Articles: critical-care.
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Respiratory medicine · Jul 2005
Multicenter StudyCosts of the COPD. Differences between intensive care unit and respiratory intermediate care unit.
To assess whether respiratory intermediate care units (RICUs) are cost effective alternatives to intensive care units (ICUs) for patients with exacerbation of chronic obstructive pulmonary disease (COPD). ⋯ Our study suggests that some COPD patients, less severe and with pure respiratory failure, could be successfully and less costly treated in RICUs.
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Critical care medicine · Jun 2005
Multicenter StudyLarge-scale implementation of sedation and delirium monitoring in the intensive care unit: a report from two medical centers.
To implement sedation and delirium monitoring via a process-improvement project in accordance with Society of Critical Care Medicine guidelines and to evaluate the challenges of modifying intensive care unit (ICU) organizational practice styles. ⋯ With minimal training, the compliance of bedside nurses using sedation and delirium instruments was excellent. Agreement of data from bedside nurses and a reference-standard rater was very high for both the sedation scale and the delirium assessment over the duration of this process-improvement project.
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Multicenter Study
Prevalence of ischaemic heart disease at admission to intensive care and its influence on red cell transfusion thresholds: multicentre Scottish Study.
Restrictive transfusion triggers are safe for most critically ill patients, but doubts exist for patients with ischaemic heart disease (IHD). We investigated the prevalence of reported IHD at admission to the intensive care unit (ICU) and investigated how this influenced red cell transfusion triggers. We also compared observed practice with the clinicians' responses to clinical scenarios. ⋯ About 29% of patients admitted to Scottish ICUs had documented IHD, which was associated with small adjustments to Hb transfusion triggers. In response to scenarios, clinicians believe that patients with IHD require higher transfusion triggers than are observed in practice.
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Multicenter Study
The Injury Severity Score or the New Injury Severity Score for predicting intensive care unit admission and hospital length of stay?
To compare the New Injury Severity Score (NISS) and the Injury Severity Score (ISS) as predictors of intensive care unit (ICU) admission and hospital length of stay (LOS) in an urban North American trauma population and in a subset of patients with head injuries. ⋯ The NISS is a better choice for case mix control in trauma research than the ISS for predicting ICU admission and LOS, particularly among patients with moderate to severe head injuries.
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Multicenter Study
Indications, timing, and techniques of tracheostomy in 152 French ICUs.
To investigate the current practice of tracheostomy in French ICUs, focusing on the frequency, timing, indications, and techniques. ⋯ There is much heterogeneity in the reported practices of tracheostomy in French ICUs. Three fourths of physicians considered that a randomized study comparing prolonged translaryngeal intubation and early tracheostomy in patients expected to receive prolonged MV would be necessary to clarify those issues.