Intensive care medicine
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Intensive care medicine · Apr 2001
Comparative StudyA comparison of post mortem findings with post hoc estimated clinical diagnoses of patients who die in a United Kingdom intensive care unit.
To determine the accuracy of clinical diagnosis compared to post mortem findings in intensive care patients. ⋯ This study reveals that in an intensive care unit important diagnostic discrepancies were found in 19.6% of patients who underwent a post mortem examination. In a fifth of these (4.1%), survival may have been adversely affected. Haemorrhage was the most commonly missed diagnosis. Despite technological advances in intensive care medicine the post mortem examination continues to have an important role in auditing clinical practice and diagnostic performance.
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Intensive care medicine · Apr 2001
Effect of an acute increase in PCO2 on splanchnic perfusion and metabolism.
To evaluate the acute effects of an increase in PCO2 on splanchnic tissue perfusion and metabolism. ⋯ Our results suggest that acute moderate changes in PCO2 have no major effect on splanchnic perfusion and metabolism.
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Intensive care medicine · Apr 2001
Clinical TrialUsefulness of a strategy based on bronchoscopy with direct examination of bronchoalveolar lavage fluid in the initial antibiotic therapy of suspected ventilator-associated pneumonia.
To evaluate (a) the routine accuracy of bronchoalveolar lavage by direct examination (BAL-D) in diagnosing ventilator-associated pneumonia (VAP), and (b) the impact of a diagnostic strategy including clinical judgment, bronchoscopy, and BAL-D on the initial diagnosis and appropriateness of treatment when VAP is suspected. ⋯ A strategy based on bronchoscopy and BAL-D generally leads to a rapid and appropriate treatment of nosocomial pneumonia in ventilated patients.
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Intensive care medicine · Apr 2001
Clinical TrialPharmacokinetics of ciprofloxacin in ICU patients on continuous veno-venous haemodiafiltration.
To investigate the pharmacokinetics of intravenous ciprofloxacin 200 mg every 8 h in critically ill patients on continuous veno-venous haemodiafiltration (CVVHDF), one form of continuous renal replacement therapy (CRRT). ⋯ Intravenous ciprofloxacin 600 mg/day in critically ill patients using this form of CRRT produced adequate plasma levels for many resistant microbes found in intensive care units.
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Intensive care medicine · Apr 2001
A prospective cohort study of 6-month mortality in a community hospital experiencing a gradual reduction in critical care services.
To analyse the effect of reduction of critical care services on admissions, resource consumption and outcome. ⋯ The results suggest that an excess of resources were used in critical care services during 1993 and 1995. Reduction of HDU/ICU beds by 30% from 7.1 to 4.8 beds/100,000 was not associated with increased 6-month mortality of the patients admitted.