Critical care medicine
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Critical care medicine · Oct 1993
A case-control study of patients readmitted to the intensive care unit.
To determine characteristics of patients requiring readmission to an intensive care unit (ICU). ⋯ Readmission to an ICU carries a risk of high mortality rate and increased length of stay and may represent premature discharge in at least 30% of patients. Pulmonary failure is the immediate cause of readmission in more than half of the readmitted patients. Increased respiratory rate correlates with ICU readmission. Intermediate care areas for patients with poor pulmonary function may help to avoid readmission to an ICU, prevent death, and conserve hospital resources.
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Critical care medicine · Oct 1993
Multicenter StudyImproving intensive care: observations based on organizational case studies in nine intensive care units: a prospective, multicenter study.
To examine organizational practices associated with higher and lower intensive care unit (ICU) outcome performance. ⋯ The best and worst organizational practices found in this study can be used by ICU leaders as a checklist for improving ICU management.
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Critical care medicine · Oct 1993
Glasgow Coma Scale score in the evaluation of outcome in the intensive care unit: findings from the Acute Physiology and Chronic Health Evaluation III study.
To investigate the ability of the Glasgow Coma Scale score to predict hospital mortality rate for adult medical-surgical intensive care unit (ICU) patients without trauma. ⋯ We demonstrated the prognostic importance of admission levels of consciousness as measured by the Glasgow Coma Scale score on ICU and hospital mortality rates. We concluded that the Glasgow Coma Scale score may be used to stratify and predict mortality risk in general intensive care patients, but lack of sensitivity in the intermediate range of Glasgow Coma Scale Score should be noted. Ideally, the Glasgow Coma Scale score should also be applied in the context of other physiologic information and the patient's specific diagnosis. Variation in the use of sedatives in different ICUs means that imputing or substituting a value other than normal for an unobtainable Glasgow Coma Scale score may introduce a substantial treatment bias into subsequent outcome predictions.
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Critical care medicine · Oct 1993
Extracorporeal life support for pediatric respiratory failure: predictors of survival from 220 patients.
The purpose of this report was to examine the Extracorporeal Life Support Organization registry database for predictors of outcome for severe pediatric respiratory failure managed with extracorporeal life support. ⋯ Extracorporeal life support may represent an effective rescue therapy for some selected pediatric patients with severe respiratory failure for whom conventional mechanical ventilation support has failed to improve. Predictors of survival for this life-support therapy exist that may be helpful for individual patient prognostication and future prospective study.
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Critical care medicine · Oct 1993
End-tidal CO2 changes under constant cardiac output during cardiopulmonary resuscitation.
To evaluate a) whether end-tidal CO2 values change under constant cardiac output during cardiopulmonary resuscitation (CPR), and b) what factors are responsible for the change. ⋯ End-tidal CO2 changes under constant cardiac output during CPR. When end-tidal CO2 is used to estimate the effectiveness of the cardiac massage, this type of change must be recognized.