Critical care medicine
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Critical care medicine · Dec 1999
Randomized Controlled Trial Comparative Study Clinical TrialComparison of two semicontinuous cardiac output pulmonary artery catheters after valvular surgery.
To compare semicontinuous cardiac output (CCO) with bolus cardiac output (BCO), in the immediate postoperative period after valvular surgery, under hypothermic cardiopulmonary bypass with two CCO pulmonary artery catheters, based on the pulsed warm thermodilution technique, i.e., Opti-Q from Abbott or IntelliCath from Baxter-Edwards (Abbott and Baxter groups, respectively). ⋯ This study, during the immediate postoperative period in valvular surgery under hypothermic cardiopulmonary bypass, showed a satisfactory correlation between CCO and BCO with the two systems.
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Critical care medicine · Dec 1999
Comparative StudyVascular hyporesponsiveness of the renal circulation during endotoxemia in anesthetized pigs.
To compare the vascular reactivity of the renal circulation in control and septic conditions. ⋯ This study shows a hyporesponsiveness of the renal circulation to vasoactive agents during endotoxemia. Vasoconstriction to NE, endothelium-dependent as well as endothelium-independent relaxations are altered during endotoxemia but not abolished, and despite the continuous infusion of endotoxin for 18 hrs, no recovery was observed over time.
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Critical care medicine · Dec 1999
Randomized Controlled Trial Comparative Study Clinical TrialA randomized comparison of ketorolac tromethamine and morphine for postoperative analgesia in critically ill children.
To evaluate the efficacy of a single dose of ketorolac compared with morphine for the relief of pain in children, and to determine the safety of ketorolac. ⋯ Ketorolac is comparable to morphine in relief of postoperative pain in children. A single dose of ketorolac does not result in abnormal postoperative bleeding or alter renal function. However, ketorolac may cause nausea and vomiting in some patients.
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Critical care medicine · Dec 1999
ReviewDoes bicarbonate therapy improve the management of severe diabetic ketoacidosis?
The use of bicarbonates in the treatment of severe diabetic ketoacidosis remains controversial, especially regarding the benefit/risk ratio. The aim of this study was to assess the efficacy of bicarbonate therapy during severe diabetic ketoacidosis (pH <7.10). ⋯ Data from the literature and this study are not in favor of the use of bicarbonate in the treatment of diabetic ketoacidosis with pH values between 6.90 and 7.10.
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Critical care medicine · Dec 1999
Role of the splanchnic circulation in acid-base balance during cardiopulmonary bypass.
The role of the splanchnic circulation in the development of the metabolic acidosis of cardiopulmonary bypass (CPB) is not fully understood. New quantitative methods of acid-base balance now offer the ability to define this phenomenon more accurately. Accordingly, we studied acid-base changes across the splanchnic circulation during CPB and defined and quantified the factors that contributed to acid-base balance. ⋯ Using quantitative biophysical methods it can be demonstrated that the splanchnic circulation does not contribute to the metabolic acidosis of CPB, and that it continues to have a metabolic alkalinizing effect involving significant lactate extraction. However, its respiratory acidifying effect continues, although at a reduced rate.