Critical care medicine
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Critical care medicine · May 1998
Left ventricular performance following the arterial switch operation: use of noninvasive wall stress analysis in the postoperative period.
To determine postoperative left ventricular mechanics following the arterial switch operation (ASO). ⋯ Left ventricular performance is impaired in infants during the period immediately following the ASO. A persistent preload deficit closely matches the pattern of impaired ventricular performance. Decreased IVRT points to impaired ventricular compliance as the etiology of the altered preload. In contrast, left ventricular contractility remains normal in the majority of post-ASO patients. Decreased contractility may account for impaired ventricular performance in selected cases.
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Critical care medicine · May 1998
Case ReportsProtein C in the treatment of coagulopathy in meningococcal disease.
To evaluate the clinical and laboratory effects of the substitution of protein C (PC) as an adjunct to conventional therapy in the treatment of purpura fulminans associated with meningococcal sepsis. ⋯ The administration of PC had a beneficial effect on coagulopathy and peripheral gangrene formation associated with meningococcal disease and showed no adverse effects.
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Critical care medicine · May 1998
Comment Letter Review Case ReportsRecombinant tissue plasminogen activator restores perfusion in meningococcal purpura fulminans.
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Critical care medicine · May 1998
Randomized Controlled Trial Comparative Study Clinical TrialEffects of isoenergetic glucose-based or lipid-based parenteral nutrition on glucose metabolism, de novo lipogenesis, and respiratory gas exchanges in critically ill patients.
To compare the effects of isocaloric, isonitrogenous carbohydrate nutrition vs. lipid-based total parenteral nutrition on respiratory gas exchange and intermediary metabolism in critically ill patients. ⋯ The rate of glucose administration commonly used during TPN of critically ill patients does not suppress endogenous glucose production or net protein loss, but markedly stimulates de novo lipogenesis and CO2 production. Increasing the proportion of fat may be beneficial, provided that lipid emulsion has no adverse effects.
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Critical care medicine · May 1998
Review Comparative StudyComplications of sedation with midazolam in the intensive care unit and a comparison with other sedative regimens.
To describe the various complications that have been reported with use of midazolam for sedation in the intensive care unit (ICU). ⋯ Continuous infusion midazolam provides effective sedation in the ICU with few complications overall, especially when the dose is titrated.