Critical care medicine
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Critical care medicine · Nov 1985
Readmission of patients to the surgical intensive care unit: patient profiles and possibilities for prevention.
Because experience is lacking regarding the profile of patients readmitted to a surgical ICU (SICU), we retrospectively reviewed total admissions, readmissions, patient profiles, and characteristics of illness requiring readmission to a multidisciplinary SICU. During a 1-yr period, the 721 recorded admissions included 68 readmissions for 57 patients (9.4% of the total). Eight patients had multiple readmissions. ⋯ The most common new problems were cardiopulmonary insufficiency and infection. All but one patient readmitted with pulmonary problems displayed retrospective evidence of clear warning signs before the original discharge. Recognition of SICU readmission patterns will allow more precise discharge planning: to delay discharge, to effect a lateral transfer, or to initiate a stepdown unit which may be able to help prevent costly and potentially lethal patient outcomes.
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Critical care medicine · Nov 1985
Acid-base determinants of survival after cardiopulmonary resuscitation.
The acid-base and electrolyte conditions which favor survival were examined in 105 patients during and after CPR. There was a sharp decrease in survival when arterial pH exceeded 7.55 during the initial 10 min after initiation of CPR. ⋯ Arterial blood lactate also served as a sensitive quantitative indicator of prognosis, both during and one hour after successful CPR. The adverse effects of alkalemia were largely explained by increases in whole-blood bicarbonate, plasma sodium, and plasma osmolality after administration of sodium bicarbonate.
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Critical care medicine · Nov 1985
Comparative StudyManual versus mechanical cardiopulmonary resuscitation in an experimental canine model.
Manual and mechanical chest compressions during CPR were compared in the canine model. Endpoints were hemodynamics produced during CPR, resuscitation success at 30 min, 24-h survival, neurologic function of survivors, and CPR-produced trauma. Ten animals in each group underwent 20 min of ventricular fibrillation, during which CPR was performed for 17 min. ⋯ Neurologic function of survivors was excellent and similar in each group. There was no significant difference in trauma between the two types of chest compression. The similar results for manual and mechanical chest compression in this canine model suggest that different experimental CPR studies can be compared regardless or whether manual or mechanical chest compressions were performed.