Heart & lung : the journal of critical care
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the effects of assist-control, SIMV, and SIMV with pressure support on ventilation, oxygen consumption, and ventilatory equivalent.
To quantify the ventilatory efficiency of different modes of mechanical ventilation used to achieve full ventilatory support in normal subjects. Modes compared were assist-control, synchronized intermittent mandatory ventilation (SIMV), and SIMV with 10 cm H2O (0.98 kPA) of pressure support. ⋯ SIMV with pressure support significantly increased minute volume and ventilatory equivalent when compared with assist-control or SIMV alone, and thus was the most efficient mode of full ventilatory support for our subjects. We found no difference in ventilatory efficiency between assist-control and SIMV. All three mechanical modes were less efficient for our subjects than spontaneous breathing. The inspiratory time of 1 second used in this study, although common in clinical practice, may be inadequate for some patients.
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Comparative Study
The identification of ICU-specific outcome predictors: a comparison of medical, surgical, and cardiothoracic ICUs from a single institution.
To identify ICU-specific predictors of mortality. ⋯ We identified the presence of ICU-specific predictors of mortality amongst the three ICUs examined. These data suggest that ICU-specific interventions could be developed to improve the quality of patient care and potentially to reduce patient mortality.
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To examine the trajectory of uncertainty and symptoms of psychologic stress during the first 3 months after coronary angioplasty and coronary bypass surgery and to study the impact of social support on uncertainty and psychologic stress in these patient populations. ⋯ These results suggest that angioplasty patients may be in particular need of interventions aimed at reducing uncertainty, and that interventions that increase social support could be important in achieving this reduction.
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To examine patient characteristics and situational and clinical factors that affect utilization of Emergency Medical Services (EMS) for symptoms of acute myocardial infarction (AMI). ⋯ The findings are discussed in a theoretical context, using Leventhal's self-regulatory model to suggest avenues for future research and interventions.