Journal of critical care
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Journal of critical care · Dec 2004
The value and limits of severity adjusted mortality for ICU patients.
Intensive care unit (ICU) data systems serve a variety of valuable functions for ICU directors, quality-of-care managers, safety officers and health service researchers. Although controversial, severity adjusted mortality cross-linked with resource measures may provide additional value when comparisons are made to similar types of ICUs. This article describes several options for improving the standardized mortality ratio. An essential ingredient for fostering wider application of ICU data systems is through automated information technology to assure high quality data input and to minimize the burden of manual data collection effort.
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Journal of critical care · Sep 2004
ReviewInterventions to reduce mortality among patients treated in intensive care units.
Using sensitivity analysis to estimate the impact, in terms of patient lives, of the failure to use proven therapies known to reduce mortality in critically ill intensive care unit patients. ⋯ Mistakes of omission are common in the critical care setting and lead to significant preventable mortality. There is a significant gap between the discovery of effective interventions and their use in clinical practice. By viewing the delivery of healthcare as a science and increasing funding for health services research, we may be able to increase the use of effective therapies and, as a result, reduce patient mortality.
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Journal of critical care · Sep 2004
Randomized Controlled Trial Clinical TrialThe effect of a managerial-based intervention on the occurrence of out-of-range-measurements and mortality in intensive care units.
To evaluate the effect of an organization-based managerial intervention on performance of intensive care units (ICUs). ⋯ The intervention reduced both the ICU and hospital mortalities and the incidences of the out-of-range measurements. Registering ORMs provides a feasible method for evaluating ICU performance and could help to optimize individual patient care.
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Journal of critical care · Sep 2004
Clinical TrialTransesophageal Pulsed Doppler echocardiography of pulmonary venous flow to assess left ventricular filling pressure in ventilated patients with acute respiratory distress syndrome.
To determine whether the systolic fraction (SF) of the pulmonary venous flow (PVF), measured by transesophageal echocardiography (TEE) could be used to estimate the pulmonary artery occlusion pressure (PAOP). ⋯ The SF of the PVF measured by Pulsed Doppler TEE seems to be a valuable index to estimate the left ventricular filling pressure in mechanically ventilated patients with ARDS.
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Journal of critical care · Sep 2004
An empirical analysis of the decision-making of limiting life-sustaining treatment for patients with advanced chronic obstructive pulmonary disease in Hong Kong, China.
To understand the prognostic and quality-of-life considerations surrounding life-sustaining treatment decisions for patients with advanced chronic obstructive pulmonary disease (COPD) in Hong Kong China. ⋯ A decision-making framework used by patients/families/physicians to limit life-sustaining treatments in patients with advanced COPD is delineated. Observations regarding how treatment limiting decision-making for patients with advanced chronic illnesses can be improved in Hong Kong are discussed.