Critical care medicine
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Critical care medicine · Jun 2001
Randomized Controlled Trial Clinical TrialAmiodarone versus diltiazem for rate control in critically ill patients with atrial tachyarrhythmias.
To compare the rate-lowering effect of diltiazem and two amiodarone regimens in critically ill patients with recent-onset atrial tachyarrhythmias. ⋯ Sufficient rate control can be achieved in critically ill patients with atrial tachyarrhythmias using either diltiazem or amiodarone. Although diltiazem allowed for significantly better 24-hr heart rate control, this effect was offset by a significantly higher incidence of hypotension requiring discontinuation of the drug. Amiodarone may be an alternative in patients with severe hemodynamic compromise.
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Critical care medicine · Jun 2001
Randomized Controlled Trial Comparative Study Clinical TrialPercutaneous dilational tracheostomy: a comparison of single- versus multiple-dilator techniques.
To compare the safety and efficacy of single- vs. multiple-dilator techniques in the performance of percutaneous dilational tracheostomy. ⋯ The single-dilator percutaneous tracheostomy technique is a safe, cost-effective, and more rapidly performed method for bedside tracheostomy in the intensive care unit.
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Critical care medicine · Jun 2001
Randomized Controlled Trial Clinical TrialPartial liquid ventilation in severely surfactant-depleted, spontaneously breathing rabbits supported by proportional assist ventilation.
We hypothesized that partial liquid ventilation (PLV) would improve oxygenation in nonparalyzed, surfactant-deficient rabbits breathing spontaneously while supported by proportional assist ventilation (PAV). This ventilation mode compensates for low pulmonary compliance and high resistance and thereby facilitates spontaneous breathing. ⋯ PLV improved oxygenation and pulmonary compliance in spontaneously breathing, severely surfactant-depleted rabbits supported by PAV. The severity of lung injury by histology was unaffected.
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Critical care medicine · Jun 2001
Randomized Controlled Trial Clinical TrialBlockade of central histaminergic H2 receptors aggravates ischemic neuronal damage in gerbil hippocampus.
Histaminergic H2 antagonists have been reported to provoke central nervous system dysfunction in humans. They also aggravate ischemic neuronal damage in experimental animals. Because energy failure and glutamate release are crucial factors in ischemic neuronal damage, the effects of ranitidine on energy state and the extracellular concentration of glutamate were investigated in gerbil brain. ⋯ The deleterious effect of ranitidine on ischemic neuronal damage may involve the increase in the extracellular concentration of glutamate and facilitation of energy depletion in an anaerobic state.
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Critical care medicine · Jun 2001
Comparative StudyCan generic scores (Pediatric Risk of Mortality and Pediatric Index of Mortality) replace specific scores in predicting the outcome of presumed meningococcal septic shock in children?
To compare, in children with septic shock and purpura, the accuracy in predicting death of two specific scores (the MenOPP bedside clinical [MOC] score of Gedde Dahl and the score of Groupe Francophone de Réanimation Pédiatrique [GFRP]), the C-reactive protein (CRP) level, and the two pediatric generic scores (the Pediatric Risk of Mortality [PRISM] and Pediatric Index of Mortality [PIM] scores). ⋯ The PRISM score performed better than the PIM score, and was not surpassed by specific scores. Thus, we propose its use for outcome prediction in children with septic shock and purpura. However, if the PRISM score is to be used as inclusion criterion for clinical trials, it should be evaluated within a few hours after admission.