Critical care medicine
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Critical care medicine · Sep 1999
ReviewIncorporating palliative care into critical care education: principles, challenges, and opportunities.
To identify the goals and methods for medical education about end-of-life care in the intensive care unit (ICU). ⋯ Teaching care of the dying in the ICU should emphasize the following: a) the goals of care should guide the use of technology; b) understanding of prognostication and treatment withholding and withdrawal is essential; c) effective communication and trusting relationships are crucial to good care; d) cultural differences should be acknowledged and respected; and e) the delivery of excellent palliative care is appropriate and necessary when patients die in the ICU.
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Critical care medicine · Sep 1999
Randomized Controlled Trial Clinical TrialSelenium replacement in patients with severe systemic inflammatory response syndrome improves clinical outcome.
To determine the effect of selenium replacement on morbidity and mortality in patients with systemic inflammatory response syndrome (SIRS). ⋯ Selenium replacement in patients with SIRS seems to improve clinical outcome and to reduce the incidence of acute renal failure requiring hemodialysis.
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Critical care medicine · Sep 1999
Results of a collaborative quality improvement program on outcomes and costs in a tertiary critical care unit.
To demonstrate that by using the knowledge and skills of the primary care provider and by applying statistical and scientific principles of quality improvement, outcomes can be improved and costs significantly reduced. ⋯ A focused quality improvement program in the ICU can have a beneficial impact on care and simultaneously reduce costs.
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Critical care medicine · Sep 1999
The effect of positive end-expiratory pressure during partial liquid ventilation in acute lung injury in piglets.
To investigate the effects of positive end-expiratory pressure (PEEP) application during partial liquid ventilation (PLV) on gas exchange, lung mechanics, and hemodynamics in acute lung injury. ⋯ Partial liquid ventilation is a useful technique to improve oxygenation in severe acute lung injury. The application of PEEP during PLV further improves oxygenation and lung mechanics. PEEP levels of 10 cm H2O seem to be optimal to improve oxygenation and lung mechanics.
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Critical care medicine · Sep 1999
The patient-related costs of care for sepsis patients in a United Kingdom adult general intensive care unit.
To determine the patient-related costs of care for critically ill patients with severe sepsis or early septic shock. ⋯ Patients with severe sepsis or early septic shock had a high mortality rate, spent prolonged periods of time in the ICU, and were significantly more expensive to treat than nonsepsis ICU patients.