Intensive care medicine
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Intensive care medicine · Oct 2002
Multicenter StudyEffect of centre-, patient- and procedure-related factors on intensive care resource utilisation after cardiac surgery.
To determine associations between intensive care resource utilisation and centre-, patient- and procedure-related factors. ⋯ In European ICUs resource utilisation is highly variable after cardiac surgery. Up to two thirds more patients could be treated with current ICU resources if the most efficient strategies and structures were applied across all centres.
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Intensive care medicine · Oct 2002
Multicenter StudyIntermittent versus continuous renal replacement therapy for acute renal failure in intensive care units: results from a multicenter prospective epidemiological survey.
To describe the current practice of hemodialysis in acute renal failure (ARF) and to estimate the impact of hemodialysis modality on patient outcome. ⋯ Renal replacement therapy mode was not found to have any prognostic value. Randomized controlled trials should be undertaken to assess this important question.
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Intensive care medicine · Oct 2002
Multicenter StudyA multicenter survey of visiting policies in French intensive care units.
To determine the visiting policies of French intensive care units. ⋯ Responding ICUs provide homogeneously restrictive visiting policies concerning visiting hours, number and type of visitors. However, family reception cannot be reduced to some quantitative factors and depends on multiple other parameters such as the organization of family meetings and the use of an information leaflet. These results should be an interesting starting point to observe any change in mentalities and practices in the future.
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Intensive care medicine · Oct 2002
Randomized Controlled Trial Clinical TrialPlasmapheresis in severe sepsis and septic shock: a prospective, randomised, controlled trial.
To determine the therapeutic efficacy and safety of plasmapheresis in the treatment of patients with severe sepsis and septic shock. ⋯ Plasmapheresis may be an important adjuvant to conventional treatment to reduce mortality in patients with severe sepsis or septic shock. Plasmapheresis is a safe procedure in the treatment of septic patients. A prospective randomised multicentre trial is warranted to confirm our results and to determine which subgroups of septic patients will benefit most from this treatment modality.
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Intensive care medicine · Oct 2002
Direct costs of severe sepsis in three German intensive care units based on retrospective electronic patient record analysis of resource use.
To determine the direct costs of severe sepsis patients in German intensive care units (ICUs). ⋯ A bottom-up approach was used to determine the direct ICU cost on actual resource use (medication, laboratory tests, microbiological analysis, disposables, and clinical procedures) for patients with severe sepsis. To determine the total direct costs, center-specific personnel and basic bed ("hotel") costs were added to total resources consumed. Average hospital mortality of severely septic patients was 42.6%. Mean ICU length of stay (LOS) was 16.6 days. Survivors stayed on average 4 days longer than nonsurvivors. The mean direct ICU costs of care were 23,297+/-18,631 euros per patient and 1,318 euros per day. In comparison, average daily charges being paid for an ICU patient by the health care system in Germany are 851 euros (based on official statistics). Nonsurvivors were more expensive than survivors in total direct costs (25,446 vs. 21,984 euros) and in per day direct cost (1,649 vs. 1,162 euros). Medication makes up the largest part of the direct costs, followed by expenses for personnel. CONCLUSIONS. Patients with severe sepsis have a high ICU mortality rate and long ICU LOS and are substantially expensive to treat. Nonsurviving septic patients are more costly than survivors despite shorter ICU LOS. This is due to higher medication costs indicating increased efforts to keep patients alive.