Critical care medicine
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Critical care medicine · Jun 1993
Multicenter StudyIntraocular pressure during mechanical ventilation with different levels of positive end-expiratory pressure.
To determine the effect of positive end-expiratory pressure (PEEP) on intraocular pressure. ⋯ Short-term therapy with PEEP of < or = 15 cm H2O does not present a clinically important significant risk for intraocular pressure increase in a population with normal basal ocular tonometry. During prolonged mechanical ventilation with PEEP, increments in intraocular pressure may occur, but these increments appear to not be of a clinically relevant magnitude.
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Critical care medicine · Jun 1993
Relationship between postoperative anemia and cardiac morbidity in high-risk vascular patients in the intensive care unit.
To determine if postoperative anemia is associated with postoperative myocardial ischemia and morbid cardiac events ⋯ This study suggests that postoperative anemia may play a role in postoperative myocardial ischemia and cardiac morbidity.
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Critical care medicine · Jun 1993
Randomized Controlled Trial Clinical TrialA randomized, controlled trial of aminophylline in ventilatory weaning of premature infants.
To determine whether maximal inspiratory force predicts successful neonatal extubation, and whether aminophylline affects maximal inspiratory force or the success rate of extubation. ⋯ Aminophylline is an effective prophylaxis for postextubation apnea in the preterm infant but does not affect maximal inspiratory force or increase the success rate of extubation in this patient population.
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Critical care medicine · Jun 1993
Randomized Controlled Trial Clinical TrialEffect of maximizing oxygen delivery on morbidity and mortality rates in critically ill patients: a prospective, randomized, controlled study.
To determine the effects of optimizing oxygen delivery (DO2) to "supranormal" levels on morbidity and mortality in patients with sepsis, septic shock, and adult respiratory distress syndrome. ⋯ Although there was no statistically significant difference in the control vs. treatment groups, subgroup analysis demonstrated a strong, significant difference between patients with supranormal values of oxygen transport vs. patients with normal levels of DO2. Supranormal values of DO2I, whether self-generated or as a result of treatment, resulted in a statistically significant decrease in mortality rate. This study adds to the weight of evidence that current standard of care of treating critically ill patients to normal DO2I should be reconsidered, and that maximizing to high DO2I might be a more appropriate therapeutic end-point.
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Critical care medicine · Jun 1993
Multicenter StudyPostoperative utilization of critical care services by cardiac surgery: a multicenter study in the Canadian healthcare system.
To describe patterns of critical care services used after cardiac surgery and to evaluate whether variations in the process of care influence outcome. ⋯ Significant differences exist among hospitals in the same healthcare system in the utilization of critical care services for cardiac surgery. In spite of these differences, for similar patient "input," the outcome (mortality and hospital lengths of stay) appeared similar. Assessments of utilization of critical care must focus on more detailed specific issues than unit length of stay, and must include factors such as availability of intermediate care areas, the unit management system, chronic health status, and the operative procedures performed, if a utilization management process is to effect improved resource use in critical care.