Critical care medicine
-
Critical care medicine · Apr 2004
Costs associated with delirium in mechanically ventilated patients.
To determine the costs associated with delirium in mechanically ventilated medical intensive care unit patients. ⋯ Delirium is a common clinical event in mechanically ventilated medical intensive care unit patients and is associated with significantly higher intensive care unit and hospital costs. Future efforts to prevent or treat intensive care unit delirium have the potential to improve patient outcomes and reduce costs of care.
-
Critical care medicine · Apr 2004
Sepsis severity is the major determinant of circulating thrombopoietin levels in septic patients.
To measure serum thrombopoietin levels and to investigate their relationship with platelet counts and other potential determinants in septic patients. ⋯ Sepsis severity is the major determinant of elevated thrombopoietin levels in septic patients, whereas platelet count is a secondary determinant. Thrombopoietin represents a potential marker of sepsis severity.
-
Critical care medicine · Apr 2004
Comparative StudyStroke in patients with heparin-induced thrombocytopenia and the effect of argatroban therapy.
To investigate the frequency, mortality rate, and characteristics of stroke in heparin-induced thrombocytopenia and the effect of argatroban therapy in that setting. ⋯ Stroke, particularly ischemic stroke, is common in heparin-induced thrombocytopenia and significantly increases mortality risk. Stroke in heparin-induced thrombocytopenia occurs most often in females, in patients with more severe thrombocytopenia, and within 2 wks of heparin-induced thrombocytopenia presentation. Argatroban therapy vs. control significantly reduces the likelihood of new stroke and stroke-associated mortality in heparin-induced thrombocytopenia without increasing intracranial hemorrhage.
-
Critical care medicine · Apr 2004
ReviewPreoperative planning of airway management in critical care patients.
The aim of this article is to review aspects of airway evaluation that may affect the care of the critical care patient whose airway is to be managed. This information must then be incorporated into the decision-making process of the "airway manager." ⋯ Rote decision making on airway management, based on commonly used indexes, is not adequate. The vital role of airway in anesthetic management of the critical care patient demands thoughtful consideration. Patient conditions including the need for airway control, the likelihood of difficult laryngoscopy or supraglottic ventilation, the patient's inability to take food orally, and the medical state of the patient must be incorporated.
-
The objectives of our study were to accurately describe the costs and resources required to treat survivors of severe sepsis subsequent to hospital discharge and to determine what factors influenced these costs. ⋯ Cost of care for survivors of severe sepsis was highest in the first year after hospital discharge. Acuity of illness and patient comorbidity were the main determinants of cost. In assessing whether new therapeutic innovations for intensive care unit patients with severe sepsis are cost-effective, an accurate estimate of the cost of subsequent health care for survivors treated with and without the new intervention will be important.