Intensive care medicine
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Intensive care medicine · Nov 2002
Multicenter StudyTop-down costing: problems in determining staff costs in intensive care medicine.
To describe the activities carried out by the staff of Italian ICUs and to quantify the amount of working time devoted to ICU patients. ⋯ Given the wide variation in the number of activities performed and in the proportion of working time spent performing non-ICU related activities, data comparing costs between different ICUs should be interpreted with caution.
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To evaluate serum soluble L-selectin as a prognostic factor for survival in patients with sepsis. ⋯ Serum sL-selectin is a predictor of survival in patients with sepsis. Those admitted with low sL-selectin (<470 ng/ml) are characterized by a high mortality within the subsequent 12-month period.
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Intensive care medicine · Nov 2002
Randomized Controlled Trial Comparative Study Clinical TrialEffect of the humidification device on the work of breathing during noninvasive ventilation.
Heat and moisture exchangers (HME) increase circuitry deadspace compared to heated humidifiers (HH). This study compared the effect of HH and HME during noninvasive ventilation (NIV) on arterial blood gases and patient's effort assessed by respiratory muscles pressure-time product and by work of breathing (WOB). ⋯ In patients receiving NIV for moderate to severe acute hypercapnic respiratory failure, the use of HME lessens the efficacy of NIV in reducing effort compared to HH.
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Intensive care medicine · Nov 2002
Comparative StudyThe Multiple Organ Dysfunction Score (MODS) versus the Sequential Organ Failure Assessment (SOFA) score in outcome prediction.
To compare outcome prediction using the Multiple Organ Dysfunction Score (MODS) and the Sequential Organ Failure Assessment (SOFA), two of the systems most commonly used to evaluate organ dysfunction in the intensive care unit (ICU). ⋯ MODS and SOFA are reliable outcome predictors. Cardiovascular dysfunction is better related to outcome with the SOFA score than with the MODS.
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Intensive care medicine · Nov 2002
Acute lung injury and acute respiratory distress syndrome at the intensive care unit of a general university hospital in Brazil. An epidemiological study using the American-European Consensus Criteria.
To determine: (1) the frequency of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); (2) the mortality associated with these syndromes and (3) the influence of risk factors, comorbidities and organ system dysfunction in the mortality of ALI patients. ⋯ (1) The frequency of ALI was 3.8%, of which the frequency of ARDS was 2.3% and of ALI/non-ARDS 1.5%; (2) The ICU and hospital mortality of ALI patients was 44.0% and 48.0%, respectively; mortality rates of ARDS and ALI/non-ARDS did not differ significantly; (3) Renal and hematological dysfunction were associated with mortality in ALI patients.