Critical care medicine
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Critical care medicine · Jan 2005
Editorial Comment Comparative StudyLevosimendan and gut mucosal blood flow--not all inotropes are created equal.
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Critical care medicine · Jan 2005
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialAcute effects of tidal volume strategy on hemodynamics, fluid balance, and sedation in acute lung injury.
To examine the effects of mechanical ventilation with a tidal volume of 6 mL/kg compared with 12 mL/kg predicted body weight on hemodynamics, vasopressor use, fluid balance, diuretics, sedation, and neuromuscular blockade within 48 hrs in patients with acute lung injury and acute respiratory distress syndrome. ⋯ When compared with ventilation with 12 mL/kg predicted body weight, patients treated with the lung-protective 6 mL/kg predicted body weight tidal volume protocol had no difference in their supportive care requirements. Therefore, concerns regarding potential adverse effects of this protocol should not preclude its use in patients with acute lung injury or the acute respiratory distress syndrome.
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Critical care medicine · Jan 2005
Comparative StudyHaloperidol use is associated with lower hospital mortality in mechanically ventilated patients.
To determine whether haloperidol use is associated with lower mortality in mechanically ventilated patients. ⋯ Haloperidol was associated with significantly lower hospital mortality. These findings could have enormous implications for critically ill patients. Because of their observational nature and the potential risks associated with haloperidol use, they require confirmation in a randomized, controlled trial before being applied to routine patient care.
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Critical care medicine · Jan 2005
Specificity of computerized physician order entry has a significant effect on the efficiency of workflow for critically ill patients.
Critically ill patients require rapid care, yet they are also at risk for morbidity from the potential complications of that care. Computerized physician order entry (CPOE) is advocated as a tool to reduce medical errors, improve the efficiency of healthcare delivery, and improve outcomes. Little is known regarding the essential attributes of CPOE in the intensive care unit (ICU). ⋯ Appropriate CPOE applications can improve the efficiency of care for critically ill patients. The workflow requirements of individual units must be analyzed before technologies like CPOE can be properly developed and implemented.