Articles: intensive-care-units.
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Physiologic and psychologic changes associated with sleep disturbance decrease the ability of a critically ill child to adapt to hospitalization and thus hamper recovery. Research demonstrates that intensive care settings interfere with sleep of adults, but little is known about the impact of these settings on children's sleep. An exploratory field study was conducted to describe the sleep-wake patterns of 1- and 2-year-old children in intensive care, identify intensive care environmental stimuli associated with sleep and waking states, compare the intensive care sleep-wake pattern to the pre-illness sleep-wake pattern, and determine the time required for children to return to their pre-illness sleep-wake pattern. ⋯ Sleep changes persisted after discharge from the PICU and the hospital. Total sleep time recovered more rapidly than nighttime awakening. Parents perceived that their child's sleep remained different longer than total sleep time and night awakening values demonstrated.
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Revista médica de Panamá · Jan 1996
[Cause of mortality in the surgery intensive care unit at the Social Security Branch of Panamá].
The authors analyzed the mortality of patients admitted to the Surgical Intensive Care Unit of the Social Security Metropolitan Hospital Complex (SSMHC) in the city of Panama, from January to July 31, 1994. They determined that most of patients were males under 65 years of age and that the main cause of death was multiple trauma with shock. There was also a strong correlation between the syndrome of multiple organ failure, sepsis and death. The 17% mortality indicates an acceptable, good management of the patients admitted to the Surgical Intensive Care Unit of the SSMHC.
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Am. J. Respir. Crit. Care Med. · Jan 1996
Comparative StudyResource use implications of do not resuscitate orders for intensive care unit patients.
This study describes the use of do not resuscitate (DNR) orders for ICU patients in four northeastern U. S. teaching hospitals and investigates the relationship between DNR orders and length of stay. The use of detailed data from the mortality probability model (MPM II) study on 6,290 consecutive ICU admissions to general adult medical and surgical ICUs during 1989 through 1991 allows us to control for severity of illness and the time during the ICU stay at which the DNR order was entered. ⋯ Nonsurvivors with early (first 24 h) DNR had shorter mean and median ICU and hospital stays than the comparison group of non-DNR patients. The percentage of patients with very long ICU (> 30 d) and hospital (> 60 d) stays was smaller among DNR patients. The use of DNR orders, particularly early in the ICU stay, may be associated with significant resource use reduction for an identifiable group of patients.