Articles: intensive-care-units.
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient outcomes for the chronically critically ill: special care unit versus intensive care unit.
The purpose of this study was to compare the effects of a low-technology environment of care and a nurse case management case delivery system (special care unit, SCU) with the traditional high-technology environment (ICU) and primary nursing care delivery system on the patient outcomes of length of stay, mortality, readmission, complications, satisfaction, and cost. A sample of 220 chronically critically ill patients were randomly assigned to either the SCU (n = 145) or the ICU (n = 75). Few significant differences were found between the two groups in length of stay, mortality, or complications. ⋯ The average total cost of delivering care was $5,000 less per patient in the SCU than in the traditional ICU. In addition, the cost to produce a survivor was $19,000 less in the SCU. Results from this 4-year clinical trial demonstrate that nurse case managers in a SCU setting can produce patient outcomes equal to or better than those in the traditional ICU care environment for long-term critically ill patients.
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health-care practitioners should be aware of how their equipment and practices can increase the patient's risk for noise-induced hearing loss. ⋯ We conclude that heated humidifiers produce lowest sound intensities at the lowest sound frequencies and, consequently, are most appropriate for use in the NICU.
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Japanese heart journal · Nov 1995
Case ReportsCorrected transposition of the great arteries: dynamic three-dimensional echocardiography and volumetry. A new diagnostic tool in intensive care management.
Today, an increasing incidence of severe complications of cardiac malformations in adult patients must be expected since the life expectancy of such individuals is prolonged due to improved management. A 32-year-old woman with corrected transposition of the great arteries (CTGA) was admitted to the intensive care unit because of cardiac decompensation. ⋯ In CTGA uncommon complications may cause pulmonary edema. Using dynamic three-dimensional echocardiography to reveal function, volume parameters and the morphology of both ventricles and to exclude additional complications may be considered an adequate diagnostic tool for responding to this challenge.
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The American surgeon · Oct 1995
ICU care after infra-inguinal arterial surgery: an analysis of indications and outcomes.
The authors analyzed 632 consecutive, nontrauma Surgical Intensive Care Unit (SICU) admissions after infra-inguinal arterial surgery over a 3-year period (4/89-3/92) for the need for postoperative SICU care. Group I consisted of 122 patients (58 males, 64 females) with at least one absolute indication for SICU care, including mechanical ventilation, pulmonary artery, catheter monitoring, or intravenous infusion of vasoactive or antiarrythmic drugs. Group II comprised 510 patients (275 males, 235 females) without an absolute indication for SICU care. ⋯ There was no significant difference in the age of Group I and Group II patients, but Group I patients had a significantly longer preoperative LOS (6.1 +/- 0.7 vs 3.2 +/- 0.3 days, P < 0.0005). In Group II patients there were significant correlations between patient age and postoperative death, as well as between preoperative LOS and SICU LOS > 1 day. Patient age > or = 80 years and preoperative LOS > 3 days are significant preoperative correlates of the need for SICU care following infra-inguinal arterial surgery in patients who do not have an absolute indication for such care.