The American surgeon
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The American surgeon · Feb 1998
Outcomes from abdominal aortic aneurysm resection: does surgical intensive care unit length of stay make a difference?
Recent studies indicate that surgical intensive care unit (SICU) length of stay (LOS) may be shortened without significantly compromising patient care. We tested the validity of that claim in patients following abdominal aortic aneurysm (AAA) resection, a group that traditionally mandated SICU care, to determine whether recent changes in care have affected outcomes. Severity of illness, utilization of SICU-specific resources, lengths of stay, and outcomes were measured in 295 consecutive AAA patients admitted to the SICU postoperatively over a 6-year period (1988-1994). ⋯ Over a 6-year period, SICU LOS was reduced by nearly 50 per cent in patients receiving elective AAA resections without affecting outcome, as measured by hospital LOS or mortality. Decreasing the SICU LOS was effected by transferring patients to floor care with a higher severity of illness. This change saved approximately $175,000 per year in SICU costs.
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The American surgeon · Feb 1998
Indications and complications of arterial catheter use in surgical or medical intensive care units: analysis of 4932 patients.
In critical care settings, arterial catheters (ACs) are very useful in monitoring the blood pressure and are often used for repetitive blood sampling. No studies have been performed that compare the approach and complication rates of ACs in a medical intensive care unit (MICU) to those in a surgical intensive care unit (SICU). Over a 24-month period, 3255 patients were admitted to the MICU and 1677 to the SICU of Howard University Hospital. ⋯ Arterial spasm and pulselessness were more commonly found after new-site insertion. The site of AC placement and the timing/number of catheter/site changes made no significant difference in terms of complications, which is a new finding compared to other previous reports. The rates of infection between radial and femoral artery were similar.