Critical care medicine
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Critical care medicine · Mar 1998
Severity-of-illness scores for neutropenic cancer patients in an intensive care unit: Which is the best predictor? Do multiple assessment times improve the predictive value?
To use three severity of illness scores to estimate the probability of hospital mortality among patients with cancer and neutropenia; to compare the performance of these scores, calculated at admission to an intensive care unit (ICU); and to test the improvement in estimation obtained by taking into account the first 72-hr period. ⋯ For cancer patients hospitalized in an ICU for a neutropenic episode, the severity of illness and the risk of death can be accurately assessed by the SAPS II score and the number of acute organ failures at admission. The OSF values on the first and third days of hospitalization both provided information, allowing the classification of patients into groups with different probabilities of hospital mortality.
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Critical care medicine · Mar 1998
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of central venous pressure and common iliac venous pressure in critically ill mechanically ventilated patients.
To investigate the possibility of using common iliac venous pressure (CIVP) as an alternative to superior vena cava pressure (SVCP) in mechanically ventilated, critically ill, adult patients. ⋯ For clinical purposes, CIVP measured by a catheter of 15 to 20 cm placed through the femoral route is interchangeable with SVCP in mechanically ventilated adult patients. This finding provides an alternative route for assessment of central venous pressure when other routes are not appropriate.
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Critical care medicine · Mar 1998
Randomized Controlled Trial Clinical TrialEfficacy of heat and moisture exchangers after changing every 48 hours rather than 24 hours.
To determine whether changing heat and moisture exchangers every 48 hrs rather than 24 hrs would affect their efficacy to preserve heat and moisture of expiratory gases. ⋯ Changing the heat and moisture exchanger after 48 hrs rather than 24 hrs did not affect its technical performance in terms of heat and water preservation of ventilatory gases. There is also some indirect evidence of very few, if any, changes in heat and moisture exchanger resistance. However, other large clinical trials should be undertaken to confirm the safety of extending the time between heat and moisture exchanger change. The heated humidifier, supplied with electric energy maintained high levels of humidification and temperature over the 48-hr study period.
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Critical care medicine · Mar 1998
Randomized Controlled Trial Clinical TrialDecreased corticosteroid-binding globulin in burn patients: relationship with interleukin-6 and fat in nutritional support.
To analyze the effect of low-fat nutritional solutions, with or without fish oil, on serum interleukin (IL)-6, and to explore the relationships between IL-6, corticosteroid-binding globulin (CBG; the main cortisol carrier in plasma), and protein metabolism in severely burned adult patients. ⋯ a) Low-fat feeding, with or without fish oil, does not change the early production of IL-6 after burn injury; b) serum IL-6 is negatively correlated with CBG, which supports the hypothesis that this cytokine inhibits hepatic CBG production; and c) IL-6 does not appear to directly influence protein metabolism in burn patients.