Critical care medicine
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Critical care medicine · Jan 1999
Randomized Controlled Trial Multicenter Study Clinical TrialInstillation of calf lung surfactant extract (calfactant) is beneficial in pediatric acute hypoxemic respiratory failure. Members of the Mid-Atlantic Pediatric Critical Care Network.
Prospective study of the efficacy of calf lung surfactant extract in pediatric respiratory failure. ⋯ Administration of calf lung surfactant extract, calfactant, appears to be safe and is associated with rapid improvement in oxygenation, earlier extubation, and decreased requirement for intensive care in children with acute hypoxemic respiratory failure. Further study is needed, however, before widespread use in pediatric respiratory failure can be recommended.
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Critical care medicine · Jan 1999
Meta Analysis Comparative StudyCrystalloids vs. colloids in fluid resuscitation: a systematic review.
To systematically review the effects of isotonic crystalloids compared with colloids in fluid resuscitation. ⋯ Overall, there is no apparent difference in pulmonary edema, mortality, or length of stay between isotonic crystalloid and colloid resuscitation. Crystalloid resuscitation is associated with a lower mortality in trauma patients. Methodologic limitations preclude any evidence-based clinical recommendations. Larger well-designed randomized trials are needed to achieve sufficient power to detect potentially small differences in treatment effects if they truly exist.
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Critical care medicine · Jan 1999
Randomized Controlled Trial Clinical TrialFlumazenil in drug overdose: randomized, placebo-controlled study to assess cost effectiveness.
To investigate cost effectiveness of administration of flumazenil to patients presenting with suspected acute drug overdose. ⋯ Use of flumazenil in intentional drug overdose of unknown etiology is not cost effective.
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Critical care medicine · Jan 1999
Prognostic value of blood lactate, base deficit, and oxygen-derived variables in an LD50 model of penetrating trauma.
To determine whether blood lactate, base deficit, or oxygen-derived hemodynamic variables correlate with morbidity and mortality rates in a clinically-relevant LD50 model of penetrating trauma. ⋯ Arterial lactate is a stronger index of blood loss after penetrating trauma than base deficit or oxygen-derived hemodynamic variables. The reliability of arterial lactate depends on several factors, such as the time after injury, the proportion of survivors and nonsurvivors in the study population, and on factors other than tissue hypoxia.
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Critical care medicine · Jan 1999
Selective inhibition of inducible nitric oxide synthase: effects on hemodynamics and regional blood flow in healthy and septic sheep.
To investigate the effects of S-ethylisothiourea (S-EITU) on hemodynamics, oxygen transport, and regional blood flow in healthy and septic sheep. ⋯ With the inducible form of nitric oxide synthase expressed under septic, but not under nonseptic conditions, S-EITU was expected to have vasoconstrictive properties only in the septic phase. It produced a comparable vasoconstriction during the nonseptic phase of the experiment. Thus, either S-EITU does not selectively block the inducible nitric oxide synthase in sheep, or other vasodilators besides nitric oxide play an important role in septic vasodilation.