Crit Care Resusc
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Multicenter Study Comparative Study
A brief review of recent trends in Victorian intensive care, 2000-2011.
Review of resource use and patient outcomes of intensive care unit services over time provides insights into service delivery and safety. ⋯ There was an increase in ICU resource availability and evidence of improvement in hospital survival, suggesting improved quality of care. These evaluation methods may be useful in monitoring statewide capacity, service delivery and patient safety.
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Comparative Study
Continuous intra-arterial blood glucose monitoring using quenched fluorescence sensing: a product development study.
Continuous glucose monitoring (CGM) has the potential to improve the management of blood glucose (BG) and so improve patient safety and outcomes in intensive care units. The GluCath Intravascular CGM (IV-CGM) System (GluMetrics) uses a novel quenched chemical fluorescence sensing mechanism to measure BG. ⋯ In this product development study, use of the GluCath system for 24 hours after cardiac surgery had no adverse effect on haemodynamic monitoring, arterial blood sampling or clinical care. Overall accuracy was acceptable in the context of the first phase of a product development study.
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Comparative Study
Invasive blood pressure recording comparing nursing charts with an electronic monitor: a technical report.
Blood pressure management (assessed using nursing charts) in the early phase of septic shock may have an effect on renal outcomes. Assessment of mean arterial pressure (MAP) values as recorded on nursing charts may be inaccurate. ⋯ With multiple measurements over time, mean blood pressure as recorded on nursing charts reasonably approximates mean blood pressure recorded on the monitor.
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In critically ill patients, glycaemic variability (GV) was reported as a better predictor of mortality than mean blood glucose level (BGL). We compared the ability of different GV indices and mean BGLs to predict mortality and intensive care unit-acquired infections in a population of ICU patients. ⋯ High GV is associated with higher risk of ICUCrit acquired infection and mortality.
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Comparative Study
Improved consistency in interpretation and management of cardiovascular variables by intensive care staff using a computerised decision-support system.
To investigate the potential of a computerised decision-support system (CDSS) to improve consistency of haemodynamic evaluation and treatment suggestions by intensive care unit clinical staff with different levels of expertise and experience. ⋯ Use of a CDSS significantly improved the consistency between categories of clinical ICU staff in assessing the cardiovascular status and making management decisions in postoperative cardiac surgery patients.