Critical care medicine
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Critical care medicine · Nov 1993
Comparative StudySurvival in the elderly after out-of-hospital cardiac arrest.
To evaluate the survival prognosis for the elderly (> or = 70 yrs of age) after out-of-hospital cardiac arrest in a large urban center, and to identify any specific differences in survival factors relative to those adults < 70 yrs of age. ⋯ Survival chances for the elderly after out-of-hospital cardiac arrest are not bleak, and are reasonable if ventricular fibrillation/tachycardia is the presenting rhythm. Survival determinants are similar for younger and older adults.
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Critical care medicine · Nov 1993
Comparative StudyDecreased mortality rate and length of hospital stay in surgical intensive care unit patients with successful selective decontamination of the gut.
Current studies concerning selective decontamination of the digestive tract have failed to demonstrate a decrease in the length of hospital stay and mortality rate, despite the finding of a significantly lower number of infections. To evaluate this issue in more detail, the relationship between the mortality rate and length of stay with respect to colonization and infections was studied within a group of patients receiving selective decontamination. Special attention was given to the efficacy of decontamination within each patient. The main question addressed was whether an effect on mortality rate was present, and if so, why this effect was not apparent until now. ⋯ These results indicate that selective decontamination is beneficial in terms of mortality rate and length of stay in surgical patients only when successful decontamination has been achieved. The subgroup of patients for whom decontamination is not successful might be responsible for the obscurity in mortality effects of selective decontamination in studies until now. It is expected that identification and subsequent elimination of possible risk factors that cause a failure of selective decontamination can result in lower morbidity and mortality rates in critically ill, surgical patients admitted to the ICU.
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Critical care medicine · Nov 1993
Modes of death in the pediatric intensive care unit: withdrawal and limitation of supportive care.
To determine the frequency of withdrawal or limitation of supportive care for children dying in a pediatric intensive care unit (ICU). ⋯ In a large, multidisciplinary pediatric ICU, the most common mode of death was active withdrawal of support. In addition, more than half (173/300, 58%) of children dying in the pediatric ICU underwent either active withdrawal or limitation (do-not-resuscitate status) of supportive care.
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Critical care medicine · Nov 1993
Comparative StudyMultiple organ failure in patients with thermal injury.
To assess the frequency and significance of multiple organ failure in patients with burn injuries. ⋯ Multiple organ failure was almost invariably present in burn patients who died > 72 hrs after injury. Burn victims, who have been excluded from reviews of multiple organ failure, appear to manifest organ failure in a manner similar to that of other surgical populations. The scoring system reported here may prove useful in evaluating organ failure in thermally injured patients.