Clinical intensive care : international journal of critical & coronary care medicine
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Clin Intensive Care · Jan 1994
Comparative StudyQuality of life at three months following admission to intensive and coronary care units.
Measurement of quality of life three months following critical illness, to assess impact on health expectations. ⋯ ICU patient quality of life three months after admission compares favourably with a corresponding group of CCU patients, particularly in areas of sleep and social isolation. CCU patients' general functional status deteriorated significantly compared to their pre-admission status. Critical illness is a costly area of medicine, but the results suggest that outcomes are beneficial in terms of quality of life for those surviving acute illness.
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Clin Intensive Care · Jan 1994
Oxygen extraction in patients with sepsis and heart failure: another look at clinical studies.
We collected all complete sets of measurements of cardiac index and oxygen-derived variables available in the recent literature (1975-1991; computerised Medline search) on critically ill patients with sepsis (n=21 studies), septic shock (n=20 studies) or severe heart failure (n=13 studies). For each study, the mean value for cardiac index, oxygen delivery (DO 2), oxygen uptake (VO 2), oxygen extraction ratio (O 2ER) and lactate concentration (when available) were analysed together with mortality rates. There was a significant relationship between VO 2 and DO 2 for the studies on patients with severe heart failure (r=0.79, p less than 0.001) or septic shock (r=0.55, p less than 0.01), but not in patients with sepsis (r=0.3, p=NS). ⋯ Furthermore, the positive relationship between O 2ER and lactate suggests that, despite the alterations in oxygen extraction capabilities in severe sepsis, mean O 2ER may be higher in the most severe cases of septic shock. This could reflect an attempt to maintain VO 2 when DO 2 is insufficient. The prevailing opinion that 0 2ER is a meaningless variable in septic shock needs to be reassessed.