Journal of the Medical Association of Thailand = Chotmaihet thangphaet
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Randomized Controlled Trial
Desflurane concentrations and consumptions during low flow anesthesia.
Desflurane is the least soluble and most expensive inhalation agent. Hence, low flow technique is suitable for anesthesia with desflurane. However, one of the disadvantages of low flow technique is the discrepancy among the end-tidal concentration, inspired concentration, and vaporizer setting. ⋯ Using FGF 2 L x min(-1) has no advantage over FGF 1 L x min(-2), because they both have the similar FdDES. Regarding at FGF 0.5 and 1 L x min(-1), the delivered concentration has to be increased to obtain the desired expired concentration with more intense at FGF 0.5 L x min(-1) because there are more discrepancies between FdDES and FeDES.
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There was a lack of available data regarding intensive care unit (ICU) characteristics, human resources, workload, and ICU outcomes in Thai ICUs. Therefore, the objectives of the present study were to describe these parameters and to demonstrate the association of these predictors to ICU outcome indicators including crude mortality, ventilator days and ICU length of stay (ICU-LOS). ⋯ Thai ICUs showed differences in administration systems. The outcome indicators of crude mortality, ventilator days and ICU-LOS were impacted by the ICU characteristics, human resources and ICU workload (Thai Clinical Trial Registry: TCTR-201200005).
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To assess the cost effectiveness of an initial ICU admissionforpatients with severe sepsis or those in septic shock following the initial resuscitation in the emergency department. ⋯ Immediate ICU admission for patients with severe sepsis or in septic shock following the initial resuscitation in the emergency department has shown a satisfactory cost-effectiveness profile in low-to-middle income countries.
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Health information technology (IT) has become an important part of current medical practice, especially in critical care services. One significant advance is the use of telemedicine which was initiated in Thailand nearly two decades ago. ⋯ In this article, the author has reviewed the evidence of health IT on critical care services in Thailand, focusing on telemedicine, as well as the concept of the 'Tele-ICU' and its challenges. These factors may assist intensivists to reach more critically ill patients in remote areas.
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Multicenter Study
A multi-center Thai university-based surgical intensive care units study (THAI-SICU study): methodology and ICU characteristics.
Although there were two large intra-operative observational studies on Thai surgical patients (THAI and THAI-AIMS), there has been no available study on critically ill surgical patients regarding their adverse events and outcomes. A THAI-Surgical Intensive Care Unit (SICU) study has been established for monitoring the occurrence of these adverse events and outcomes in the SICU. The objective of this report is to describe the methodology of the THAI-SICU study and participating SICUs' characteristics as well as the early recruitment results on patients enrolled in the present study. ⋯ There were differences in ICU management systems, physician and specialist coverage, nurse burdens, nurse sparing, and types of patients admitted in the university based SICUs. This presentation is the pioneer multi-center study on Thai SICUs in which adverse events and outcomes are reported.