Critical care medicine
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Critical care medicine · Oct 1995
Comparative StudyHigh-risk intrahospital transport of critically ill patients: safety and outcome of the necessary "road trip".
Intrahospital transport of critically ill patients is often necessary for optimal patient care. However, transport of intensive care unit (ICU) patients within the hospital has been associated with a high rate of potentially detrimental complications. This study was designed to determine the occurrence rate of transport-related complications and to determine if these complications have any effect on patient morbidity and mortality. ⋯ Intrahospital transport of critically ill patients is safe and carries a low risk of detrimental complications. Although patients requiring "high-risk" interventions experienced a higher mortality rate than did APACHE-matched controls, the increase in mortality does not appear to be directly related to the intrahospital transport. Patients requiring transport out of the surgical ICU are a more critically ill group of patients. These patients require a greater length of stay in the surgical ICU and may experience an increased mortality rate by virtue of the severity of their illness.
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Critical care medicine · Oct 1995
ReviewMultiple organ dysfunction score: a reliable descriptor of a complex clinical outcome.
To develop an objective scale to measure the severity of the multiple organ dysfunction syndrome as an outcome in critical illness. ⋯ This multiple organ dysfunction score, constructed using simple physiologic measures of dysfunction in six organ systems, mirrors organ dysfunction as the intensivist sees it and correlates strongly with the ultimate risk of ICU mortality and hospital mortality. The variable, delta Multiple Organ Dysfunction Score, reflects organ dysfunction developing during the ICU stay, which therefore is potentially amenable to therapeutic manipulation. (ABSTRACT TRUNCATED)
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Critical care medicine · Oct 1995
Comparative StudyMonitoring of tissue oxygenation in shock: an experimental study in pigs.
To evaluate different methods and markers for assessing adequacy of tissue oxygenation in shock. ⋯ Many conventional markers of tissue hypoxia are useful when assessing general hypoperfusion, whereas intestinal intramucosal pH is the only reliable and clinically useful indicator of inadequate regional intestinal tissue oxygenation.
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Critical care medicine · Oct 1995
Comparative Study Clinical Trial Controlled Clinical TrialEffect of heparin on whole blood activated partial thromboplastin time using a portable, whole blood coagulation monitor.
To evaluate the responsiveness of whole blood activated partial thromboplastin time (aPTT) to varying heparin doses in vitro and to examine the ex vivo relationship of whole blood aPTT to plasma heparin concentration. ⋯ Heparin responsiveness of whole blood aPTT, measured with a portable whole blood coagulation monitor, is similar to that of conventional laboratory aPTT over a clinically relevant range of heparin concentrations in vitro and ex vivo. On-site whole blood aPTT measurements should be useful in clinical situations requiring rapid aPTT results.