Articles: intensive-care-units.
-
Anaesth Intensive Care · Sep 2009
Randomized Controlled Trial Comparative StudyThe performance of customised APACHE II and SAPS II in predicting mortality of mixed critically ill patients in a Thai medical intensive care unit.
The aim of this study was to evaluate and compare the performance of customised Acute Physiology and Chronic Health Evaluation HII (APACHE II) and Simplified Acute Physiology Score HII (SAPS II) in predicting hospital mortality of mixed critically ill Thai patients in a medical intensive care unit. A prospective cohort study was conducted over a four-year period. The subjects were randomly divided into calibration and validation groups. ⋯ The customised SAPS II showed good calibration in only the younger, postoperative and sepsis patients subgroups. The overall performance of the customised APACHE II was better than the customised SAPS II (Brier score 0.089 and 0.109, respectively). Our results indicate that the customised APACHE II shows better performance than the customised SAPS II in predicting hospital mortality and could be used to predict mortality and quality assessment in our unit or other intensive care units with a similar case mix.
-
Journal of critical care · Sep 2009
Randomized Controlled Trial Multicenter StudyA randomized controlled trial comparing a computer-assisted insulin infusion protocol with a strict and a conventional protocol for glucose control in critically ill patients.
The objective of this study is to evaluate blood glucose (BG) control efficacy and safety of 3 insulin protocols in medical intensive care unit (MICU) patients. ⋯ The CAIP is safer than and as effective as the standard strict protocol for controlling glucose in MICU patients. Hypoglycemia was rare under conventional treatment. However, BG levels were higher than with IV insulin protocols.
-
Pediatric emergency care · Sep 2009
Randomized Controlled Trial Comparative StudyEffectiveness of fever education in a pediatric emergency department.
This study was designed to assess the impact of a brief educational video shown to parents during an emergency department visit for minor febrile illnesses. We hypothesized that a video about home management of fever would reduce medically unnecessary return emergency department visits for future febrile episodes. ⋯ A brief standardized video about home management of fever improved caregiver knowledge of fever but did not decrease emergency department use or increase medical necessity for subsequent febrile episodes.
-
Critical care medicine · Aug 2009
Randomized Controlled Trial Multicenter StudySubgroup mortality probability models: are they necessary for specialized intensive care units?
To examine the sensitivity of the performance of the latest Mortality Probability Model at intensive care unit admission (MPM0-III) to case-mix variations and to determine how specialized models for these subgroups would affect intensive care unit performance assessment. MPM0-III is an important benchmarking tool for intensive care units in Project IMPACT. Overall, MPM0-III has excellent discrimination and calibration but its performance varies on six common patient subsets. ⋯ We recommend users of MPM make MPM0-III their primary model. Subgroup models may have utility when evaluating highly specialized intensive care units or in research on specific, homogeneous populations.
-
Nephrol. Dial. Transplant. · Jul 2009
Randomized Controlled Trial Comparative StudyThe Hannover Dialysis Outcome study: comparison of standard versus intensified extended dialysis for treatment of patients with acute kidney injury in the intensive care unit.
Increasing the dose of renal replacement therapy has been shown to improve survival in critically ill patients with acute kidney injury (AKI) in several smaller European trials. However, a very recent large multicentre trial in the USA could not detect an effect of dose of renal replacement therapy on mortality. Based on those studies, it is not known whether a further increase in dialysis dose above and beyond the currently employed doses would improve survival in patients with AKI. We therefore aimed to assess mortality and renal recovery of patients with AKI receiving either standard (SED) or intensified extended dialysis (IED) therapy in the intensive care unit. ⋯ Although this study cannot deliver a definitive answer, it suggests that increasing the dose of extended dialysis above the currently recommended dose might neither reduce mortality nor improve renal recovery in critically ill patients, mainly septic patients, with AKI.