Critical care medicine
-
Critical care medicine · Oct 1991
Acute physiology and chronic health evaluation (APACHE II) scoring in a cardiothoracic intensive care unit.
To evaluate the predictive value of the Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system in cardiothoracic surgical patients. ⋯ There was a good relationship between the APACHE II score and mortality rate. Low APACHE II scores accurately predicted survival but only very high scores accurately predicted death.
-
Critical care medicine · Oct 1991
Comparative StudyReduction of duration and cost of mechanical ventilation in an intensive care unit by use of a ventilatory management team.
To test the hypothesis that a formal interdisciplinary team approach to managing ICU patients requiring mechanical ventilation enhances ICU efficiency. ⋯ We conclude that a ventilatory management team, or some component thereof, can significantly and safely expedite the process of "weaning" patients from mechanical ventilatory support in the ICU.
-
Critical care medicine · Oct 1991
Gastric tonometry and venous oximetry in cardiac surgery patients.
To determine the relationship between gastric intramucosal pH and several other indices of splanchnic perfusion in patients undergoing cardiopulmonary bypass. ⋯ Gastric intramucosal pH may provide a minimally invasive way to monitor the adequacy of splanchnic DO2 in patients undergoing cardiopulmonary bypass. Additional data are necessary to determine whether low gastric intramucosal pH is truly a marker of supply-dependent oxygen uptake across the hepatosplanchnic vascular bed under these conditions.
-
Critical care medicine · Oct 1991
Cardiac output from carbon dioxide production and arterial and venous oximetry.
To determine cardiac output from measurements of CO2 production (VCO2), and arterial (SaO2) and mixed venous (SvO2) oxygen saturations, using a modified Fick equation, in which cardiac output = VCO2/[k (SaO2 - SvO2)], where k represents a constant. ⋯ The proposed method for calculating cardiac outputs solely from VCO2 and oximetry saturations yields results that correspond closely to thermodilution determined cardiac outputs. The method is simple and avoids the difficulties in the Fick method associated with accurate VO2 measurement. This approach may be suitable for continuous cardiac output monitoring in critically ill patients.
-
Critical care medicine · Oct 1991
Randomized Controlled Trial Comparative Study Clinical TrialReduction of colonization and infection rate during pediatric intensive care by selective decontamination of the digestive tract.
To compare the effects of two different antibiotic regimes on the colonization and infection rates of critically ill pediatric patients. ⋯ Selective oropharyngeal and gastrointestinal decontamination combined with systemic cefotaxime application allows for a significant reduction of the colonization rate with Gram-negative bacteria and yeasts in critically ill pediatric patients undergoing prolonged intensive care. In addition, it significantly reduces the Gram-negative infection rate of the respiratory system. However, this therapeutic approach does not alter ICU length of stay or mortality rate.