Critical care medicine
-
Critical care medicine · Jul 2000
Relationship of pediatric overall performance category and pediatric cerebral performance category scores at pediatric intensive care unit discharge with outcome measures collected at hospital discharge and 1- and 6-month follow-up assessments.
Given the current focus on outcomes, there is a crucial need for easily utilized measures that can effectively quantify morbidity or disability after a child's critical illness or injury. The purpose of this study is to significantly extend the research on two such promising measures: the Pediatric Overall Performance Category (POPC) and the Pediatric Cerebral Performance Category (PCPC). ⋯ The results of this study offer additional support for the use of the PCPC and POPC. These brief and easily completed measures can provide useful information regarding probable outcomes for pediatric intensive care patients when more extensive psychometric testing is not feasible or desirable.
-
Critical care medicine · Jul 2000
Survival, morbidity, and quality of life after discharge from intensive care.
To assess survival, morbidity (physical and psychological), quality of life (QOL), and employment status of intensive care survivors up to 12 months after discharge from the intensive care unit (ICU). ⋯ Assessment of outcome after ICU stay must include QOL measurements. Three months after discharge, there is a low incidence of ICU-related psychological or psychiatric illness and the majority of patients are satisfied. Differences in the incidence and nature of morbidity exist between the genders.
-
Critical care medicine · Jul 2000
Directly measured tissue pH is an earlier indicator of splanchnic acidosis than tonometric parameters during hemorrhagic shock in swine.
To compare tissue pH in the stomach, bowel, and abdominal wall muscle during hemorrhagic shock and recovery using tissue electrodes; also, to compare tissue electrode pH measurements to gastric intramucosal pH (pHi), gastric luminal PCO2, and PCO2 gap (gastric luminal CO2--arterial CO2) measured with an air-equilibrated tonometer. ⋯ Direct measurement of tissue pH indicates that intra-abdominal organ pH varies during hemorrhagic shock. The small bowel pH changes the most in magnitude and rapidity compared with stomach pH or abdominal wall muscle pH. Tonometrically derived parameters were not as sensitive in the detection of tissue acidosis during shock and resuscitation as pH measured directly in the submucosa of the stomach or small bowel.
-
Critical care medicine · Jul 2000
Continuous measurement of backrest elevation in critical care: a research strategy.
To develop and test a procedure for continuous measurement of backrest elevation in critical care for enhancing the precision of this measurement for research purposes. ⋯ The measurement technique described here was developed for research purposes to add precision to research studies examining the appropriate height of the backrest. However, the procedure could be used in a continuous quality improvement process to enhance compliance with patient care procedures involving backrest elevation or to confirm actual nursing practice and its correlation with patient outcome. In light of the risks associated with the use of supine positioning in critically ill and mechanically ventilated patients, the information gained from continuous measurement of backrest position could be an extremely valuable research tool.
-
To describe the frequency, background, and impact of decisions to give analgesic or other drugs that may, intentionally or unintentionally, shorten the life-span of severely ill neonates. ⋯ The frequency with which drugs that may shorten life are administered before the death of severely ill infants confirms the important role of modern medicine in dying in neonatology. Most physicians caring for neonates feel that palliative medication may be warranted in dying infants, even if it shortens life. A distinction between intentionally ending life and providing adequate terminal care by alleviating pain or other symptoms, which is important in moral and judicial terms, is probably not easily made for some of these patients.