Critical care medicine
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Critical care medicine · Dec 1996
Comparative StudyFive-year survival after intensive care--comparison of 12,180 patients with the general population. Finnish ICU Study Group.
A) To examine the long-term survival of critically ill patients compared with the general population in a nationwide sample of patients requiring intensive care; and b) to analyze long-term survival stratified by specific diagnostic subgroups. ⋯ ICU patients reached a life expectancy similar to the general population, on average, 2 yrs after admission. The time after which the survival parallels that of the general population depends, however, on the diagnostic category.
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Critical care medicine · Dec 1996
Impairment of cerebral autoregulation during venovenous extracorporeal membrane oxygenation in the newborn lamb.
To study the effects of venovenous extracorporeal membrane oxygenation (ECMO) on cerebral autoregulation in the newborn lamb. ⋯ These findings indicate that cerebral autoregulation was altered in animals on venovenous ECMO, with cerebral blood flow decreasing at a cerebral perfusion pressure of < 25 mm Hg, compared with control animals which showed no changes at the same cerebral perfusion pressure. This disruption of cerebral autoregulation decreased cerebral oxygen metabolism despite an increased oxygen extraction in ECMO animals.
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Critical care medicine · Dec 1996
Randomized Controlled Trial Multicenter Study Clinical TrialRisk factors for upper gastrointestinal bleeding in intensive care unit patients: role of helicobacter pylori. Federal Hyperimmune Immunoglobulin Therapy Study Group.
To determine the role of preexisting Helicobacter pylori infection in the development of acute upper gastrointestinal (GI) hemorrhage in intensive care unit (ICU) patients in relation to other potential predisposing risk factors. ⋯ Increased anti-H. pylori immunoglobulin A concentrations, prolonged nasogastric intubation, alcoholism, and acute hepatic failure were found to be independently correlated with the development of acute GI bleeding in an ICU setting. These observations should be prospectively confirmed in an independent population before being used for treatment guidelines.
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Critical care medicine · Dec 1996
Multicenter Study Clinical TrialPain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. For the SUPPORT investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatmentm.
To evaluate the pain experience of seriously ill hospitalized patients and their satisfaction with control of pain during hospitalization. To understand the relationship of level of pain and dissatisfaction with pain control to demographic, psychological, and illness-related variables. ⋯ Pain is common among severely ill hospitalized patients. The most important variables associated with pain and satisfaction with pain control were patient demographics and those variables that reflected the acute illness. Pain and satisfaction with pain control varied significantly among study sites, even after adjustment for many potential confounders. Better pain management strategies are needed for patients with the serious and common illnesses studied in SUPPORT.
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Critical care medicine · Dec 1996
Effect of changing patient mix on the performance of an intensive care unit severity-of-illness model: how to distinguish a general from a specialty intensive care unit.
To analyze the effects of patient mix diversity on performance of an intensive care unit (ICU) severity-of-illness model. ⋯ The concept of critical percentages is potentially clinically important. It might provide an easy first step in checking applicability of a given severity-of-illness model and in defining a general medical-surgical ICU. If the critical percentages are exceeded, as might occur in a highly specialized ICU, the model would not be accurate. Alternative modeling approaches might be to customize the model coefficients to the population for more accurate probabilities or to develop specialized models. The MPM approach remained robust for a large variation in patient mix factors.