Journal of critical care
-
Journal of critical care · Dec 2000
Time-weighted nursing demand is a better predictor than midnight census of nursing supply in an intensive care unit.
Labor costs are the largest fraction of operating costs in an intensive care unit (ICU). Estimation of appropriate nursing supply is frequently based on the midnight census of patients, which is a "snapshot" view of the ICU. We postulated that the midnight census would not correlate as well as time-weighted nursing demand (a calculation of need for nursing staff) with the actual number of nurses who were required to staff the ICU (nursing supply). The purpose of this study was to compare the correlation between midnight census and actual nursing supply with the correlation between time-weighted nursing demand and nursing supply. ⋯ Time-weighted nursing demand is a better predictor than midnight census of nursing supply in an ICU.
-
Journal of critical care · Sep 2000
The clinical features of severe community-acquired pneumonia presenting as septic shock. Norasept II Study Investigators.
The purpose of this article was to determine the outcome, clinical and prognostic features, and microbiology of a large group of patients with community-acquired pneumonia (CAP) presenting in septic shock. ⋯ A diverse spectrum of both gram-positive and gram-negative pathogens were implicated in patients with CAP presenting in septic shock, necessitating broad spectrum empiric antimicrobial coverage. This coverage should include antipseudomonal activity, particularly in alcoholic patients. Severity of illness (APACHE II score) and IL-6 levels were important prognostic factors. Infection with P aeruginosa and Acinetobacter species carried a very high mortality.
-
Journal of critical care · Sep 2000
Acute respiratory distress syndrome: resource use and outcomes in 1985 and 1995, trends in mortality and comorbidities.
The purpose of this study was to compare resource consumption and mortality between (ARDS) patients with adult respiratory distress syndrome treated at our center in 1985 (45 patients) and those treated in 1995. ⋯ In our setting, mortality remained constant from 1985 to 1995 among ARDS trauma patients but not among nontrauma ARDS patients because of the new case-mix of the latter population, which now includes HIV and other immunodepressed patients.
-
Journal of critical care · Sep 2000
Partial liquid ventilation shows dose-dependent increase in oxygenation with PEEP and decreases lung injury associated with mechanical ventilation.
The purpose of this article is to evaluate the effect of positive end-expiratory pressure (PEEP) during partial liquid ventilation (PLV) and to investigate if lung damage associated with mechanical ventilation can be reduced by PLV. ⋯ PLV shows dose-dependent increase in oxygenation with PEEP and may reduce lung damage associated with mechanical ventilation.
-
Journal of critical care · Jun 2000
Randomized Controlled Trial Clinical TrialEffect of an additional 1-hour T-piece trial on weaning outcome at minimal pressure support.
The purpose of this article was to investigate the effect of an additional 1-hour T-piece trial at the level of minimum pressure support (PSmin) on weaning outcome. ⋯ There were no advantages in weaning outcome by the addition of a 1-hour T-piece trial compared with prompt extubation at PSmin.