Articles: intensive-care-units.
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Critical care medicine · Dec 1996
Effect of changing patient mix on the performance of an intensive care unit severity-of-illness model: how to distinguish a general from a specialty intensive care unit.
To analyze the effects of patient mix diversity on performance of an intensive care unit (ICU) severity-of-illness model. ⋯ The concept of critical percentages is potentially clinically important. It might provide an easy first step in checking applicability of a given severity-of-illness model and in defining a general medical-surgical ICU. If the critical percentages are exceeded, as might occur in a highly specialized ICU, the model would not be accurate. Alternative modeling approaches might be to customize the model coefficients to the population for more accurate probabilities or to develop specialized models. The MPM approach remained robust for a large variation in patient mix factors.
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An in-depth examination of ventilators currently marketed for the pediatric population and the technology associated with each is provided with this article. Also included is a discussion of an "ideal pediatric ventilator" and its application to the pediatric intensive care patient. Triggering, cycling, and limiting variability, costs, and special features currently available are detailed.
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Critical care consumes a significant portion of health care costs. Although there are currently increasing pressures to limit expenditures, data are not always available to allow physicians and patients to make informed therapeutic or triage decisions regarding prolonged intensive care unit (ICU) stays. The purpose of this study was to evaluate long-term outcome, quality of life, and charges in surgical patients requiring prolonged ICU stays (> 14 days). ⋯ In this population, prolonged ICU stays resulted in acceptable quality of life and a relatively high survival rate despite significant economic investment. This study does not support withdrawal of therapy or triage decisions based solely or primarily on age or length of ICU stay.
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Comparative Study
Experience in a neonatal intensive care unit affects pain response.
To determine the effect of being in the neonatal intensive care unit (NICU) on pain responses in infants of 32 weeks' postconceptual age (PCA). ⋯ Preterm infants who spend PCA weeks 28 through 32 in an NICU are less mature in their pain response than newborn premature infants of 32 weeks' PCA. Greater frequency of invasive procedures is associated with behavioral immaturity, whereas birth factors are associated with physiological immaturity.