Critical care medicine
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Critical care medicine · Jun 1996
Comparative StudyPrivate attending physician status and the withdrawal of life-sustaining interventions in a medical intensive care unit population.
To assess the influence of private attending physician status on the withdrawal of life-sustaining interventions among patients dying within a medical intensive care unit (ICU). ⋯ Among patients dying within a medical ICU, those patients without a private attending physician are more likely to undergo the active withdrawal of life-sustaining interventions.
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Critical care medicine · Jun 1996
Comparative StudyProspective, controlled study of the outcome of human immunodeficiency virus-1 antibody-positive children admitted to an intensive care unit.
Intensive care resources are both scarce and costly in South Africa. We set out to ascertain whether human immunodeficiency virus (HIV) status affects the spectrum of disease and the prognosis in children treated in pediatric intensive care units (ICUs). ⋯ Outcome in children with AIDS admitted to the pediatric ICU was significantly worse than the outcome in HIV-uninfected children. However, the number of AIDS patients studied was small. HIV antibody-positive children without AIDS do as well as uninfected controls. Ethics committees in resource-constrained countries may be assisted by such data when making difficult decisions on the admissions of HIV-infected patients to pediatric ICU facilities.
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Critical care medicine · Jun 1996
Myocardial dysfunction after successful resuscitation from cardiac arrest.
To investigate the functional and metabolic changes in the myocardium after successful resuscitation from cardiac arrest. ⋯ Postresuscitation myocardial dysfunction in this animal model was characterized by impaired contractile function, decreased work capability, and ventricular dilation.
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Critical care medicine · Jun 1996
Selective brain cooling in infant piglets after cardiac arrest and resuscitation.
To test the hypothesis that selective brain cooling could be performed in an infant model of cardiac arrest and resuscitation without changing core temperature and to study its acute effects on regional organ blood flow, cerebral metabolism, and systemic hemodynamics. ⋯ Selective brain cooling by surface cooling can be achieved rapidly in an infant animal model of cardiac arrest and resuscitation without changing core temperature. Brain temperatures known to improve neurologic outcome can be achieved by this technique with minimal adverse effects. Because of its ease of application, selective brain cooling may prove to be an effective, inexpensive method of cerebral resuscitation during pediatric CPR.
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Critical care medicine · Jun 1996
Comparative StudyIntraosseous resuscitation of hemorrhagic shock in a pediatric animal model using a low sodium hypertonic fluid.
To study the efficacy of a low sodium hypertonic resuscitation fluid for resuscitation of severe hemorrhage in a pediatric animal, using the intraosseous route. ⋯ Isosal solution was as effective as hypertonic saline in "small volume" resuscitation of severe hemorrhagic shock in a pediatric animal model through the intraosseous route, and produced significantly less hypernatremia when compared with hypertonic saline.