Articles: intensive-care-units.
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Intensive care medicine · Feb 1997
Multicenter Study Comparative StudyOutcome prediction in intensive care: results of a prospective, multicentre, Portuguese study.
To compare the performance of the New Simplified Acute Physiology Score (SAPS II) and Acute Physiology and Chronic Health Evaluation (APACHE) II in an independent database, using formal statistical assessment. ⋯ SAPS II performed better than APACHE II in this independent database, but the results do not allow its use, at least without being customised, to analyse quality of care or performance among ICUs in the target population.
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Troubling aspects of the experiences of patients at the ends of their lives have fueled interest in special benefits or privileges for this group. There is a presumption that being "at the end of life" is discernible. This study examines this presumption using data from two previously collected databases: the Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) and the Acute Physiology and Chronic Health Evaluation III (APACHE III). ⋯ Median prognostication estimates were not much different when given by physicians and were only a little more pessimistic in APACHE (median estimate for hospital survival on the day before death was .14 and 7 days before was .45). To make plans about care and to optimally support most dying persons and families, conversations must occur while the patient still has a considerable chance of surviving the current episode of illness. Using statistical estimates of prognosis to designate a category of "terminally ill" patients for public policy purposes is unavoidably arbitrary, will often be contested, and will have differential effects upon those dying with differing diseases.
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Intensive Crit Care Nurs · Feb 1997
ReviewCritically ill children: the case for short-term care in general intensive care units.
This paper contests the claim that all children should be nursed in paediatric intensive care units (PICUs). Although there is an undoubted need for prolonged care to be undertaken within PICUs, they are a scarce resource and many children's critical illness is of short duration. Following a discussion on the negative aspects of transferring a critically ill child this paper then establishes how a general intensive care unit (GICU) can maintain-awareness and standards which make it a safe environment for children with a short-term critical illness, as well as contribute towards future management and practice.
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J Paediatr Child Health · Feb 1997
A national study of risk factors associated with mortality in very low birthweight infants in the Malaysian neonatal intensive care units. Malaysian Very Low Birth Weight Study Group.
To determine the risk factors associated with mortality in very low birthweight (VLBW) infants admitted to the neonatal intensive care units (NIUC) in Malaysia. ⋯ The mortality of VLBW infants admitted to the Malaysian NICU was high and was also associated with a number of preventable risk factors.
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Infect Control Hosp Epidemiol · Feb 1997
Nosocomial infections in neonates receiving extracorporeal membrane oxygenation.
To determine the incidence of, and risk factors for, nosocomial infections in neonates during and after treatment with extracorporeal membrane oxygenation (ECMO). ⋯ Nosocomial infections occurred in 30% of patients undergoing ECMO. Although nosocomial infections were not associated with an increase in mortality, hospitalization was prolonged.