Critical care medicine
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Critical care medicine · Sep 1994
Randomized Controlled Trial Clinical TrialPropofol versus midazolam for intensive care unit sedation after coronary artery bypass grafting.
To compare the safety and effectiveness of propofol (2,6-diisopropylphenol) to midazolam for sedation of mechanically ventilated patients after coronary artery bypass grafting. ⋯ Both propofol and midazolam provided safe and effective sedation of coronary artery bypass graft patients recovering from high-dose opioid anesthesia. The reduced need for both antihypertensive medication and opioids seen in the propofol group may be advantageous. However, the hypotension seen after the initial bolus dose of propofol may be a concern. No difference between the two drugs could be demonstrated in time to extubation or ICU discharge, although it is probable that time to extubation was governed more by residual operative opioids than the study agents.
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Critical care medicine · Sep 1994
Multicenter StudyA method for assessing the clinical performance and cost-effectiveness of intensive care units: a multicenter inception cohort study.
To present an approach for assessing intensive care unit (ICU) performance which takes into account both economic and clinical performance while adjusting for severity of illness. To present a graphic display which permits comparisons among a group of hospitals. ⋯ Cross-indexing of clinical and economic ICU performance is easy to calculate. It has potential as a research and evaluation tool used by physicians, hospital administrators, payers, and others.
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Critical care medicine · Sep 1994
Multicenter Study Comparative StudyIntensive Care Society's Acute Physiology and Chronic Health Evaluation (APACHE II) study in Britain and Ireland: a prospective, multicenter, cohort study comparing two methods for predicting outcome for adult intensive care patients.
To compare the ability of two methods--Acute Physiology and Chronic Health Evaluation (APACHE II) and Mortality Prediction Model (MPM)--to predict hospital outcome for a large group of intensive care patients from Britain and Ireland. ⋯ APACHE II demonstrated a higher degree of overall goodness of fit, which was superior to MPM for groups of intensive care patients from Britain and Ireland.
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Critical care medicine · Sep 1994
Multicenter StudyMortality probability models for patients in the intensive care unit for 48 or 72 hours: a prospective, multicenter study.
To develop models in the Mortality Probability Model (MPM II) system to estimate the probability of hospital mortality at 48 and 72 hrs in the intensive care unit (ICU), and to test whether the 24-hr Mortality Probability Model (MPM24), developed for use at 24 hrs in the ICU, can be used on a daily basis beyond 24 hrs. ⋯ Models developed for use among ICU patients at one time period are not transferable without modification to other time periods. The MPM48 and MPM72 calibrated well to their respective time periods, and they are intended for use at specific points in time. The increasing constant terms and associated increase in the probability of hospital mortality exemplify a common clinical adage that if a patient's clinical profile stays the same, he or she is actually getting worse.