Intensive care medicine
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Intensive care medicine · May 1997
Meta AnalysisAssessing the efficiency of the admission process to a critical care unit: does the literature allow the use of benchmarking?
To determine the ability of the current literature to supply appropriate data for benchmarking admission practice to a multidisciplinary critical care unit. ⋯ The current literature does not provide adequate data on critical care unit admission practices to allow useful application of the method of benchmarking. There is a need for publicly accessible large databases to allow individual critical care units to determine their level of efficiency when compared to similar institutions.
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Intensive care medicine · May 1997
Respiratory system mechanics in the early phase of acute respiratory failure due to severe kyphoscoliosis.
To evaluate respiratory mechanics in the early phase of decompensation in a group of seven patients with severe kyphoscoliosis (KS) (Cobb angle > 90 degrees) requiring mechanical ventilatory support. ⋯ During acute decompensation, both lung and chest-wall compliance are severely reduced in KS patients: conversely, and, contrary to that in patients with chronic obstructive pulmonary disease, increases in airway resistance and PEEPi seem to play only a secondary role.
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Intensive care medicine · May 1997
Breathing pattern and additional work of breathing in spontaneously breathing patients with different ventilatory demands during inspiratory pressure support and automatic tube compensation.
We designed a new ventilatory mode to support spontaneously breathing, intubated patients and to improve weaning from mechanical ventilation. This mode, named Automatic Tube Compensation (ATC), compensates for the flow-dependent pressure drop across the endotracheal tube (ETT) and controls tracheal pressure to a constant value. In this study, we compared ATC with conventional patient-triggered inspiratory pressure support (IPS). ⋯ The breathing pattern response to IPS and ATC is different in patients with differing ventilatory demand. ATC, in contrast to IPS, is a suitable mode to compensate for WOBadd in patients with increased ventilatory demand. When WOBadd was avoided using ATC, the patients did not need additional pressure support.
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To estimate the incidence of the acute respiratory distress syndrome (ARDS) in an Australian urban community, and to describe the pattern of disease and outcomes in a community hospital intensive care unit (ICU). ⋯ These data show that for ARDS, at least, mortality outcome can be comparable in a community ICU to a tertiary referral institution. The pattern of disease in an urban Australian community hospital is different to that often reported from tertiary centres. The incidence of ARDS in an Australian urban community is comparable to the reported incidence in North America and Western Europe.