Critical care medicine
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Critical care medicine · Oct 1997
Multicenter Study Comparative StudyPediatric critical care training programs have a positive effect on pediatric intensive care mortality.
Comparison of severity and diagnosis-adjusted mortality rates from pediatric intensive care units (ICUs) staffed by physicians training in pediatric critical care, as well as pediatric residents, with mortality rates from pediatric ICUs staffed with only pediatric residents. ⋯ Pediatric ICUs with critical care fellowship programs are generally associated with better risk-adjusted mortality rates than pediatric ICUs without such fellowship training programs. The cause for this effect requires a more in-depth study. The presence or absence of such training programs does not guarantee superior or inferior performance.
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Critical care medicine · Oct 1997
Comparative Study Clinical Trial Controlled Clinical TrialAirway humidification in mechanically ventilated neonates and infants: a comparative study of a heat and moisture exchanger vs. a heated humidifier using a new fast-response capacitive humidity sensor.
To study the efficiency of a heated humidifier and a heat and moisture exchanger in mechanically ventilated neonates and infants. ⋯ Passive airway humidification by a heat and moisture exchanger is effective in mechanically ventilated neonates and infants over a 6-hr period. However, the performance and safety of a heat and moisture exchanger in prolonged mechanical ventilation remain to be proven.
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Critical care medicine · Oct 1997
Meta AnalysisEffect of noninvasive positive pressure ventilation on mortality in patients admitted with acute respiratory failure: a meta-analysis.
To critically appraise and summarize the trials examining the addition of noninvasive positive pressure ventilation to standard therapy on hospital mortality and need for endotracheal intubation in patients admitted with acute respiratory failure. ⋯ The addition of noninvasive positive pressure ventilation to standard therapy in patients with acute respiratory failure improves survival and decreases the need for endotracheal intubation. However, this effect is restricted to patients whose cause of acute respiratory failure is an exacerbation of COPD. Further research is warranted to determine whether noninvasive positive pressure ventilation confers benefit in patients without COPD who have acute respiratory failure.
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Critical care medicine · Oct 1997
Comparative StudySerial electrocardiogram changes in acute tricyclic antidepressant overdoses.
To describe the changes over time of the QRS interval and terminal 40-msec QRS frontal axis (T40-ms) in patients with acute tricyclic antidepressant poisoning, to identify clinical factors and treatment associated with these changes, and to determine if patients with tricyclic antidepressant-related complications (seizures and/or arrhythmias) had differences in such serial electrocardiogram (ECG) changes when compared with patients without complications. ⋯ The conduction abnormalities seen in severe tricyclic antidepressant toxicity vary widely in the time observed for resolution of these abnormalities and sometimes remain persistently abnormal. All ECG parameters were significantly more abnormal in those patients who developed seizures and/or arrhythmias. Clinical improvement occurred both before and during these ECG changes.
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Critical care medicine · Oct 1997
Multicenter Study Comparative StudyLimitation of therapeutic activity in elderly critically ill patients. Project for the Epidemiological Analysis of Critical Care Patients.
To establish whether the age of patients admitted into the intensive care unit (ICU) influences the amount of therapy received. ⋯ Patients > 75 yrs of age represent a large proportion of patients in Spanish ICUs. Although their mortality rate and severity scores were higher than those values in younger patients, patients > 75 yrs of age received less therapy.