Showing papers in "Journal of Critical Care in 1989"

TL;DR: Evidence is presented to support the following hypothesis regarding the roles of xanthine oxidase-derived oxidants and granulocytes in ischemia-reperfusion-induced microvascular injury.

TL;DR: Low levels of PEEP may improve lung mechanics and reduce the effort required of mechanically ventilated patients with severe airflow obstruction, without substantially increasing the hazards of hyperinflation.

TL;DR: Based on the observations of these studies, the following mechanism is likely: during human septic shock, the cardiovascular system is stressed by both peripheral vascular abnormalities and direct depression of the myocardium, the latter manifested clinically by a depressed ejection fraction.

TL;DR: Findings indicate that administration of TNF in man reproduces many of the acute physiologic and metabolic responses to tissue injury, including energy substrate mobilization.

TL;DR: It is suggested that continuous turning on a mechanical platform shortens the requirements for length of stay and assisted ventilation in certain critically ill patients, thereby providing a major reduction in the financial costs of medical care.

TL;DR: A non-invasive method for measurement of the static volume-pressure curves of the respiratory system in mechanically ventilated patients using the Siemens Servo Ventilator 9000, which is provided with built-in sensors for flow and pressure.

TL;DR: Analysis of experimental data on oxygen flux from arterioles in the hamster cheek pouch retractor muscle indicated that the observed oxygen flux was inconsistent with this assumption and that permeability to oxygen of a blood-perfused tissue may be an order of magnitude higher than previously assumed.

TL;DR: It is concluded that thermodilution measurements in a peripheral artery yield valid estimates of cardiac output with a 7% systematic overestimation due to thermal indicator loss.

TL;DR: Findings indicate that structurally and functionally distinct microorganisms, with or without endotoxin, can activate a common pathway resulting in similar cardiovascular injury and mortality.

TL;DR: It is suggested that normotensive, hyperdynamic sepsis is associated with a “relative” depression in biventricular contractile performance when compared with a reference group of similarly hypermetabolic, but nonseptic, patients.

TL;DR: Heart rate can influence susceptibility to ischemia- and reperfusion-induced arrhythmias, probably as a result of an effect on the rate of development of ischemic injury.

TL;DR: Routine daily and post-appliance placement chest radiographs have significant clinical value in the pediatric intensive care unit and incorrect predictions were significantly associated with radiographs from patients who were younger, intubated, mechanically ventilated, and had indwelling central venous catheters.

TL;DR: The data show that increased tissue imbibition pressure and increased net filtration pressure (tissue mechanisms) are responsible for a major part of the acute fluid shifts into thermally injured skin.

TL;DR: The low incidence of complications documented in this study suggests that the femoral vein is the preferred site in most critically ill children when central venous catheterization is indicated.

TL;DR: The pleural space and parietal pleural lymphatic pathways are important pathways for the clearance of pulmonary edema liquid after experimentally induced increased permeability pulmonary edma.

TL;DR: It is suggested that attempts to moderate inflammatory cell responses to myocardial injury should be administered early after coronary artery reperfusion to limit the accumulation of potentially deleterious inflammatory cells.

TL;DR: No microbiologic cause for the disorder was identified, but decreased plasma levels of the protease inhibitors alpha 1-antitrypsin and alpha 2-macroglobulin, together with increased levels of circulating proteolytic enzymes, were frequently present.

TL;DR: Skeletal muscle in endotoxin-treated dogs demonstrated an increase in VO2 but no defect in O2 extraction, differing in both respects from the intestine, and skeletal muscle was not overperfused in endotoxemia and did not contribute to a systemic extraction defect by stealing blood flow from other tissues.

TL;DR: This review will indicate why direct NIR monitoring could become an important tool for detecting regional tissue hypoxia and how NIRS might be applied to some of the current questions about tissue oxygenation in critically ill patients.

TL;DR: Gas exchange data are consistent with the hypothesis that VO2max is limited by peripheral tissue diffusion of O2, and suggest a barrier to lactate efflux from muscle and a possible cause of the greater fatigue seen in hypoxemia.

TL;DR: The concept that reactive oxygen metabolites mediate the microvascular and parenchymal cell injury associated with reperfusion of ischemic tissues is presented in this review and the evidence supporting this idea is examined.

TL;DR: The results show that severe hypoxia causes a marked decrease in SBV, 60% of which is caused by active splenic contraction, and suggest that the sympathetic efferent nerve activity, which is augmented by the stimulation of chemoreceptors as well as the central nervous system, contributes greatly to those hypoxic changes.

TL;DR: The voluminous literature regarding the techniques, indications, management, and complications associated with the pulmonary artery catheter is summarized, the current controversy regarding the proper place of hemodynamic monitoring is reviewed, and recommendations as to the appropriate use of this important clinical tool are presented.

TL;DR: To investigate the mechanism by which increased pleural pressure (Ppl) assists left ventricular (LV) ejection, the effects of phasic systolic or diastolic increases in Ppl were compared with use of an isolated canine heart-lung preparation with constant venous return to suggest thatphasic elevations in PPL in either S or D assisted LV ejection by decreasing LV afterload.

TL;DR: It is concluded that after an acute lung injury, RVPO induces RVF because RV myocardial O2 demand outstrips RV my cardiac O2 supply and LV function is depressed on a preload-mediated basis independent of the pericardium.

TL;DR: The safety and efficacy of caudal epidural morphine injected into the caudals for control of postoperative pain following open cardiac surgery in children was studied in this article, where 30-two children between the ages of 2-12 yr for whom early postoperative tracheal extubation was anticipated were randomly assigned to control and study groups.

TL;DR: The mortality rate in patients with secondary neurologic disorders was 59% (16 of 27) compared with a rate of 20% (11 of 55) in patients without neurologic complications (P).