Journal of critical care
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Journal of critical care · Sep 2003
Developing and pilot testing quality indicators in the intensive care unit.
To develop and implement a set of valid and reliable yet practical measures of intensive care units (ICU) quality of care in a cohort of ICUs and to estimate, based on current performance, the potential opportunity to improve quality. ⋯ To improve quality of care, we must measure our performance. This pilot study suggests that it is feasible to implement a broad set of ICU quality measures in a cohort of hospitals. By improving performance on these measures, we may realize reduced mortality, morbidity, and ICU length of stay.
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Journal of critical care · Sep 2003
Comparative StudyIncreased risk associated with pulmonary artery catheterization in the medical intensive care unit.
To determine whether the frequency of use of a pulmonary artery catheter (PAC) was declining over a 5-year period in a medical intensive care unit (ICU), and to assess whether mortality was higher in patients in whom a PAC was used on the day of ICU admission compared with matched controls. ⋯ PAC use on the day of admission to a medical ICU was associated with an increased risk for hospital death.
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Journal of critical care · Sep 2003
Comparative StudyHeart rate variability as early marker of multiple organ dysfunction syndrome in septic patients.
To determine whether measuring heart rate variability (HRV) in a group of septic patients without multiple organ dysfunction syndrome (MODS) made it possible to predict which of them would later develop this syndrome. ⋯ Reduction of HRV on ICU admission may be useful in identifying septic patients at risk for development of MODS.
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Journal of critical care · Sep 2003
Comparative StudyCost-effectiveness of recombinant human activated protein C and the influence of severity of illness in the treatment of patients with severe sepsis.
To evaluate the cost-effectiveness of recombinant human activated protein C (rhAPC) compared with usual therapy for patients with severe sepsis, and also to determine the influence that severity of illness exerts on cost-effectiveness. ⋯ The use of rhAPC for the treatment of patients with very severe sepsis, as determined by APACHE II score > or = 25, appears cost-effective, while treatment of patients with APACHE II score < 25 is not cost-effective.
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Journal of critical care · Sep 2003
Pandemic influenza-implications for critical care resources in Australia and New Zealand.
To quantify resource requirements (additional beds and ventilator capacity), for critical care services in the event of pandemic influenza. ⋯ Australasian critical care services would be overwhelmed in the event of pandemic influenza. More work is required in relation to modelling, contingency plans, and resource allocation.