Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 1999
Assessment of ventricular function in critically ill patients: limitations of pulmonary artery catheterization. Institutions of the McSPI Research Group.
To determine the accuracy of conventional hemodynamic assessment using pulmonary artery catheter-derived data in critically ill patients. ⋯ Evaluable data included 130 of 150 (87%) observations of simultaneously collected CA and TEE data, averaging 5.6+/-4.4 observations per patient. The overall predictive probability for conventional clinical assessment of normal ventricular function was 98% (118/121), whereas for abnormal ventricular function it was 0% (0/9). For CA of volume, the overall predictive probabilities for hypovolemia, normovolemia, and hypervolemia were 50% (3/6), 60% (69/115), and 22% (2/9). Although conventional clinical assessment of normal LV function in the intensive care unit correlates well with echocardiographic assessment, both LV dysfunction and extremes of preload (hypovolemia or hypervolemia) are assessed poorly by clinicians using conventional clinical monitoring with pulmonary artery catheterization.
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J. Cardiothorac. Vasc. Anesth. · Oct 1999
The association between preoperative patient characteristics and both clinical and economic outcomes after abdominal aortic surgery.
To evaluate the association between patient characteristics and both clinical and economic outcomes in patients having abdominal aortic surgery in Maryland between 1994 and 1996. ⋯ In patients having aortic surgery, several patient characteristics such as mild liver disease and chronic renal failure, were associated with increased in-hospital mortality and length of stay. The practice of admitting patients to the hospital 1 to 2 days before surgery should be reevaluated because this was not associated with reduced in-hospital mortality but was associated with increased hospital and ICU stay.