Critical care medicine
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To investigate the relationship between neurologic outcome and blood glucose concentrations in survivors of cardiopulmonary arrest. ⋯ The present study does not support an association between the concentration of glucose post-CPR and neurologic outcome. The previously reported casual relationship between hyperglycemia and neurologic prognosis may be an epiphenomenon of the severity of global cerebral ischemia in humans.
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Critical care medicine · May 1996
Risk factors for nosocomial infection in critically ill children: a prospective cohort study.
To identify factors in pediatric intensive care unit (ICU) patients that are associated with an increased risk of nosocomial infections. ⋯ Patients at risk for developing nosocomial infection can be identified using a multivariate logistic regression model with a high degree of sensitivity and specificity. These data indicate that institutional nosocomial rates need to be adjusted for risk factors. This model could help target patients at high risk for developing nosocomial infections for preventive strategies.
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Critical care medicine · May 1996
End-tidal carbon dioxide during cardiopulmonary resuscitation in humans presenting mostly with asystole: a predictor of outcome.
To determine whether continuous semiquantitative assessment of end-tidal CO2 could provide a highly sensitive predictor of return of spontaneous circulation during cardiopulmonary resuscitation (CPR). ⋯ End-tidal CO2 represents a valuable tool for monitoring patients presenting with asystole during prehospital CPR. Fluctuations in end-tidal CO2 during CPR and the utility of end-tidal CO2 in detecting return of spontaneous circulation justify its continuous measurement. In addition, a high sensitivity (>90%) in predicting return of spontaneous circulation is prospectively demonstrated using the maximal end-tidal CO2 during the first 20 mins after tracheal intubation, with a cutoff value of 10 torr. Such a prognostic indicator could be used for a more rational approach to prolonged CPR.
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Critical care medicine · May 1996
Correction of blood pH attenuates changes in hemodynamics and organ blood flow during permissive hypercapnia.
To determine whether changes in cardiac output, regional blood flow, and intracranial pressure during permissive hypercapnia are blood pH-dependent and can be attenuated by correction of intravascular acidemia. ⋯ Acute hypercapnia, induced within 1 hr, is associated with significant increases in cardiac output, organ blood flow, and intracranial pressure. These changes can be significantly attenuated by correction of blood pH with the administration of sodium bicarbonate, without adverse effects on hemodynamics.
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Critical care medicine · May 1996
Comparative StudyInspired oxygen concentration alters the phospholipids and protein content in the bronchoalveolar lavage-accessible space.
To examine the effect of FIO2 on the contents of total protein, total phospholipids, phosphatidylcholine, and phosphatidylglycerol in the bronchoalveolar lavage-accessible space in male and female rats in vivo. ⋯ Our findings support the hypothesis that hyperoxia alters surfactant composition. Further investigation is warranted to determine the mechanisms affecting secretion of phosphatidylcholine and phosphatidylglycerol into the bronchoalveolar space and to explore the gender difference in secretion.