Critical care medicine
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Critical care medicine · Sep 1992
Comparative StudyEnergy expenditure and gas exchange measurements in postoperative patients: thermodilution versus indirect calorimetry.
To compare a method of measuring energy expenditure and gas exchange using the Fick principle with the standard indirect calorimetry technique. ⋯ In postoperative patients, while VO2 and energy expenditure measurements by thermodilution are easy to perform and accurate for clinical purposes, VCO2, and respiratory quotient measurements are too imprecise and inaccurate to serve any useful function. Therefore, in those clinical situations in which an evaluation of respiratory quotient and substrate utilization may be useful for purposes of metabolic care of the surgical patient, precise measurements of gas exchange with indirect calorimetry are mandatory.
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Critical care medicine · Sep 1992
Comparative StudyFactors related to quality of life 12 months after discharge from an intensive care unit.
To perform an analysis of the quality of life of survivors after ICU discharge. ⋯ Twelve months after discharge from the ICU, a patient's functional status, as measured by the Quality of Life score, is influenced most by age and their Quality of Life score at the time of ICU admission. While there is an overall decrease in the Quality of Life score for survivors, admission and treatment in an ICU do not always result in deterioration of the Quality of Life score. This study indicates that Quality of Life scores could become a routine part of patient evaluation.
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Critical care medicine · Sep 1992
Comparative StudyHyaluronan: relationship to hemodynamics and survival in porcine injury and sepsis.
Hyaluronan is a polysaccharide normally present in low concentrations in the blood, and is rapidly cleared from the blood by the liver. Increased plasma hyaluronan concentrations have been found in patients with sepsis. We studied changes in serum hyaluronan concentrations and their relationship to hemodynamics and survival in a 48-hr porcine model of injury and sepsis. ⋯ Experimental sepsis is associated with an increase in serum hyaluronan values. The relationship between decreased MAP and increased serum hyaluronan concentrations could point to reduced liver perfusion as a cause. An association between high hyaluronan values and nonsurvival in sepsis is possible.
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Critical care medicine · Sep 1992
Acute hypoxemic respiratory failure in infants and children: clinical and pathologic characteristics.
To examine the clinical and pathologic features of acute hypoxemic respiratory failure in children. ⋯ Children with acute hypoxemic respiratory failure represent a heterogeneous subset of patients. In our group of patients, infectious pneumonitis was more commonly encountered than diffuse alveolar damage. The mortality rate of children with acute hypoxemic respiratory failure has not improved since 1980.
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Critical care medicine · Sep 1992
Comparative StudyArterial pH and carbon dioxide tension as indicators of tissue perfusion during cardiac arrest in a canine model.
Previous studies have shown that Paco2 and end-tidal CO2 reflect coronary artery perfusion pressures during cardiac arrest. We investigated the relationship of coronary artery perfusion pressure to central arterial pH and Paco2 values during resuscitation from cardiac arrest in a canine model. Twenty-four mongrel dogs were block randomized to three different resuscitation groups after induction of ventricular fibrillation and cardiac arrest: a) standard cardiopulmonary resuscitation (CPR) and advanced life support (n = 8); b) cardiopulmonary bypass (n = 8); or c) open-chest CPR (n = 8). Central arterial blood gases and perfusion pressures were monitored during cardiac arrest and during resuscitation. ⋯ Central arterial pH and Paco2 monitoring during cardiac arrest may reflect the adequacy of tissue perfusion during resuscitation and may predict resuscitation outcome from ventricular fibrillation.