min. An improvement of the minute volume detection would be desirable.