Critical care medicine
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Critical care medicine · Oct 2003
Randomized Controlled Trial Clinical TrialDecreased mortality and infectious morbidity in adult burn patients given enteral glutamine supplements: a prospective, controlled, randomized clinical trial.
Enteral glutamine supplements have been shown to reduce infectious morbidity in trauma patients, but their effect on burn patients is not known. The objective of this study was to measure the impact of enteral glutamine supplementation on infectious morbidity, length of care, and the immune system in burn patients. ⋯ Enteral glutamine supplementation in adult burn patients reduces blood infection by a factor of three, prevents bacteremia with P. aeruginosa, and may decrease mortality rate. It has no effect on level of consciousness and does not appear to influence phagocytosis by circulating polymorphonuclear cells.
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Critical care medicine · Oct 2003
Randomized Controlled Trial Clinical TrialUse of xenon as a sedative for patients receiving critical care.
Many sedative regimens are used in the intensive care setting, but none are wholly without adverse effect. Xenon is a noble gas with sedative and analgesic properties. It has been used successfully as a general anesthetic and has many desirable properties, not least of which is a minimal effect on the myocardium. In theory, xenon may provide sedation without adverse effect for certain groups of critically ill patients. The objective of this study was to assess the feasibility of using xenon as an intensive care sedative. ⋯ Xenon provided satisfactory sedation in our group of patients. It was well tolerated with minimal hemodynamic effect. Recovery from this agent is extremely rapid. We have demonstrated the feasibility of using xenon within the critical care setting, without adverse effect.
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Critical care medicine · Oct 2003
Randomized Controlled Trial Clinical TrialRehabilitation after critical illness: a randomized, controlled trial.
To evaluate the effectiveness of a rehabilitation program following critical illness to aid physical and psychological recovery. ⋯ A self-help rehabilitation manual is effective in aiding physical recovery and reducing depression. However, in those patients recalling delusional memories from the ICU, further psychological care may be needed to reduce the incidence of anxiety and PTSD-related symptoms.
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Critical care medicine · Oct 2003
Changes in intensive care unit nurse task activity after installation of a third-generation intensive care unit information system.
OBJECTIVE To determine the percentage of time that intensive care unit (ICU) nurses spend on documentation and other nursing activities before and after installation of a third-generation ICU information system. ⋯ Installation of a third-generation ICU information system decreased the percentage of time ICU nurses spent on documentation by >30%. Almost half of the time saved on documentation was spent on patient assessment, a direct patient care task.
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Critical care medicine · Oct 2003
Clinical impact of pneumonia caused by Acinetobacter baumannii in intubated patients: a matched cohort study.
To determine whether ventilator-associated pneumonia caused by Acinetobacter baumannii (VAPAB) is associated with increased mortality rate. ⋯ In intubated patients, pneumonia by A. baumannii is not significantly associated with attributable mortality rate or an increased length of intensive care unit stay.