Journal of critical care
-
Journal of critical care · Mar 2002
ReviewQualitative review of intensive care unit quality indicators.
The purpose of this study was to (1) conduct a systematic review of the literature to identify interventions that improve patient outcomes in the intensive care unit (ICU); (2) evaluate potential measures of quality based on the impact, feasibility, variability, and the strength of evidence to support each measure and to categorize these measures as outcome, process, access, or complication measures; and (3) select a list of candidate quality measures that can be broadly applied to improve ICU care. ⋯ Further work is needed to create operational definitions and to pilot test the selected measures. The value of these measures will be determined by our ability to evaluate our current performance and implement interventions designed to improve the quality of ICU care.
-
Journal of critical care · Mar 2002
Randomized Controlled Trial Clinical TrialAttitudes regarding organ donation from non-heart-beating donors.
To determine the attitudes toward organ donation from non-heart-beating cadaver donors in a sample of the general public and health care workers. ⋯ Both the general public and health care workers support the use of non-heart-beating cadaver donors once a decision has been made to withdraw life support. However, both groups raised concerns regarding how the decision to withdraw life support is made.
-
Journal of critical care · Mar 2002
ReviewA new conceptual framework for ICU performance appraisal and improvement.
This study examined the use of outcomes for the purposes of ICU evaluation and improvement. We reviewed the strengths and weaknesses of an outcomes-centered approach to intensive care unit (ICU) evaluation and present a more comprehensive conceptual framework for ICU evaluation and improvement. ⋯ Performance variables offer distinct advantages over outcome variables for ICU evaluation. Their use, however, will require additional development of current evaluation tools and methods. They provide the ability to identify the value an ICU adds to patient care in a hospital or to an episode of illness, and to evaluate integrated systems for providing care.
-
Journal of critical care · Mar 2002
Patient characteristics and costs of severe sepsis and septic shock in Quebec.
We investigated the cost of health care resources for the treatment of severe sepsis and/or septic shock patients. ⋯ The cost of severe sepsis is a significant burden to the Quebec health care system.
-
Journal of critical care · Mar 2002
Acidosis induced by lactate, pyruvate, or HCl increases blood viscosity.
Serum lactate correlates with the severity of disease and the mortality in shock. It is not clear if lactate is only a marker or a mediator of disease. We tested the hypothesis that acidosis induced by lactate and pyruvate affects blood flow properties. ⋯ Pronounced acidosis induced by either lactate, pyruvate, or HCl impairs blood flow properties, which may contribute to the understanding of the pathophysiology of critical illness.