Critical care medicine
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Critical care medicine · Dec 1999
Comparative StudyComparison of intravenous and endotracheal epinephrine during cardiopulmonary resuscitation in newborn piglets.
To compare the efficacy of intravenous and endotracheal epinephrine administration, and intravenous administration above and below the diaphragm, during cardiopulmonary resuscitation in newborn piglets. ⋯ During cardiopulmonary resuscitation in newborn piglets, intravenous administration of epinephrine is more efficacious than endotracheal administration. Furthermore, efficacy is similar between femoral venous and right atrial administration.
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Critical care medicine · Dec 1999
Automated infusion of vasoactive and inotropic drugs to control arterial and pulmonary pressures during cardiac surgery.
To evaluate the feasibility of a closed-loop system for simultaneous control of systemic arterial and pulmonary artery blood pressures during cardiac surgery. ⋯ Closed-loop control of both arterial and pulmonary pressures using multiple drugs is feasible during cardiac surgery.
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Critical care medicine · Dec 1999
Comparative StudyConventional ventilation modes with small pressure amplitudes and high positive end-expiratory pressure levels optimize surfactant therapy.
High-frequency oscillation studies have shown that ventilation at high end-expiratory lung volumes combined with small volume cycles at high rates best preserves exogenous surfactant and gas exchange in lavaged lungs. We investigated whether surfactant composition and gas exchange can also be preserved by conventional modes of mechanical ventilation, which combine high levels of positive end-expiratory pressure (PEEP) with small pressure amplitudes. ⋯ We conclude that exogenous surfactant composition is preserved by conventional modes of mechanical ventilation that use small pressure amplitudes, and adequate oxygenation is maintained by high end-expiratory pressure levels. Effective carbon dioxide removal can be achieved by applying a ventilation mode that creates auto PEEP and not by a mode that applies the same level of PEEP by static PEEP only.
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Critical care medicine · Dec 1999
A quantitative assessment of how Canadian intensivists believe they utilize oxygen in the intensive care unit.
To investigate attitudes and practices regarding oxygen therapy in intensive care units (ICUs) and to devise quantitative descriptive indices. ⋯ Considerable variation exists in the attitudes, beliefs, and stated practices relating to the management of oxygen therapy in the ICU. These data are amenable to quantitative description and illustrate the necessity for documentation of actual practice and development of support systems for decision-making in this and similar areas.
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Critical care medicine · Dec 1999
Differential expression pattern of heme oxygenase-1/heat shock protein 32 and nitric oxide synthase-II and their impact on liver injury in a rat model of hemorrhage and resuscitation.
To investigate the role of the vasodilator systems heme oxygenase-1/heat shock protein 32 (HO-1/HSP32) and nitric oxide synthase-II (NOS-II), generating carbon monoxide and nitric oxide respectively, as modulators of liver injury in an experimental model of reversible hemorrhagic shock. ⋯ These data suggest that HO-1/HSP32, but not the alternative cyclic guanosine monophosphate-generating enzyme NOS-II, is induced after hemorrhage and resuscitation and protects against hepatocellular injury. Both metabolites generated by the heme oxygenase pathway, e.g., carbon monoxide (a vasodilator) and biliverdin (an antioxidant) seem to contribute to the salutary effects of induction of HO-1/HSP32.