Articles: critical-illness.
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Critical care medicine · Dec 1992
Pediatric risk of mortality scoring overestimates severity of illness in infants.
To validate Pediatric Risk of Mortality (PRISM) scoring in infants and children admitted for intensive care. ⋯ In our center, PRISM scoring overestimates severity of illness in infants. PRISM scoring is not institutionally independent and therefore, at present, a comparison between units may not be justified. A reappraisal of the parameter ranges for infants is suggested.
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Critical illness, surgery and hypocaloric feeding are accompanied by a high rate of total body nitrogen loss. Loss of body protein, occurring despite adequate nutrition, results in increased incidence of infection, poor wound healing, skeletal muscle weakness and increased mortality. Growth hormone (GH) administration together with nutritional support attenuates protein catabolism. This review focuses on normal GH physiology and the administration of GH in adult catabolic patients.
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The American surgeon · Dec 1992
Glucose intolerance in critically ill surgical patients: relationship to total parenteral nutrition and severity of illness.
The authors evaluated the relative influence of severity of illness and total parenteral nutrition (TPN) on glucose intolerance in critically ill surgical patients. Records of TPN administration, serum glucose measurements, and the simplified acute physiology score (SAPS) were extracted from the surgical intensive care unit (SICU) and hospital clinical information systems (CIS) for all patients admitted to the SICU from October 1, 1989 through March 31, 1990. Critical hyperglycemia was defined as glucose > 400 mg/dL and critical hypoglycemia as < 40 mg/dL. ⋯ Mean glucose levels rose with increasing SAPS in both TPN and non-TPN patients. When stratified by severity of illness, TPN patients did not have significantly higher glucose levels than non-TPN patients except for the SAPS = 15 category. The authors conclude that the glucose intolerance noted in critically ill TPN patients reflects their underlying severity of illness rather than TPN administration per se.
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The purpose of this article is to provide an overview of completed studies that consider visitors in critical care areas. Studies from coronary care, intensive care, pediatric PACUs, and adult PACUs are reviewed.
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Crit Care Nurs Clin North Am · Dec 1992
Needs of families of critically ill patients: state of the science and future directions.
This article provides an overview of the needs of families of critically ill patients and offers suggestions for future research. Continuous, systematic study about the needs of families of critically ill patients is necessary for nursing to be responsive to the health care needs of society in the 21st century.