Critical care medicine
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Critical care medicine · Jan 2001
Readmission to the intensive care unit after liver transplantation.
We undertook this study to understand the factors at our transplant center that contribute to patients' return to the ICU after their liver transplant and their initial discharge from that unit. Patients who, after liver transplantation, fail discharge from the Intensive Care Unit (ICU) and must be readmitted to that unit may well utilize many more resources than those patients who are well enough to stay out of the ICU. ⋯ We conclude that the most important means of preventing ICU readmission in liver transplantation patients is to optimize cardiopulmonary function and status. Close monitoring of fluid balance to avoid hypervolemia is essential. Readmitted patients have a greater resource utilization and have lower survival rates.
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Critical care medicine · Jan 2001
Randomized Controlled Trial Multicenter Study Clinical TrialExtending inspiratory time in acute respiratory distress syndrome.
To assess the short-term effects of extending inspiratory time by lengthening end-inspiratory pause (EIP) without inducing a clinically significant increase in intrinsic positive end-expiratory pressure (PEEPi) in patients with acute respiratory distress syndrome (ARDS). ⋯ In patients with ARDS, extending EIP without inducing a clinically significant increase in PEEPi does not consistently improve arterial oxygenation but enhances CO2 elimination.
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Critical care medicine · Jan 2001
Multicenter StudyDaily assessment of severity of illness and mortality prediction for individual patients.
To refine the prognosis of critically ill patients using a statistical model that incorporates the daily probabilities of hospital mortality during the first week of stay in the intensive care unit (ICU). ⋯ To have an accurate measurement of the prognosis, it is necessary to update the severity measure. The best estimate of hospital mortality was the probability of death on the current day. Severity at admission and at previous days did not improve the assessment of prognosis.
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Critical care medicine · Jan 2001
The activity of tissue factor pathway inhibitor in experimental models of superantigen-induced shock and polymicrobial intra-abdominal sepsis.
To study recombinant human tissue factor pathway inhibitor (rhTFPI) in a superantigen-induced shock model and in a cecal ligation and puncture (CLP) model of peritonitis in mice. ⋯ Tissue factor pathway inhibitor significantly improves the mortality rate in models of superantigen-induced shock and polymicrobial intra-abdominal infection, supporting its potential use in clinical trials for septic shock.
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Critical care medicine · Jan 2001
Randomized Controlled Trial Comparative Study Clinical TrialComparison of superior vena caval and femoroiliac venous pressure measurements during normal and inverse ratio ventilation.
The aim of this study was to estimate the agreement between superior vena caval pressure (SVCP) and femoroiliac venous pressure (FIVP) measurements by using short (<20 cm) femoral catheters commonly used in an adult intensive care unit. In addition, the effects of two modes of ventilation on agreement were assessed. ⋯ The study showed excellent overall agreement with acceptable clinical agreement for SVCP and FIVP measurements that was not affected by changing the mode of ventilation. IRV significantly increased central venous pressure measurements from both catheter sites but had no effect on overall agreement.