Critical care medicine
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Critical care medicine · Oct 1996
Multicenter Study Comparative StudyA comparison of risks and outcomes for patients with organ system failure: 1982-1990.
To compare the outcomes for patients with one or more organ system failures treated in 1988 to 1990 with those outcomes from 1979 to 1982; to document risk factors for developing organ system failure; and investigate the relationship of these factors to hospital survival. ⋯ Organ system failure remains a major contributor to death in patients in ICUs. The incidence and overall outcome have not significantly changed over the past 8 yrs, but there has been significant improvement in survival for patients with persistent severe organ system failure. A continuous measure of individual patient severity of illness is a more sensitive and accurate method for describing patients and estimating outcome than counting the number of organ system failures.
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Critical care medicine · Oct 1996
Randomized Controlled Trial Clinical TrialDexamethasone for the prevention of postextubation airway obstruction: a prospective, randomized, double-blind, placebo-controlled trial.
To determine whether dexamethasone prevents postextubation airway obstruction in young children. ⋯ Pretreatment with dexamethasone decreases the frequency of postextubation airway obstruction in children.
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Critical care medicine · Oct 1996
Comparative StudyA comparison of the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Trauma-Injury Severity Score (TRISS) for outcome assessment in intensive care unit trauma patients.
To assess the ability of the Acute Physiology and Chronic Health Evaluation (APACHE II) system and Trauma-Injury Severity Scoring (TRISS) system in predicting group mortality in intensive care unit (ICU) trauma patients. ⋯ Both APACHE II and TRISS scores were shown to accurately predict group mortality in ICU trauma patients. APACHE II and TRISS may be utilized for quality assurance in ICU trauma patients. However, neither APACHE II nor TRISS provides sufficient confidence for prediction of outcome of individual patients.
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Critical care medicine · Oct 1996
Extramyocardial acidosis impairs cardiac resuscitability in isolated, perfused, rat hearts.
Patients suffering out-of-hospital cardiac arrest have various degrees of acidemia when cardiopulmonary resuscitation is initiated. Myocardial hypercarbia, rather than decreases in myocardial pH, may determine cardiac resuscitability. Accordingly, we questioned whether different degrees of acidemia accompanying cardiac arrest affect cardiac resuscitability. We evaluated the effect of different degrees of extramyocardial acidosis on cardiac performance and resuscitability after ventricular fibrillation using isolated, perfused, rat hearts. ⋯ Extramyocardial acidosis below pH 7.1 decreased cardiac performance and resuscitability after ventricular fibrillation. This result indicates that progressive acidemia during cardiac arrest is one of the important determinants of cardiac resuscitability.
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Critical care medicine · Oct 1996
Dopaminergic receptor-mediated effects in the mesenteric vasculature and renal vasculature of the chronically instrumented newborn piglet.
To determine the effects of stimulation of vascular dopaminergic receptor subtype 1 (dopamine-1) receptors in the renal and mesenteric vascular beds of a neonatal model. ⋯ These data demonstrate the absence of dopaminergic receptor-mediated vasodilation in the porcine neonatal renal vascular bed. In the mesenteric artery, dopamine-1 receptor-mediated vasodilation may be obtained. Dopamine itself, probably because of stimulation of other receptors, causes renal artery vasoconstriction and does not increase superior mesenteric artery blood flow.