Articles: intensive-care-units.
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Intensive care medicine · Aug 2002
Randomized Controlled Trial Clinical TrialProtocol-directed weaning from mechanical ventilation: clinical outcome in patients randomized for a 30-min or 120-min trial with pressure support ventilation.
To investigate the possibility of successful extubation performing a spontaneous breathing trial (SBT) in pressure support ventilation (PSV) with target durations of 30 and 120 min. ⋯ An SBT with PSV of 7 cmH(2)O lasting 30 min is equally effective in recognizing the successfully extubated patients as a 120-min trial.
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Randomized Controlled Trial Clinical Trial
Infection, multiple organ failure, and survival in the intensive care unit: influence of glutamine-supplemented parenteral nutrition on acquired infection.
We investigated the effect of a glutamine-supplemented parenteral nutrition on intensive-care-acquired infection (ICAI) and its relation to outcome. ⋯ In these severely ill patients, parenteral nutrition containing glutamine may not reduce the overall incidence of ICAI, but it may reduce the risk of dying from acquired infections. The improved survival seen at 6 mo appeared related mostly to reduced mortality in the intensive care unit from multiple organ failure in those patients in whom acquired infections are common.
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Am. J. Respir. Crit. Care Med. · Feb 2002
Randomized Controlled Trial Multicenter Study Clinical TrialImpact of a family information leaflet on effectiveness of information provided to family members of intensive care unit patients: a multicenter, prospective, randomized, controlled trial.
Comprehension and satisfaction are relevant criteria for evaluating the effectiveness of information provided to family members of intensive care unit (ICU) patients. We performed a prospective randomized trial in 34 French ICUs to compare comprehension of diagnosis, prognosis, treatment, and satisfaction with information provided by ICU caregivers, in ICU patient family representatives who did (n = 87) or did not (n = 88) receive a family information leaflet (FIL) in addition to standard information. An FIL designed specifically for this study was delivered at the first visit of the family representative: it provided general information on the ICU and hospital, the name of the ICU physician caring for the patient, a diagram of a typical ICU room with the names of all the devices, and a glossary of 12 terms commonly used in ICUs. ⋯ The FIL reduced the proportion of family members with poor comprehension from 40.9% to 11.5% (p < 0.0001). In the representatives with good comprehension, the FIL was associated with significantly better satisfaction (21 [18 to 24, quartiles] versus 27 [24 to 29, quartiles], p = 0.01). These results indicate that ICU caregivers should consider using an FIL to improve the effectiveness of the information they impart to families.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Economic evaluation of propofol for sedation of patients admitted to intensive care units.
The goal of the current study was to evaluate the economic impact of propofol as compared with midazolam for sedating patients in the intensive care unit (ICU). ⋯ The analysis demonstrated that using propofol resulted in a reduction of time to extubation and higher sedative regimen costs. There was no difference in intensity of resource use or ICU length of stay and hence in costs. Issues regarding discharge delay among propofol-treated patients remain to be explored.
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Revue médicale de Liège · Dec 2001
Randomized Controlled Trial Clinical Trial[Clinical study of the month. Toxicity of hyperglycemia in intensive care and beneficial effects of optimized insulin therapy].
A large Belgian, prospective, controlled study was performed in 1.548 critically ill patients (83% without history of diabetes) hospitalised in a surgical intensive care unit. On admission, patients were randomly assigned to receive intensive intravenous insulin therapy (maintenance of blood glucose at a level between 80 and 110 mg/dl) or conventional treatment (infusion of insulin only if the blood glucose level exceeded 215 mg/dl and maintenance of glucose at a level between 180 and 200 mg/dl). Intensive insulin therapy reduced morbidity and mortality by 40%. These remarkable results should influence further therapeutical attitudes in intensive care units and open new perspectives for the management of critically ill patients.