Critical care medicine
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Critical care medicine · Nov 1992
Oxygen consumption, energy expenditure, and substrate utilization after cardiac surgery in children.
To determine the oxygen consumption (VO2), resting energy expenditure, and substrate utilization after cardiac surgery in children. ⋯ Cardiovascular surgery in children does not significantly alter resting energy expenditure but influences the substrate utilization. Perioperative hormonal stress responses and therapeutically administered catecholamines may explain the shift toward fat oxidation.
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Critical care medicine · Nov 1992
Bacterial and fungal colonization of endotracheal tubes in children: a prospective study.
To evaluate both the frequency and route of endotracheal colonization of intubated children by pathogens and to assess the usefulness of Pediatric Risk of Mortality scoring and measurement of gastric pH in predicting this colonization. ⋯ Colonization of the buccal mucosa appears to be the crucial antecedent to endotracheal colonization in children. In children, gastric pH and Pediatric Risk of Mortality scores at the time of endotracheal intubation can predict pathogenic endotracheal colonization within 4 days of intubation. Selective decontamination regimes may be appropriate for these patients, especially those regimes that are directed to the buccal mucosa.
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Critical care medicine · Nov 1992
Right ventricular systolic time intervals determined by means of a pulmonary artery catheter.
To evaluate the right ventricular systolic time interval as an index of right ventricular function and also to ascertain whether the right ventricular ejection fraction may be determined by means of a conventional pulmonary artery catheter. ⋯ Right ventricular systolic time intervals, measured using the simultaneous display of the pulmonary artery catheter curve and EKG, provide adequate information regarding right ventricle performance in critically ill patients. The close linear correlation between the right ventricular preejection period/right ventricular ejection time quotient and the right ventricular ejection fraction enables the investigator to estimate, with a high degree of accuracy, the right ventricular ejection fraction and the values derived from the preload of the right ventricle, without the need for a modified pulmonary artery catheter.
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Critical care medicine · Nov 1992
Effect of extracorporeal membrane oxygenation on cerebral hemodynamics in newborn lambs.
Neurologic injury caused by changes in cerebral blood flow is a concern in infants treated with extracorporeal membrane oxygenation (ECMO). To investigate the hypothesis that cerebral hemodynamics would be influenced by bypass flow rates, eight ketamine anesthetized lambs (age range 1 to 8 days) had measurements of cerebral hemodynamics before and after institution of venoarterial bypass. ⋯ These findings demonstrate that changes in cerebral blood flow and cerebral oxygen metabolism can occur in the newborn lamb with the initiation of ECMO, and that these changes are dependent on bypass flow rate.
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Critical care medicine · Nov 1992
Comment Letter Case ReportsProlonged paralysis after long-term vecuronium infusion.