Critical care medicine
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Critical care medicine · Feb 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of propofol and midazolam for sedation in intensive care unit patients.
To evaluate the comparative safety and effectiveness of intravenous infusion of propofol or midazolam when used for 12 to 24 hrs of sedation and to evaluate the quality of sedation during stimulation. ⋯ Propofol was as safe and as efficacious as midazolam for continuous intravenous sedation. The quality of sedation was better in the propofol group.
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To review the evolution and development of mortality risk prediction methods as they have been applied to the management of septic patients. ⋯ Severity of illness scoring systems are widely used in critically ill patients. However, their use in patients with sepsis has largely been limited to a means of stratification in clinical trials. As newer sepsis therapies become available, it may be possible to use such systems for refining their indications, and monitoring their utilization. Finally, as the databases supporting the systems increase in size and complexity, it may be possible to utilize them in clinical decision-making.
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Critical care medicine · Feb 1995
Pentoxifylline prevents a decrease in arterial oxygen tension in oleic acid-induced lung injury.
a) To determine whether pentoxifylline has a preventive effect on the decrease in PaO2 that is caused by oleic acid, and whether pentoxifylline facilitates normalization of PaO2 from the decreased state. b) To examine whether pentoxifylline can attenuate an increase in pulmonary vascular permeability that is induced by oleic acid. ⋯ Pentoxifylline is a noteworthy drug that could be a candidate as a therapy to help prevent hypoxemia in lung injuries that share a common mechanism with oleic acid-induced lung injury.
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Critical care medicine · Feb 1995
Hypertonic saline-dextran resuscitation from hemorrhagic shock induces transient mixed acidosis.
To evaluate the magnitude and mechanism of potential metabolic acidosis after resuscitation with 7.5% sodium chloride/6% dextran-70. ⋯ Hypertonic saline/dextran caused an immediate, transient acidemia, which was primarily due to a hyperchloremic, hypokalemic, metabolic acidosis with normal anion gap and decreased inorganic strong ion difference, but which was partially due to a mild transient respiratory acidosis. The acidemia was transient because of the offsetting alkalotic effects of decreasing serum protein, normalization of electrolytes, and transient nature of the increase in CO2. Lactic acidosis was not the cause of the acidemia. Over time, the acid-base status appeared to be improved more effectively with hypertonic saline/dextran than with isotonic saline resuscitation.