Intensive care medicine
-
Intensive care medicine · Jun 1997
A new method of accurately identifying costs of individual patients in intensive care: the initial results.
To analyse the patient-related and non-patient-related costs of intensive care using an activity-based costing methodology. ⋯ The use of average costs or scoring systems to cost intensive care is limited, as these methods cannot determine actual resource usage in individual patients. The methodology described here allows all the resources used by an individual patient or group of patients to be identified and thus provides a valuable tool for economic evaluations of different treatment modalities.
-
Intensive care medicine · Jun 1997
Comparative StudyEffects of high-frequency oscillatory ventilation on circulation in neonates with pulmonary interstitial emphysema or RDS.
Mechanical ventilation may impair cardiovascular function if the transpulmonary pressure rises. Studies on the effects of high-frequency oscillatory ventilation (HFOV) on cardiovascular functions have yielded conflicting results. This study was done to compare alterations in left ventricular output and blood flow velocities in the anterior cerebral artery, internal carotid artery, and celiac artery using a Doppler ultrasound device before and 2 h after initiating HFOV in neonates with respiratory distress syndrome (RDS) or pulmonary interstitial emphysema (PIE). ⋯ The results show that HFOV as used in this study, improves oxygenation, CO2 elimination, and circulation in infants with RDS and PIE. However, systemic, cerebral, and intestinal circulation improved more in neonates with PIE than in those with RDS. This may be due to higher pulmonary compliance in infants with PIE when compared to those with RDS.
-
Intensive care medicine · Jun 1997
Is bleomycin-detectable iron present in the plasma of patients with septic shock?
To assess plasma iron status in critically ill patients with septic shock. ⋯ Patients with septic shock rarely have iron saturated transferrin in their plasma leading to the presence of bleomycin-detectable iron.
-
Intensive care medicine · Jun 1997
Effects of epinephrine on right ventricular function in patients with severe septic shock and right ventricular failure: a preliminary descriptive study.
To recognize patients with unresponsive septic shock and right ventricular (RV) failure and to evaluate the effects of epinephrine on RV performance in these patients. ⋯ In patients with severe septic shock, RV dysfunction was identified by the use of an RVEF pulmonary artery catheter and was improved by epinephrine by means of an improvement in RV contractility.
-
Intensive care medicine · Jun 1997
Comparative StudyDrawover vaporizers for sedation in intensive care.
We have undertaken a laboratory study to determine whether a drawover vaporizer in the inspiratory limb of an intensive care ventilator circuit can produce safe and therapeutic concentrations of isoflurane. ⋯ The experimental findings suggest that the OMV inhaler in plenum mode can be relied upon to produce safe concentrations of isoflurane over a clinically useful range of inspired concentrations. Furthermore, it behaves predictably over the range of airway pressures likely to be encountered in the patient admitted with acute severe asthma. However, we found that the Ohmeda TEC vaporizer did not perform reliably in this setting.