Articles: intensive-care-units.
-
Pediatr Crit Care Me · Oct 2000
Assessment of respiratory drive and muscle function in the pediatric intensive care unit and prediction of extubation failure.
Extubation failure can result from poor respiratory drive, impaired respiratory muscle function, or excessive inspiratory load. Measurement of airway pressure changes either during tidal breathing or after end-expiratory occlusion allows assessment of respiratory drive and muscle function. ⋯ Assessment of P0.1 was the most useful airway pressure measurement in predicting extubation failure. Assessment of P0.1 may help to characterize children likely to fail extubation.
-
In patients with traumatic or ischemic brain injury, hyperthermia is thought to worsen the neurological injury. We studied fever in the neurosurgical intensive care unit (ICU) population using a definition common to surgical practice (rectal temperature >38.5 degrees C). We sought to determine fever incidence, fever duration, and peak temperature and to quantify the use of antipyretic therapy. We also attempted to determine the patient subgroups that are at highest risk for development of fever. ⋯ Fever is common in critically ill neurosurgical patients, especially those with a prolonged length of stay in the ICU or a cranial disease. If hyperthermia worsens the functional outcome after a primary ischemic or traumatic injury, as has been suggested by several studies of stroke patients, treatment of fever is a clinical issue that requires better management.
-
Intensive care medicine · Oct 2000
Prevalence of tracheostomy in ICU patients. A nation-wide survey in Switzerland.
To assess the frequency, timing and technique of tracheostomy and its variation between different intensive care units (ICUs) in Switzerland. ⋯ Despite its frequency, tracheostomy in Swiss ICUs is far from being standardized with regard to indication, timing and choice of technique.
-
It is likely that greater on-site intensivist coverage in critical care units will be observed in the future. Regionalization of critical care services will make this a financial reality because this level of expertise cannot realistically be provided to all hospitals. ⋯ As technology advances, telemedicine will play a greater role in providing intensivist coverage to ICUs during off hours or to community hospitals in remote areas. Advanced technology and reorganization of critical care services offer opportunities for creative and nontraditional ways to deliver improved care to patients.