Critical care medicine
-
Critical care medicine · Aug 1998
Comparative StudyDetermination of cardiac output during mechanical ventilation by electrical bioimpedance or thermodilution in patients with acute lung injury: effects of positive end-expiratory pressure.
To evaluate the usefulness of transthoracic electrical bioimpedance in sedated and paralyzed patients with acute lung injury during mechanical ventilation with and without early application of positive end-expiratory pressure (PEEP). ⋯ In patients with acute lung injury: a) the agreement between TEB-CO and TD-CO measurements is poor; b) agreement is not clinically improved by application of PEEP; and c) TEB cannot monitor trends in CO.
-
Critical care medicine · Aug 1998
Comparative StudyImportance of the sampling site for measurement of mixed venous oxygen saturation in shock.
To determine if oxyhemoglobin saturation in blood samples taken from the superior vena cava or right atrium can be substituted for oxyhemoglobin saturation in blood taken from the proximal pulmonary artery (SVO2) in patients in shock. ⋯ These wide range differences and confidence limits would lead to large errors if superior vena cava or right atrial oxyhemoglobin saturations were substituted for true mixed venous blood in oxygen transport or pulmonary venous admixture calculations, or if clinical decision making was based on individual results. In patients in shock in whom clinical decisions may be based on the value of mixed venous oxyhemoglobin, oxyhemoglobin saturation is only reliably measured in samples taken from the pulmonary artery.
-
Critical care medicine · Aug 1998
Comparative StudySevere depression of host immune functions following closed-bone fracture, soft-tissue trauma, and hemorrhagic shock.
To determine the contribution of soft-tissue trauma plus hemorrhage, bone fracture and hemorrhage, as well as the contribution of bone fracture, soft-tissue trauma and hemorrhage on host immune function. ⋯ The combination of closed-bone fracture and soft-tissue trauma before hemorrhage leads to even more compromised immunity than either soft-tissue trauma or closed-bone fracture along with hemorrhage. The markedly depressed immune function following bone injury, soft-tissue trauma, and hemorrhagic shock may contribute to the increased susceptibility of severely injured patients to sepsis and the ensuing multiple organ failure in the clinical situation.
-
Critical care medicine · Aug 1998
Editorial CommentContinuous cardiac output: how accurate and how timely?
-
Critical care medicine · Aug 1998
Editorial CommentEfficacy of buffers in the management of cardiac arrest.