British journal of anaesthesia
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Early warning scores using physiological measurements may help identify ward patients who are, or who may become, critically ill. We studied the value of abnormal physiology scores to identify high-risk hospital patients. ⋯ Simple physiological observations identify high-risk hospital inpatients. Those who die are often inpatients for days or weeks before death, allowing time for clinicians to intervene and potentially change outcome. Access to critical care beds could decrease mortality.
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There is increasing evidence that weaning protocols improve outcome from mechanical ventilation, but it is unclear how best to implement such protocols in large intensive care units. We evaluated a checklist of simple bedside criteria to determine whether it could be used reliably to predict successful discontinuation of mechanical ventilation. ⋯ A simple checklist can assist nurse assessment of suitability for weaning and could be used as a trigger to commence a weaning protocol. The day on which criteria are met is a useful way of stratifying patients for likely patterns of weaning.
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Clinical Trial Controlled Clinical Trial
Detection of cognitive decline after coronary surgery: a comparison of computerized and conventional tests.
Postoperative cognitive decline is a common complication after coronary artery bypass graft (CABG) surgery. Postoperative cognitive decline is defined on the basis of change in cognitive function detected with repeated assessments using neuropsychological tests. Therefore improvement in neuropsychological testing instruments may increase our understanding of postoperative cognitive decline. ⋯ Computerized tests are suitable for measuring cognitive change after CABG surgery and may detect change in a greater proportion of patients 6 days after CABG surgery than conventional neuropsychological tests.