Articles: critical-illness.
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Intensive care medicine · Feb 1997
Multicenter Study Comparative StudyOutcome prediction in intensive care: results of a prospective, multicentre, Portuguese study.
To compare the performance of the New Simplified Acute Physiology Score (SAPS II) and Acute Physiology and Chronic Health Evaluation (APACHE) II in an independent database, using formal statistical assessment. ⋯ SAPS II performed better than APACHE II in this independent database, but the results do not allow its use, at least without being customised, to analyse quality of care or performance among ICUs in the target population.
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Am. J. Respir. Crit. Care Med. · Jan 1997
Multicenter StudyIntensive care of patients with HIV infection: utilization, critical illnesses, and outcomes. Pulmonary Complications of HIV Infection Study Group.
To examine intensive care unit (ICU) admission rates and diagnoses of patients with HIV infection, and to determine the outcomes of different critical illnesses, we analyzed data derived from the 63 patients who were admitted to an ICU from among the 1,130 adults with HIV infection who did not have AIDS at the time of enrollment in a multicenter prospective study. Patients were admitted and treated according to the judgment of their physicians. During 4,298 patient-years of follow-up for the entire cohort, there were 1,320 hospital admissions, of which 68 (5%) included admission to an ICU. ⋯ In conclusion, the range of indications for critical care in patients with HIV infection is diverse. PCP accounted for only 16% of the ICU admissions, and mechanical ventilation for PCP and other pulmonary disorders was associated with a high mortality rate. In contrast, mechanical ventilation for nonpulmonary disorders, and admission to the ICU for nonpulmonary diagnoses was associated with a more favorable outcome.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of subcutaneous tunneling on internal jugular catheter-related sepsis in critically ill patients: a prospective randomized multicenter study.
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Multicenter Study
Application of total body bioimpedance to the critically ill patient. Brazilian Group for Bioimpedance Study.
In the past several years, considerable interest has developed in the study of total body bioimpedance analysis (TBBIA) and body composition in healthy subjects. This simple and noninvasive technique uses derived and regression equations to validate data comparative to the gold standards of total body water determination and body composition. However, this approach has not proved to be of value in the critically ill patient with distorted body composition under the effects of multiple drugs and interventions. ⋯ Some authors have demonstrated that this relation Xc/R is highly correlated with mortality and could be used for the staging of critically ill patients throughout their stay in the ICU. The role of TBBIA as a simple and noninvasive technique, and its implications for the management of critically ill patients are presented and discussed. Areas for future investigations, with single and multiple frequency, have the potential to clarify many aspects of this emergent technology at the bedside.
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Multicenter Study
The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators.
To examine the association between the use of right heart catheterization (RHC) during the first 24 hours of care in the intensive care unit (ICU) and subsequent survival, length of stay, intensity of care, and cost of care. ⋯ In this observational study of critically ill patients, after adjustment for treatment selection bias, RHC was associated with increased mortality and increased utilization of resources. The cause of this apparent lack of benefit is unclear. The results of this analysis should be confirmed in other observational studies. These findings justify reconsideration of a randomized controlled trial of RHC and may guide patient selection for such a study.