Ann Acad Med Singap
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The optimal haematocrit for the critically ill patient is undetermined. ⋯ Oxygen consumption requires oxygen delivery. Haematocrit delivers oxygen. However, if oxygen delivery is not limited by haematocrit or is achieved by other means, then the concept of the optimal haematocrit is irrelevant. There are currently no guidelines for the management of anaemia in the critically ill.
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The following article reviews the experience of using human simulators for medical education at the University of Pittsburgh in the Department of Anesthesiology and Critical Care Medicine. The intent of the authors is to provide the reader with an overview of 1) what human simulators can do, 2) the components of a simulation training facility, 3) some of the economic considerations in operating a simulation training facility, and 4) how this centre is made use of.
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Traditionally, outcome from intensive care has focused on mortality. The cost of intensive care and the limited resources devoted to patients who have a poor prognosis also raises questions about the utilisation of such resources. There is increasing pressure for outcome evaluation of intensive care to incorporate assessment of long-term survival and the quality of life in survivors. The principal objectives of this article were to examine current methods of assessing quality of life measures in critically ill patients surviving intensive care and to determine the quality of life of these survivors. ⋯ Assessment of outcome after intensive care should include health related quality of life measurements. A unifying framework is required to enhance communication between clinicians, administrators and investigators of quality of life research and also to enable more rational and effective decision making at the bedside. Patients who survive intensive care appear to enjoy a reasonable standard of quality of life. While their health status may not be as good, subjectively patients find this acceptable.
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Ann Acad Med Singap · May 2001
Clinical TrialThe role of early tracheostomy in critically ill neurosurgical patients.
To determine the value of early tracheostomy (within 7 days) in ventilated neurosurgical patients. ⋯ Early tracheostomy in selected neurosurgical patients with poor GCS scores was associated with reduced incidence of tracheobronchial colonisation by multiple pathogens, improvement in chest infections, and rapid weaning from ventilatory support.
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Ann Acad Med Singap · May 2001
Obstetric admissions to the intensive therapy unit of a tertiary care institution.
Between 0.1% and 0.9% of women develop pregnancy complications which require admission to an intensive therapy unit. The aim of this study was to review all obstetric admissions to the intensive therapy unit at the KK Women's and Children's Hospital from 1998 to 1999 with respect to indications for admission, interventions employed and clinical outcome. ⋯ The admission rate to the intensive therapy unit in our institution was 0.73% of all deliveries during the 2-year study period. Hypertensive disease and haemorrhage were the predominant admitting diagnoses.