Crit Care Resusc
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It is often assumed that critical care outcomes in the elderly are uniformly poorer than those in younger populations. We examined the pattern of admissions to our intensive care unit in Dublin, Ireland, between 2002 and 2005 to determine the admission characteristics and mortality in those aged 80 years and older. ⋯ The nature of the admission and severity of illness, but not age, are determinants of ICU survival. Evidence-based criteria are needed to assess the appropriateness of ICU admission in the very elderly. Clear criteria would help to prevent initiation of futile therapies and also to ensure that the very elderly are not denied potentially beneficial ICU care. We need to study triage patterns and outcome data further to ensure that the very elderly have the same opportunities to access appropriate intensive care treatment as the rest of the population.
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To review the indications for admission, demographics, clinically relevant aspects of medical care and outcomes of critically ill obstetric patients admitted to a tertiary hospital intensive care unit. ⋯ This audit is a reminder that continued vigilance is required to ensure maternal safety. It also emphasises the need to integrate free-standing maternity units with hospital intensive care services.
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Comparative Study
Outcomes of patients admitted to tertiary intensive care units after interhospital transfer: comparison with patients admitted from emergency departments.
To compare outcomes of patients admitted to tertiary-level intensive care units after interhospital transfer (IHT) with those of similar patients admitted from the emergency department (ED). ⋯ Patients admitted to an ICU from another hospital have higher hospital mortality and longer stay than those admitted from the ED, with the differences varying between diagnoses. These differences are important considerations for resource allocation and triage, and as a measure of quality.
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Severe septicaemia secondary to melioidosis carries a high mortality. Although melioidosis can involve most tissues and organs, pericardial involvement is rare. ⋯ This is the first case in Australia or New Zealand of melioid sepsis presenting with pericarditis and subsequent cardiac tamponade. We review the literature on cardiac involvement in melioidosis.