Intensive care medicine
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Intensive care medicine · Jul 2002
Comparative StudySurvival of mechanically ventilated patients admitted to a specialised weaning centre.
Hospital mortality and survival rates of long-term ventilated patients.DESIGN. Retrospective cohort study. ⋯ Difficult-to-wean patients have a high hospital mortality rate and poor long-term prognosis. Age, main diagnosis, severity of illness, weaning success and institution of NIV predict survival.
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Intensive care medicine · Jul 2002
Comparative StudyThe strong ion gap does not have prognostic value in critically ill patients in a mixed medical/surgical adult ICU.
To examine whether the strong ion gap (SIG) or standard base excess corrected for abnormalities of serum chloride and albumin (BE(UA)) can predict outcome and to compare the prognostic abilities of these variables with standard base excess (SBE), anion gap (AG), pH, and lactate, the more traditional markers of acid-base disturbance. ⋯ Traditional indices of SBE, BE(UA,) lactate, pH, AG, and APACHE II all discriminated well between survivors and non-survivors. In this group of patients the SIG, SIDeff, and SIGapp appear to offer no advantage in prediction of outcome and their use as prognostic markers can therefore not be advocated.
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Intensive care medicine · Jul 2002
Comparative StudyExperience with a once-daily dosing program of aminoglycosides in critically ill patients.
As aminoglycosides show concentration-dependent killing, once-daily aminoglycoside (ODA) regimens have been instituted. Data on experience with ODA regimens in critically ill patients are limited. ⋯ An ODA-regimen of 7 mg/kg produced Cmax/MIC ratios > 10 in the majority of critically ill patients in our population. Septic shock and renal dysfunction caused an aberrant pharmacokinetic profile of aminoglycosides in these patients. Therefore, individual therapeutic drug monitoring is warranted. Signs of renal impairment were common in the presence of shock, but appeared to be reversible.
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Intensive care medicine · Jul 2002
Comparative StudyQuality of life after intensive care--evaluation with EQ-5D questionnaire.
To evaluate health-related quality of life (HR-QOL) and study its determinants in adult patients discharged from an intensive care unit (ICU). ⋯ Intensive care unit variables (e.g., diagnosis, length of stay and severity of disease) and patient's background data (e.g., age, gender, education, main activity, smoking habits, experience with serious illness and previous health status) may be significant determinants of HR-QOL. However, when adjusted for background data, most ICU variables are no longer associated with EQ-5D. This should cause attention to be paid to the role of a patient's background in the evaluation of HR-QOL and to a careful interpretation of EQ-5D results when comparing ICUs.
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Intensive care medicine · Jul 2002
Conversion of recent-onset atrial fibrillation or flutter with ibutilide after amiodarone has failed.
To evaluate whether ibutilide can convert atrial fibrillation or flutter in patients in whom amiodarone has failed. ⋯ In ICU patients ibutilide led to conversion to sinus rhythm in 81.5% of patients in whom amiodarone was unsuccessful. Nonsustained tachycardias were seen in 11%; sustained ventricular tachycardia was not seen. Ibutilide seems to be well suitable for conversion of recent onset atrial fibrillation or flutter and had no severe side effects in this study population.