Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Comparative Study
["Simplified Acute Physiology Score" (SAPS II) ina the assessment of severity of illness in surgical intensive care patients].
In 1993, Le Gall proposed a new Simplified Acute Physiology Score (SAPS II) to assess the severity of illness in intensive care patients and to predict the risk of hospital mortality using a large data base of more than 13,000 patients of different intensive care units. Up to the present time, no satisfactory form of validation for surgical intensive care patients has been available. We investigated the prognostic quality of this score system for the assessment of the severity of the illness in surgical intensive care patients. ⋯ The SAPS II score has proved to be a good prognostic instrument in surgical intensive care patients. SAPS II is particularly effective in providing an exact estimation of the risk of death, classifying patient groups in clinical studies, epidemiological investigations, and quality assessment.
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Subjective experiences of patients during their stay in the intensive care unit (ICU) have so far rarely been described. The aim of this study was to analyze the experiences of patients during their stay in the ICU. ⋯ The study results led to several practical consequences in the quality of management procedure (e.g., the introduction of a thorough night's rest at the ICU, optimized information for patients). Additionally, we initiated further studies concerning the quality of life of ICU patients.
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The pathomorphological substratum of the pulmonary contusion is a parenchymatous hemorrhage followed by interstitial and alveolar edema, finally resulting in a severe damage of the surfactant system. The pathophysiological consequence is an imbalance between ventilation and perfusion, which causes the clinical finding of hypoxia. ⋯ Ventilation according to the OLC seems to be a highly effective treatment of ventilation-perfusion-impairment following pulmonary contusion. Minimal tidal volumes and the low PIP-levels after the recruitment procedure meet the demands of a lung-protective Low-Tidalvolume-Ventilation.