Critical care medicine
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To determine the predictive value of patient monitoring alarms as a warning system in a pediatric intensive care unit (ICU). ⋯ Over 94% of alarm soundings in a pediatric ICU may not be clinically important. Present monitoring systems are poor predictors of untoward events.
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Critical care medicine · Jun 1994
Impact of a clinical pharmacist in a multidisciplinary intensive care unit.
To describe the activities of a clinical intensive care unit (ICU) pharmacist and to determine whether pharmacist-initiated consultations lead to changes in drug costs. ⋯ Dedicated ICU pharmacists are crucial healthcare team members in a multidisciplinary ICU. In addition to substantially reducing drug costs, they provide continuity in individualized pharmacotherapeutic care, and serve an important educational function.
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Critical care medicine · Jun 1994
Comparative Study Clinical Trial Retracted PublicationCardiopulmonary actions of intravenously administered enalaprilat in trauma patients.
To determine the cardiopulmonary actions of the intravenous administration of the angiotensin-converting enzyme inhibitor enalaprilat in hypertensive trauma patients. ⋯ The intravenous administration of enalaprilat successfully decreased blood pressure in most of our patients. Mechanisms other than the renin-angiotensin system also appear to be involved in hypertensive, critically ill patients. Pulmonary function was not altered; right ventricular function, and both oxygen consumption and oxygen delivery improved in the enalaprilat responder group. Thus, the availability of intravenous enalaprilat seems to enlarge our armamentarium for treating hypertension in the critically ill patient.
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Critical care medicine · Jun 1994
Patterns of prescribing and administering drugs for agitation and pain in patients in a surgical intensive care unit.
To describe the variety of medications prescribed along with the doses administered and routes of administration, and to delineate the clarity of orders written and the accuracy of transcription of drugs used for sedation, anxiety, pain, and neuromuscular blockade in a surgical intensive care unit (ICU). ⋯ A wide variety of sedatives and analgesics are frequently used in surgical ICU patients. These agents are often ordered on an "as-needed" basis using a range of doses, sometimes without adequate directions about the indication for their use. Daily doses received are significantly less than their maximum allowable daily doses. Orders for these medications are sometimes transcribed and charted incorrectly. In contrast, neuromuscular blocking agents are not commonly prescribed. Future studies are needed to improve order writing of these agents, and to determine the criteria used by physicians and nurses in the selection and administration of these agents, the outcomes of therapy, and the most cost-effective regimen.