Critical care medicine
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Critical care medicine · Aug 1998
Multicenter Study Comparative StudyPediatric risk of mortality: an assessment of its performance in a sample of 26 Italian intensive care units.
To assess the validity of the Pediatric Risk of Mortality (PRISM) scoring system in accurately predicting the probability of mortality in an Italian intensive care unit (ICU) sample. ⋯ The analyses suggest that the unsatisfactory calibration of PRISM can be attributed to various reasons. Among those reasons, a poor performance of the system, as well as its sensitivity to factors not connected to clinical ICU performance, seem particularly important. A special caution is needed in adopting a severity of illness scoring system to assess quality of care, particularly in contexts different from the one in which the instrument was originally developed.
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Critical care medicine · Aug 1998
Meta Analysis Comparative StudyTunneling short-term central venous catheters to prevent catheter-related infection: a meta-analysis of randomized, controlled trials.
To evaluate the efficacy of tunneling short-term central venous catheters to prevent catheter-related infections. ⋯ Tunneling decreases central venous catheter-related infections. However, current evidence does not support routine tunneling until its efficacy is evaluated at different placement sites and relative to other interventions.
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Critical care medicine · Aug 1998
Comparative StudyExogenous surfactant and positive end-expiratory pressure in the treatment of endotoxin-induced lung injury.
To evaluate the efficacy of treating endotoxin-induced lung injury with single dose exogenous surfactant and positive end-expiratory pressure (PEEP). ⋯ We conclude that PEEP plus surfactant treatment of endotoxin-induced lung injury transiently improves oxygenation, but is unable to maintain this salutary effect indefinitely. Thus, repeat bolus dosing of surfactant or bolus treatment followed by continuous aerosol delivery may be necessary for a continuous beneficial effect.
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Critical care medicine · Aug 1998
Multicenter Study Comparative Study Clinical TrialA multicenter evaluation of a new continuous cardiac output pulmonary artery catheter system.
To validate a new system of continuous cardiac output monitoring. ⋯ This continuous cardiac output system provides a reliable estimate of cardiac output for clinical use if applied in conditions similar to this study. The combination of a continuous measure of cardiac output with other continuous physiologic monitoring (arterial and mixed venous oxygen saturation, oxygen consumption, etc.) may provide important information that no single parameter could achieve.
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Critical care medicine · Aug 1998
Multicenter Study Comparative StudyEvaluation of acute physiology and chronic health evaluation III predictions of hospital mortality in an independent database.
To assess the accuracy and validity of Acute Physiology and Chronic Health Evaluation (APACHE) III hospital mortality predictions in an independent sample of U.S. intensive care unit (ICU) admissions. ⋯ APACHE III accurately predicted aggregate hospital mortality in an independent sample of U.S. ICU admissions. Further improvements in calibration can be achieved by more precise disease labeling, improved acquisition and weighting of neurologic abnormalities, adjustments that reflect changes in treatment outcomes over time, and a larger national database.