Intensive care medicine
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Intensive care medicine · Feb 2002
Multicenter Study Comparative StudyEpidemiology of sepsis and infection in ICU patients from an international multicentre cohort study.
To examine the incidence of infections and to describe them and their outcome in intensive care unit (ICU) patients. ⋯ The crude incidence of ICU infections remains high, although the rate varies between ICUs and patient subsets, illustrating the added burden of nosocomial infections in the use of ICU resources.
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Intensive care medicine · Feb 2002
Comparative StudyScoring systems in pediatric intensive care: PRISM III versus PIM.
To compare the performance of two different clinical scoring systems that were developed to assess mortality probability in pediatric intensive care. ⋯ PRISM III and PIM scores are both adequate indicators of mortality probability for heterogeneous patient groups in pediatric intensive care. Possibly in larger studies (equivalence trial) a significant and relevant difference between these scores would be demonstrated.
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Intensive care medicine · Feb 2002
Is the bispectral index appropriate for monitoring the sedation level of mechanically ventilated surgical ICU patients?
To determine the value of the bispectral index (BIS) in assessing the depth of sedation in sedated and mechanically ventilated ICU patients, compared with clinical sedation scores. ⋯ BIS is correlated only in some ICU patients with the clinical assessment of their sedation level as based on various scores. At deeper sedation levels the interindividual differences increase. There were no criteria found to distinguish patients with and without correlation. This suggests that the BIS is not suitable for monitoring the sedation in a heterogeneous group of surgical ICU patients.
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Intensive care medicine · Feb 2002
Liver tissue oxygenation as measured by near-infrared spectroscopy in the critically ill child in correlation with central venous oxygen saturation.
To evaluate the clinical usefulness of near-infrared spatially resolved spectroscopic quantitative assessment of liver tissue oxygenation for simple, non-invasive estimation of global tissue oxygenation in critically ill neonates and children. ⋯ Near-infrared spatially resolved spectroscopic quantitative measurement of liver tissue oxygenation correlates well with SvO(2) in critically ill neonates and children. Large inter-individual SvO(2) to TOI(Liver) differences may prevent its use for non-invasive single-point estimation of global tissue oxygenation. Further clinical studies are required to validate the method with other regional and global haemodynamic parameters and to evaluate its clinical use for continuous non-invasive haemodynamic monitoring.
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Intensive care medicine · Feb 2002
Airway obstruction and ventilator dependency in young children with congenital cardiac defects: a role for self-expanding metal stents.
Young children with congenital cardiac defect and airway obstruction leading to ventilator dependency present a significant clinical challenge with uncertain outcome. ⋯ Airway stenting in such young children is an infrequent procedure often undertaken in dire circumstances. We have found it valuable in enabling ventilator-dependent children to be extubated with encouraging early results. Their long-term outlook remains uncertain and is dependent on the underlying cardiac status.