Critical care medicine
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Critical care medicine · Jul 2002
Multicenter StudyFamily satisfaction with care in the intensive care unit: results of a multiple center study.
To determine the level of satisfaction of family members with the care that they and their critically ill relative received. ⋯ Most family members were highly satisfied with the care provided to them and their critically ill relative in the intensive care unit. Efforts to improve the nature of interactions and communication with families are likely to lead to improvements in satisfaction.
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Critical care medicine · Jul 2002
Comparative StudyHow reliable is the Bispectral Index in critically ill patients? A prospective, comparative, single-blinded observer study.
To establish a correlation between a reliable subjective measure, the Sedation-Agitation Scale (SAS), and an objective tool, the Bispectral Index (BIS), for monitoring critically ill patients with a decreased level of consciousness. ⋯ The correlation between SAS and BIS scores was suboptimal and inconsistent in a heterogeneous group of critically ill patients. The generation of BIS hardware and software, studied herein, is neither reliable nor valid for routinely monitoring the level of consciousness in the critically ill patient. Excessive muscle movement by the patient is an important and spurious influence on BIS values and seriously undermines BIS reliability.
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Critical care medicine · Jul 2002
Multicenter StudyInternal and external validation of the NOSEP prediction score for nosocomial sepsis in neonates.
To evaluate the performance of a scoring system (NOSEP) to predict nosocomial sepsis in neonates at the hospital where the score was developed (internal validation) and in an independent data set from other centers (external validation). ⋯ The predictive power of the original NOSEP score is very good in neonates at the original neonatal intensive care unit. In other neonatal intensive care units, its discriminatory performance is satisfactory but could be improved after modification of the variables in the model or adding additional variables. To use such a NOSEP score in other neonatal intensive care units, its accuracy has to be validated and adjusted if necessary.
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Critical care medicine · Jul 2002
Randomized Controlled Trial Clinical TrialAutomatic tube compensation in patients after cardiac surgery: effects on oxygen consumption and breathing pattern.
To evaluate patients without prior pulmonary disease after cardiac surgery and to determine whether resistive unloading by automatic tube compensation, pressure support ventilation, and continuous positive airway pressure has different effects on oxygen consumption, breathing pattern, gas exchange, and hemodynamics. ⋯ In postoperative tracheally intubated patients with normal ventilatory demand, automatic tube compensation and pressure support ventilation with 5 cm H2O lead to identical oxygen consumption, breathing patterns, gas exchange, and hemodynamics. We, therefore, suggest that this group of patients does not need any additional positive pressure support from the ventilator to overcome the additional work of breathing imposed by the endotracheal tube during the weaning phase from mechanical ventilation.
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Critical care medicine · Jul 2002
Comment Comparative Study Clinical TrialNoninvasive ventilation in acute exacerbations of chronic obstructive pulmonary disease in patients with and without home noninvasive ventilation.
The frequency of home ventilation has increased greatly. The objective of the study was, first, to compare the outcome of episodes of acute exacerbation of chronic obstructive pulmonary disease treated with mask intermittent positive-pressure ventilation (MIPPV) in patients with home MIPPV and in patients without home ventilatory support and, second, for each category of patients, to compare patients successfully ventilated with MIPPV with those who failed with MIPPV. ⋯ MIPPV may also be favorable during episodes of acute exacerbations in patients with chronic obstructive pulmonary disease. Experience with MIPPV could benefit selected patients in the management of acute respiratory failure.