Crit Care Resusc
-
Comparative Study
Outcomes of patients admitted to tertiary intensive care units after interhospital transfer: comparison with patients admitted from emergency departments.
To compare outcomes of patients admitted to tertiary-level intensive care units after interhospital transfer (IHT) with those of similar patients admitted from the emergency department (ED). ⋯ Patients admitted to an ICU from another hospital have higher hospital mortality and longer stay than those admitted from the ED, with the differences varying between diagnoses. These differences are important considerations for resource allocation and triage, and as a measure of quality.
-
Comparative Study
Observational study of patients admitted to intensive care units in Australia and New Zealand after interhospital transfer.
To describe the demographics, illness categories and outcomes of adult intensive care unit patients who underwent interhospital transfer (IHT). ⋯ Patients admitted to an ICU after IHT have significant resource implications based on their severity of illness, hospital stay and mortality, and adversely affect ICU capacity for elective and operating theatre admissions. Regional differences and temporal trends have implications for planning of ICU resources and require ongoing surveillance.
-
Biography Historical Article
19th century pioneers of intensive therapy in North America. Part 2: Joseph O'Dwyer.
Dr Joseph O'Dwyer's principal distinction lies in his dedication and achievements in battling laryngeal diphtheria among children at the New York Foundling Asylum, where he was a physician from 1872. He was also active at the Presbyterian Hospital of New York and in private practice. ⋯ The first intubated patient recovered, November 1882, only after change to prolonged wearing of a tracheotomy tube, so O'Dwyer did not date his first intubation success until 21 May 1884. * Introduction of his tubes into the Fell method of forced respiration, with the resultant Fell-O'Dwyer apparatus supplying practical instrumentation for intermittent positive pressure ventilation. * Demonstration that this apparatus, primarily used for saving lives after acute opiate poisoning, was also useful with some intracranial disasters, 1894. * Provision of a system, which others then applied, enabling surgeons to overcome the great "pneumothorax problem" of intrathoracic operations, and thereby conduct safe surgery inside the chest, 1898. * Development of an intubating method using successive short-term dilatations for treating chronic laryngeal stenosis, usually syphilitic, in adults, 1885. Throughout his medical lifetime, O'Dwyer was held in the highest regard as an altruistic, compassionate person of "sincere simplicity and frank goodness of character".
-
Case Reports
Independent lung ventilation in the intensive care unit: desperate measure or viable treatment option?
Independent lung ventilation is often used intra-operatively but has also been used in intensive care in a variety of clinical situations. Ventilating lungs independently of each other may be life-saving when a lung abnormality is predominantly unilateral. We successfully used independent lung ventilation in two patients, who benefited from anatomical and physiological separation of their lungs. These cases remind intensivists that independent lung ventilation is a viable option to be considered in cases of pulmonary abnormality when conventional mechanical ventilation is deleterious.