Intensive care medicine
-
Intensive care medicine · Jan 2001
Multicenter StudyA cost-effectiveness analysis of stays in intensive care units.
To evaluate patient outcome and the efficiency of stays in intensive care units (ICUs). ⋯ This work provides medical and economic information on ICU stays in teaching hospitals and enables comparisons with other health-care options.
-
Intensive care medicine · Jan 2001
Comparative StudyAre transoesophageal Doppler parameters a reliable guide to paediatric haemodynamic status and fluid management?
Transoesophageal Doppler (TOD) has been used in adults to optimise left ventricular filling on the basis of the waveform parameters. We wished to see if a similar relationship exists in children, specifically: (a) whether change in thermodilution stroke volume (SV) following a fluid bolus corresponded to change in Doppler stroke distance, Doppler corrected flow time (FTc), or central venous pressure (CVP); (b) whether a response to fluid challenge (defined as an increase in SV of greater than 10%) can be predicted on the basis of an absolute value for FTc or CVP prior to fluid bolus; and (c) the relationship between FTc and systemic vascular resistance index. ⋯ TOD stroke distance is able to follow changes in SV following fluid bolus amongst ventilated children, and can predict when further volume loading is unlikely to improve SV amongst general, but not cardiac ICU patients. CVP is a poor discriminator of volume status in this group of patients.
-
Intensive care medicine · Jan 2001
Comparative StudyChanges in quality of life after medical intensive care.
To determine outcome and changes in health-related quality of life (QOL) in medical intensive care patients. ⋯ Six months after admission to a medical ICU most survivors had regained their preadmission health-related QOL. Multivariate analysis showed that preadmission QOL, age, and severity of illness were most strongly associated with follow-up QOL. Of the survivors 86 % were living at home, and all but one of those previously in employment had returned to their former work. Most patients (94%) would undergo ICU treatment again if necessary.
-
Intensive care medicine · Jan 2001
Clinical TrialThe Internal jugular veins are asymmetric. Usefulness of ultrasound before catheterization.
To demonstrate an asymmetry of the internal jugular veins, a finding which will have consequences for catheterization. ⋯ Using a simple technique, ultrasound identifies the dominant internal jugular vein, thus indicating the safer side before blind catheterization.