Critical care medicine
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Critical care medicine · Oct 1993
Comparative StudyComparison of ear-based, bladder, oral, and axillary methods for core temperature measurement.
To determine the accuracy and repeatability of ear-based, bladder, oral, and axillary temperature methods. ⋯ Infrared ear thermometry provided a relatively close estimate of pulmonary artery core temperature, although with more variability than bladder or oral methods, while axillary readings were substantially lower than the pulmonary artery temperature and highly variable.
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Critical care medicine · Oct 1993
Comparative StudyPredictability of creatinine clearance estimates in critically ill patients.
a) To evaluate the predictive ability of different creatinine clearance methods as compared with the criterion standard, inulin clearance; and b) to determine which of the predictive methods yields the most accurate estimation of creatinine clearance. ⋯ The utilization of the Cockcroft-Gault equation as used clinically (the lower of ideal or total body weight and the higher of actual serum creatinine or corrected serum creatinine concentration to 1 mg/dL [85 mumol/L]) results in more accurate predictions of glomerular filtration rate in the medical, critically ill patient than urine creatinine clearance measures. If creatinine clearance measures are used, the 30-min collection provided results not different from those results obtained with 24-hr urinary collections.
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Critical care medicine · Oct 1993
Eliminating needless testing in intensive care--an information-based team management approach.
To determine if the application of an information-based management system in adult intensive care units (ICU) can produce sustained decreases in the use of laboratory resources and costs. ⋯ Application of an information-based multidisciplinary management system in the ICU can produce marked and sustained reductions in unnecessary testing in a cost-effective manner. Although rationing of intensive care services may be necessary, reducing needless testing can be a safe and effective cost-containment strategy in the ICU.
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Critical care medicine · Oct 1993
Randomized Controlled Trial Comparative Study Clinical TrialTitration of intravenous anesthetics for cardioversion: a comparison of propofol, methohexital, and midazolam.
To compare propofol, methohexital, and midazolam administered as titrated infusions for sedation during electrical cardioversion. ⋯ All three drugs are acceptable choices for use during elective direct-current cardioversion. Titration of the agent results in a total drug dose which is usually less than the typical induction dose. There were no significant differences in the hemodynamic actions of these drugs at any time interval. Both propofol and methohexital proved superior in their ability to provide a more rapid anesthetic onset and recovery as compared with midazolam. Propofol offers the advantage of requiring no premixing or dilution, and it is not a controlled substance, although it does result in more pain on injection.
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To review the pathophysiologic basis for intensive care management of patients with intracerebral hematoma and to present management strategies based on that analysis. ⋯ The primary injury from intracerebral hemorrhage is exacerbated by disturbed intracranial physiology. Management should include principles that improve intracranial compliance and reduce intracranial pressure.