Critical care medicine
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Critical care medicine · May 2000
Randomized Controlled Trial Clinical TrialRecombinant human growth hormone treatment in pediatric burn patients and its role during the hepatic acute phase response.
Recombinant human growth hormone (rHGH) has been shown to increase mortality in adult trauma patients; however, little has been reported on its side effects in children. The acute phase response has been suggested to be a contributing factor to trauma mortality. Therefore, the purpose of this study was to examine the effects of exogenous rHGH on the acute phase response in pediatric bum patients. ⋯ Data indicate that rHGH does not increase mortality. rHGH decreased acute phase proteins, tumor necrosis factor-alpha, and IL-1beta, which is associated with increases in constitutive hepatic proteins and IGF-I.
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Critical care medicine · May 2000
Multicenter StudyPrevalence of infections in intensive care units in Mexico: a multicenter study.
To determine the 1-day prevalence of community-acquired, hospital-acquired, or intensive care unit (ICU)-acquired infections in Mexican ICUs. To identify associated risk factors, predominant infecting organisms, and mortality rates. ⋯ Evidence of a high frequency of nosocomial infections was found, and potential risk factors for acquiring infections and mortality were identified. Mortality rates according to the hierarchy of the systemic inflammatory response syndrome in Latin American ICUs are reported.
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Critical care medicine · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialEffects of dopamine and epinephrine infusions on renal hemodynamics in severe malaria and severe sepsis.
To describe and compare the effects of dopamine and epinephrine in various doses on renal hemodynamics and oxygen transport in patients with severe malaria and severe sepsis. ⋯ Although dopamine increased and epinephrine decreased fractional renal blood flow, there was no evidence that either drug produced either a beneficial or a deleterious effect on renal oxygen metabolism or function at any of the doses investigated.
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Critical care medicine · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialProlonged use of heat and moisture exchangers does not affect device efficiency or frequency rate of nosocomial pneumonia.
To determine whether use of a single heat and moisture exchanger (HME) for < or =120 hrs affects efficiency, resistance, level of bacterial colonization, frequency rate of nosocomial pneumonia, and cost compared with changing the HME every 24 hrs. ⋯ Changing the hydrophobic or hygroscopic HME after 3 days does not diminish efficiency, increase resistance, or alter bacterial colonization. The frequency rate of nosocomial pneumonia was also unchanged. Use of HMEs for >24 hrs, up to 72 hrs, is safe and cost effective.
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Critical care medicine · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialPercutaneous dilational tracheostomy or conventional surgical tracheostomy?
Percutaneous dilational tracheostomy (PDT) is increasingly used in intensive care units (ICU), and it has a low incidence of complications. The aim of this study was to compare the costs, complications, and time consumption of PDT with that of conventional surgical tracheostomy (ST) when both procedures were performed in the ICU. ⋯ We found that PDT is a cost-effective procedure in critically ill ICU patients. Although we performed ST at the bedside in the ICU to avoid the risks associated with moving critically ill patients to the operating room, we found PDT to be a simple and safe procedure.