Articles: intensive-care-units.
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Paediatr Perinat Epidemiol · Oct 1997
Comparative StudyThe EURONIC Project: a European concerted action on information to parents and ethical decision-making in neonatal intensive care.
The paper presents the background, objectives and methods of a European concerted action project aimed at exploring the transmission of information to parents and the ethical decision-making process in neonatal intensive care from the perspective of health personnel, and in relation to the legal, cultural, social and ethical backgrounds of the various European countries. Eight countries are taking part in the project (France, Germany, Italy, Luxembourg, Spain, Sweden, The Netherlands and the United Kingdom), which is about to be extended also to Central and Eastern Europe (Estonia, Lithuania and Hungary). ⋯ Information on the organisation and policies of the Units and on the national legislation will also be collected. The key features of the study lie in the multidisciplinary and international approach, the random selection of the sample as a guarantee of representativeness and lack of selection bias, the focus on the staff practices as well as on their attitudes and opinions.
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Comparative Study
A 10-year survey of nutritional support in a surgical ICU: 1986-1995.
Total parenteral nutrition (TPN) has long been considered the optimal nutrition technique in critically ill patients, but recently the use of enteral nutrition (EN) has increased. This study describes the evolution of the different nutritional support techniques in a surgical intensive care unit (ICU) in a university hospital, through (1) a global survey over 10 y assessing the evolution of the use of EN and TPN, and (2) a prospective study performed over 6 mo. Severity of illness and diagnostic categories were stable (n = 11,539 patients). ⋯ The frequency of nutritional support provided in general has increased to 40% of ICU treatment days. TPN has been largely overtaken by EN, with the risk of insufficient energy delivery, related to the difficulties of EN in the critically ill. These results reinforce the importance of continuous quality control by daily assessment of nutrient supply.
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This study explores parental lived experience following admission of their child to a pediatric intensive care unit. The interview data used were collected from 10 randomly chosen families from the Family Impact of Catastrophic Childhood Illness Project recruited during the early phase of critical care hospitalization of their child. ⋯ The analysis uncovered a multidimensional and holistic phenomenon consisting of four organizing concepts: initial boundary ambiguity, parents' coping patterns, family resources, and functioning of the family boundary. These results provide evidence of a collective family level perception of stress when experiencing the health crisis of a child and support further use of family stress perception as a family level phenomenon that represents family meaning construction during critical illness of a child.
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Critical care medicine · Oct 1997
Multicenter Study Comparative StudyPediatric critical care training programs have a positive effect on pediatric intensive care mortality.
Comparison of severity and diagnosis-adjusted mortality rates from pediatric intensive care units (ICUs) staffed by physicians training in pediatric critical care, as well as pediatric residents, with mortality rates from pediatric ICUs staffed with only pediatric residents. ⋯ Pediatric ICUs with critical care fellowship programs are generally associated with better risk-adjusted mortality rates than pediatric ICUs without such fellowship training programs. The cause for this effect requires a more in-depth study. The presence or absence of such training programs does not guarantee superior or inferior performance.
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The Journal of pediatrics · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialThe Pediatric Risk of Mortality III--Acute Physiology Score (PRISM III-APS): a method of assessing physiologic instability for pediatric intensive care unit patients.
To develop a physiology-based measure of physiologic instability for use in pediatric patients that has an expanded scale compared with the Pediatric Risk of Mortality (PRISM) III score. ⋯ The PRISM III-APS score is an expanded measure of physiologic instability that has been validated against mortality. Compared with PRISM III, PRISM III-APS should be more sensitive to small changes in physiologic status.