Intensive care medicine
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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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Intensive care medicine · Feb 1997
Multicenter Study Comparative Study Clinical TrialPaediatric index of mortality (PIM): a mortality prediction model for children in intensive care.
To develop a logistic regression model that predicts the risk of death for children less than 16 years of age in intensive care, using information collected at the time of admission to the unit. ⋯ Scores that use the worst value of their predictor variables in the first 12-24 h should not be used to compare different units: patients mismanaged in a bad unit will have higher scores than similar patients managed in a good unit, and the bad unit's high mortality rate will be incorrectly attributed to its having sicker patients. PIM is a simple model that is based on only eight explanatory variables collected at the time of admission to intensive care. It is accurate enough to be used to describe the risk of mortality in groups of children.
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Intensive care medicine · Feb 1997
Randomized Controlled Trial Clinical TrialDecrease in nosocomial pneumonia in ventilated patients by selective oropharyngeal decontamination (SOD).
To determine the influence of selective oropharyngeal decontamination (SOD) on the rate of colonization and infection of the respiratory tract in intensive care patients requiring mechanical ventilation for more than 4 days. A financial assessment was also performed. ⋯ The use of SOD significantly reduced the colonization and pneumonia and the total charge for antibiotics. The length of stay in the ICU, duration of ventilation, and mortality were similar. No resistance was observed. Staphylococcus aureus was selected by SOD in some patients and the clinical relevance needs further observation.
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To analyze the actual cost of pediatric intensive care and its different components, particularly the differences between various patient groups, with special reference to the variable cost and the elements included in it. ⋯ The cost of personnel was the biggest factor in intensive care costs: 62.4% of the total costs. Nonsurvivors generated 3 times the mean variable daily expenditure on survivors and had longer stays in the PICU. The increase in PSI score on the first day was associated with a global increase in variable costs. The cost of treatment techniques significantly increased as the illness became more severe but consumption of antibiotics and parenteral nutrition and use of bacteriologic tests and radiology did not.
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To evaluate the effects of prolonged neuromuscular blockade (NMB) on oxygenation and duration of mechanical ventilation in children with respiratory failure. ⋯ Oxygenation index (OI)*: Mean Airway Pressure x FiO2 x 100/PaO2* Higher scores represent deterioration in oxygenation.