Critical care medicine
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Critical care medicine · Aug 1999
Clinical Trial Controlled Clinical TrialFinancial impact of elimination of routine chest radiographs in a pediatric intensive care unit.
To determine the change in chest radiograph use if each chest radiograph requires a separate order and clinical indication. ⋯ These results demonstrate the impact of an evaluation and subsequent change in radiology ordering practice in our PICU. The change resulted in decreased variability in ordering practice, fewer chest radiographs per patient, and an accompanying cost savings to our patients and payors.
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Critical care medicine · Aug 1999
Time-course of impairment of respiratory mechanics after cardiac surgery and cardiopulmonary bypass.
Cardiopulmonary bypass (CPB) is associated with abnormalities of lung function characterized by an increase in static elastance of the respiratory system. We examined the following: a) the effects of CPB on the total inspiratory volume-pressure (V-P) relationship of the respiratory system; b) the relative contribution of the chest wall and lung to the impairment of respiratory system mechanics; and c) the time-course of such impairment. ⋯ Sternotomy and CPB produced immediate changes in lung mechanics. Chest wall mechanics were affected only 4 hrs after sternotomy. Seven hours after disconnection from CPB, all mechanics had returned to normal.
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Critical care medicine · Aug 1999
Comparative StudyMild or moderate hypothermia but not increased oxygen breathing prolongs survival during lethal uncontrolled hemorrhagic shock in rats, with monitoring of visceral dysoxia.
To test the hypotheses that during lethal uncontrolled hemorrhagic shock (UHS) in rats compared with normothermia and room air breathing: a) mild hypothermia would prolong survival time as well as moderate hypothermia; b) oxygen breathing would prolong survival further; and c) hypothermia and oxygen would mitigate visceral ischemia (dysoxia) during UHS. ⋯ Both mild and moderate hypothermia prolonged survival time during untreated, lethal UHS in rats. Increased FIO2 had no effect on survival. The effects of hypothermia and increased FIO2 during UHS on viscera, the ability to be resuscitated, and outcome should be explored further.
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Critical care medicine · Aug 1999
Editorial Comment ReviewClinical trials in acute respiratory distress syndrome: what is ARDS?