Critical care medicine
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Critical care medicine · Feb 2001
Randomized Controlled Trial Comparative Study Clinical TrialEarly postoperative enteral nutrition improves gut oxygenation and reduces costs compared with total parenteral nutrition.
To evaluate the potential clinical, metabolic, and economic advantages of enteral nutrition over total parenteral nutrition. ⋯ EEN represents a rational alternative to TPN in patients who undergo upper gastrointestinal tract surgery for cancer and who clinically require postoperative artificial nutrition.
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Several decision-making models have been advanced to characterize the patient-physician relationship. These include the parental model, the informed decision-making model, the interpretive model, and the deliberative model. ⋯ Moreover, instead of the dyadic model of one patient and one physician, multiple voices often speak for the patient and a team of clinicians care for the ICU patient. Analysis of human relationships and communication with critically ill patients and their families require transdisciplinary, multicultural, and multidisciplinary interpretation.
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Critical care medicine · Feb 2001
Randomized Controlled Trial Clinical TrialThe role of gown and glove isolation and strict handwashing in the reduction of nosocomial infection in children with solid organ transplantation.
Nosocomial infection is an important contributor to morbidity and mortality in pediatric solid organ transplantation. The relative effect of protective gown and glove isolation was compared with strict handwashing in pediatric intensive care unit (PICU) patients with solid organ transplantation. ⋯ Increased compliance with handwashing was associated with a reduction in nosocomial infections, and gown and glove isolation appeared to have an additional protective effect. Some nosocomial infections may be preventable in the pediatric solid organ transplantation population.
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Critical care medicine · Feb 2001
Comparative Study Clinical TrialPharmacoeconomic assessment of propofol 2% used for prolonged sedation.
To demonstrate that the use of propofol 2% is comparable to propofol 1% in effectiveness and in the wake-up time used for prolonged sedation. ⋯ The new propofol 2% preparation is an effective sedative agent and is safe because of the low frequency of associated hypertriglyceridemia. The shorter weaning time associated with the use of propofol 2% as compared with midazolam compensates for its elevated cost. The economic benefit of propofol 2% is less than expected because higher doses of propofol 2% than propofol 1% are required over the first 48 hrs.
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Critical care medicine · Feb 2001
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialIs a low transfusion threshold safe in critically ill patients with cardiovascular diseases?
To compare a restrictive red blood cell transfusion strategy with a more liberal strategy in volume-resuscitated critically ill patients with cardiovascular disease. ⋯ A restrictive red blood cell transfusion strategy generally appears to be safe in most critically ill patients with cardiovascular disease, with the possible exception of patients with acute myocardial infarcts and unstable angina.