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  • 1
    Electronic Resource
    Electronic Resource
    Dopamine clearance in critically ill patients (1998)
    Springer
    Intensive care medicine 24 (1998), S. 1217-1220 
    Details
    ISSN: 1432-1238
    Keywords: Key words Dopamine ; Steady-state clearance ; Renal
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To examine the validity of the low-dose “renal” dopamine regimen in critically ill patients by investigating the steady-state clearance of dopamine. Design: A prospective clinical study. Setting: Teaching hospital intensive care unit. Patients: 48 haemodynamically stable patients receiving a dopamine infusion. Interventions: Sampling of arterial blood and dopamine infusates. Measurement and results: Plasma and infusate dopamine levels were measured by liquid chromatography with electrochemical detection. Steady-state clearance was determined by dividing the actual infusion rate by the steady-state plasma concentration. Dopamine clearance for the whole group was 46.4 ± 35.9 ml/kg per min (mean ± SD), which is significantly lower than 70 ± 15.2 ml/kg per min reported for elective surgical patients (p = 0.01). Twelve patients with renal dysfunction had significantly lower dopamine clearances (36 ± 16.6 ml/kg per min) than the remaining 36 patients (61 ± 38.5 ml/kg per min, p = 0.022). There was a very poor correlation between plasma dopamine level and infusion rate for the group as a whole (r = 0.47), and this worsened (r = 0.31)when only those patients on a “renal” dose of 2–5 μg/kg per min were considered (n = 30). Conclusion: Plasma dopamine clearance is lower in critically ill patients and there is a large interindividual variation. It is therefore impossible to predict the plasma level from the infusion rate. Consequently, the concept of a selective renovascular low-dose dopamine infusion is invalid in critically ill patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050747
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  • 2
    Electronic Resource
    Electronic Resource
    C-reactive protein as an indicator of resolution of sepsis in the intensive care unit (1995)
    Springer
    Intensive care medicine 21 (1995), S. 602-605 
    Details
    ISSN: 1432-1238
    Keywords: Sepsis ; C-reactive protein
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To investigate the value of decreasing plasma C-reactive protein (CRP) concentrations as an indicator or resolution of microbiologically-proven sepsis.Design: Retrospective analysis of CRP concentrations measured during episodes of microbiologicallyproven sepsis. A receiver-operating characteristic (ROC) curve was used to assess the usefulness of CRP as a test for resolution of sepsis. Setting The intensive care unit (ICU) of a teaching hospital.Patients and participants: 32 episodes of microbiologically-proven sepsis occurring in 18 patients were followed from diagnosis until resolution. Measurements and results Daily routine observations and blood testing were performed prospectively. The daily presence or absence of systemic inflammatory response syndrome (SIRS) was prospectively determined according to standard definitions. Concentrations of CRP were analysed retrospectively once the patients had left the ICU. A decrease in CRP by 25% or more from the previous day's level was a good indicator of resolution of sepsis, with a sensitivity of 97%, specificity of 95% and predictive value of 97%. In 13 cases (46%), a decrease in CRP preceded clinical resolution of sepsis; this was more likely to occur in patients with less severe sepsis than in those with severe sepsis or septic shock. Conclusion Daily measurement of CRP is useful for monitoring the course of microbiologically-proven sepsis in ICU patients, and may be used to indicate successful treatment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700168
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  • 3
    Electronic Resource
    Electronic Resource
    The Bain, ADE, and Enclosed Magill breathing systems A comparative study during controlled ventilation (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 45 (1990), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The Enclosed Magill, Humphrey ADE and the Bain breathing systems are all used for controlled ventilation of the lungs. This study compares the three systems in vitro with a lung model and in clinical practice. No difference was observed, with ventilatory variables commonly used in clinical practice, between the Bain and the ADE, while significantly lower end-tidal carbon dioxide values were observed with the Enclosed Magill (about 7%). Lower fresh gas flows can be used under these circumstances to maintain normocapnia with the Enclosed Magill than either the Bain or the Humphrey ADE.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1990.tb14273.x
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  • 4
    Electronic Resource
    Electronic Resource
