Intensive care medicine
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Intensive care medicine · May 1996
The effect of casemix adjustment on mortality as predicted by APACHE II.
To describe the effect of casemix on mortality as predicted by APACHE II scoring. ⋯ APACHE II did not accurately adjust for casemix in our data. Unless account is taken of differences in casemix, using mortality ratios to compare ICU is likely to be inaccurate and misleading.
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Intensive care medicine · May 1996
Review Comparative Study Clinical Trial Controlled Clinical TrialContinuous measurement of cardiac output by the Fick principle in infants and children: comparison with the thermodilution method.
To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. ⋯ Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children.
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Intensive care medicine · May 1996
Comparative Study Clinical Trial Controlled Clinical TrialThe effect of single-dose and continuous skeletal muscle paralysis on respiratory system compliance in paediatric intensive care patients.
To investigate the effect of single dose and continuous skeletal muscle paralysis on respiratory system compliance in 53 paediatric intensive care patients. ⋯ Skeletal muscle paralysis results in immediate and progressive deterioration of respiratory system compliance and increased incidence of nosocomial pneumonia. The benefits of paralysis should be balanced against the risks of deteriorating pulmonary function.
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Intensive care medicine · May 1996
Comparative Study Clinical Trial Controlled Clinical TrialAlbumin bolus administration versus continuous infusion in critically ill hypoalbuminemic pediatric patients.
To test the hypothesis that the rate of degradation of exogenously administered albumin is faster with bolus administration than with continuous infusion and thus that a bolus administration is less efficacious in restoring blood albumin concentration (BAC) in the hypoalbuminemic critically ill pediatric patient. ⋯ The half-life of exogenous albumin in the critically ill hypoalbuminemic pediatric patient is short if given as a bolus. Continuous infusion therapy appears to be more efficacious in increasing BAC over time, as the half-life with this method appears to be longer.
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Intensive care medicine · May 1996
Comparative StudyBlood lactate levels are better prognostic indicators than TNF and IL-6 levels in patients with septic shock.
Both serum levels of tumor necrosis factor-alpha (TNF alpha) and interleukin-6 (IL-6) and blood lactate levels in patients with septic shock have been shown to correlate with prognosis. The aim of the study was to define the relative predictive value of these measures. ⋯ These data indicate that the large variability in TNF alpha and IL-6 levels limit their prognostic significance in patients with septic shock. The predictive value of the trend in cytokine levels over time is not superior to that of trends in blood lactate levels.