Intensive care medicine
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Intensive care medicine · Dec 1996
Multicenter StudyThe performance of SAPS II in a cohort of patients admitted to 99 Italian ICUs: results from GiViTI. Gruppo Italiano per la Valutazione degli interventi in Terapia Intensiva.
To assess the validity of SAPS II (new Simplified Acute Physiology Score) in a cohort of patients admitted to a large sample of Italian intensive care units (ICU). ⋯ SAPS II maintained its validity in an independent sample of patients recruited in a large network of Italian ICUs only after appropriate adaptation (first-level customization). Whether the determinants of this relatively poor performance are related to differences in unmeasured case-mix, methods of application, or quality of care delivered is a matter for discussion that cannot be solved with the data presently available. However, these findings suggest that caution is warranted before implementing the standard SAPS II scoring system parameters outside formal research projects.
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Intensive care medicine · Dec 1996
Comparative StudyMeningococcal disease: a comparison of eight severity scores in 125 children.
To investigate the accuracy of eight different prognostic scores (Stiehm, Niklasson, Leclerc, Garlund, the MOC score, Tesero, the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) and Tüyzüs) in the prediction of fatal outcome in meningococcal disease. ⋯ The GMSPS is a simple score that can be reliably used for risk classification and the identification of low-risk patients.
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Intensive care medicine · Dec 1996
Impaired gastric emptying in mechanically ventilated, critically ill patients.
To measure gastric emptying in critically ill patients using an acetaminophen absorption model and determine which variables are associated with impaired gastric emptying. ⋯ Gastric emptying is delayed in critically ill patients. The important consequences of this phenomenon include intolerance to enteral nutrition and gastric colonization. Strategies to minimize the use of narcotics may improve gastric emptying. Studies to examine the effect of gastrointestinal prokinetic agents on gastric emptying are needed.
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Intensive care medicine · Dec 1996
Measuring health and health state preferences among critically ill patients.
a) to examine the EuroQol instrument's ability to assess a patient's state of health prior to admission to an ICU; b) to describe a patient's health-related quality of life (HRQoL) before the onset of the condition leading to admission to the ICU, and prior to discharge; c) to compare patients' preferences for a "common core" of EuroQol health states with preferences from healthy individuals. ⋯ The EuroQol can be reliably used with proxies to determine the state of health of patients prior to admission to the ICU. Preferences between healthy individuals and ICU patients differed.
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Intensive care medicine · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialOvernight sedation with midazolam or propofol in the ICU: effects on sleep quality, anxiety and depression.
To assess and compare the impact of overnight sedation with midazolam or propofol on anxiety and depression levels, as well as sleep quality, in non-intubated patients in intensive care. ⋯ These data show that half of the patients in the ICU experienced high levels of anxiety and depression during the first 5 post-operative or post-trauma days in the ICU. The beneficial effects of sedation on sleep quality were comparable for midazolam and propofol, regardless of a lack of improvement in anxiety and depression. However, an improved quality of sleep could help to re-establish a physiological night and day rhythm.