    Anaesthesia and substance abuse (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Current practices in the abuse of illicit drugs in the United Kingdom are described with particular reference to their pathological effects and the implications for anaesthesia. Practical guidelines are given for the anaesthetic and peri- and postoperative management of addicts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1989.tb13593.x
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  • 5
    Electronic Resource
    Electronic Resource
    A comparison of anaesthetic breathing systems during spontaneous ventilation (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Five anaesthetic breathing systems (Magill, Lack, Humphrey ADE, enclosed Magill and Bain) were compared using spontaneous ventilation in a simple lung model. The fresh gas flow at which rebreathing occurred was determined for each system by the application of four modified definitions of rebreathing. Two were based on the measurement of minimum inspired and two on end-expired carbon dioxide. The four A systems performed similarly with each individual definition. The rebreathing points found for each individual breathing system differed markedly between definitions, with those determined by the minimum inspired CO2, occurring at low, and probably misleading, FGF/V̇E ratio. The Bain system demonstrated rebreathing at considerably higher fresh gas flows whichever definition was used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1989.tb11221.x
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  • 6
    Electronic Resource
    Electronic Resource
    A reply (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 44 (1989), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1989.tb09230.x
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  • 7
    Electronic Resource
    Electronic Resource
    Delayed onset spinal after epidural analgesia (1983)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 38 (1983), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1983.tb10394.x
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  • 8
    Electronic Resource
    Electronic Resource
    Beyond the lung: oxygen delivery and tissue oxygenation (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 48 (1993), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1993.tb07186.x
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  • 9
    Electronic Resource
    Electronic Resource
    The additional work of breathing imposed by Mapleson A systems (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 48 (1993), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The additional work attributable to breathing through five Mapleson A anaesthetic breathing systems (Magill, Lack, Parallel Lack, Humphrey ADE and Enclosed Magill) was studied using a lung model. With all five systems, the additional work was found to be a function of fresh gas flow, respiratory flow as well as system geometry. Within the range of fresh gas flow and respiratory flows studied, the additional work ranged between 80 mJ.1−1 and 182 mJ.1−1. Expiratory work was always greater than the inspiratory workload, increasing fresh gas inflow into the system increases expiratory work, both resistive and elastic components. The Magill system posed the least work expenditure. The values for the additional work obtained with the lung model were of the same order of magnitude when measurements were taken in volunteers.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1993.tb07126.x
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  • 10
    Electronic Resource
    Electronic Resource
    The parallel Lack anaesthetic breathing system (1993)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 48 (1993), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The parallel Lack system is a new modification of the Mapleson A system comprising separate inspiratory and expiratory tubes. To determine that the function of the system was that anticipated of a Mapleson A, the fresh gas flow requirements to prevent rebreathing during spontaneous ventilation were assessed in three situations: (I) a lung model (2) conscious volunteers and (3) anaesthetised patients. Two sets of criteria to define rebreathing were used; (A) those based on changes in ventilation or end-expired carbon dioxide tension and (B) minimum inspired carbon dioxide tension. Using A, rebreathing occurred at afresh gas flow to minute ventilation ratio (Vfjve) of 0.75 for the lung model, and 0.73 for conscious volunteers. These results were comparable to those obtained for a Magill attachment. They were also close to the point at which mechanical dead space began to increase in the lung model. Criteria B gave much lower values for the onset of rebreathing. Rebreathing was present by criteria A in five of the six anaesthetised patients at afresh gas flow of 60 ml.kg ‘.min’ (Vfjvf of 0.78). The results confirm that the parallel Lack behaves as a Mapleson A system. The resistance to breathing posed by the parallel Lack was also comparable to the Magill system.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1993.tb07016.x
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