Intensive care medicine
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Intensive care medicine · Sep 1999
Editorial Comment ReviewUltrasound-aided thoracentesis in intensive care patients.
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Intensive care medicine · Sep 1999
Comparative StudyApplication of mortality prediction systems to individual intensive care units.
To evaluate the predictive accuracy of the severity of illness scoring systems in a single institution. ⋯ Although the overall mortality was consistent with the predicted mortality, the poor fit of the data to the model impairs the validity of the result. The observed outcome could be due to erratic quality of care, or differences between the study population and the patient population in the original studies. The data cannot be used to distinguish between these possibilities. To increase predictive accuracy when studying individual intensive care units and enhance quality of care assessments it may be necessary to adapt the model to the patient population.
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Intensive care medicine · Sep 1999
Comparative StudyImproved prognosis of acute respiratory distress syndrome 15 years on.
Evaluation of the impact of low-volume, pressure-limited ventilation on the recovery rate of acute respiratory distress syndrome (ARDS). ⋯ Mortality due to ARDS of pulmonary origin has declined in our unit over the last 15 years. Low-volume, pressure-limited (protective) ventilation seems the most likely reason for improved survival, despite hypercapnia.
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Intensive care medicine · Sep 1999
Comparative StudyLactate measurements in critically ill patients with a hand-held analyser.
To compare a recently introduced hand-held lactate analyser to a reference point of care analyser (POCI) and the hospital laboratory in a critical care setting. ⋯ The hand-held lactate analyser can reliably measure arterial blood lactate levels in critically ill patients.
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Intensive care medicine · Sep 1999
Current definitions of acute lung injury and the acute respiratory distress syndrome do not reflect their true severity and outcome.
Despite intensive research, there are no universally accepted clinical definitions for acute lung injury (ALI) or the acute respiratory distress syndrome (ARDS). A recent joint American-European Consensus Conference on ARDS formally defined the difference between ALI and ARDS based on the degree of oxygenation impairment. However, this definition may not reflect the true prevalence, severity and prognosis of these syndromes. ⋯ Since the use of PEEP in the American-European Consensus criteria for ARDS is not mandatory, that definition does not reflect the true severity of lung damage and outcome. Our data support the need for guidelines based on a specific method of evaluating oxygenation status before the American-European Consensus definition is adopted.