Articles: intensive-care-units.
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Critical care medicine · Aug 1996
Multicenter Study Comparative StudyComparative assessment of pediatric intensive care in Moscow, the Russian Federation: a prospective, multicenter study.
Comparative assessment of pediatric intensive care. ⋯ We provided a quantitative description and assessment of pediatric intensive care in Moscow. Moderate efficiency may reflect a low threshold for ICU admission due to poor nurse/patient ratios on the wards. Effectiveness in the low- and medium-risk strata is below standard, as compared with a Western reference population. Excess mortality was concentrated in the low- and medium-risk strata, and can only partially be explained by the inclusion of co-morbidity. Future analysis should focus on specific treatment protocols, protocol adherence, and the determination of infectious and therapeutic complications.
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The purpose of this study was to determine whether the institution of a clinical protocol combining 6 hours of recovery room observation and guidelines for intensive care unit (ICU) admission would allow selected patients to be safely transferred directly to a surgical floor after nonaortic arterial reconstruction. ⋯ The implementation of a clinical protocol similar to the one used in this study will allow many patients undergoing nonaortic vascular surgery to avoid the use of the ICU. This approach will conserve hospital and financial resources without adversely affecting patient morbidity and mortality rates.
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Fecal colonization with multiresistant Acinetobacter baumannii was evaluated in 189 consecutive patients in intensive care units (ICUs) during two different 2-month periods (October-November 1993 and May-June 1994). Rectal swabs were obtained weekly from admission to discharge from the ICU. Overall, 77 patients (41%) had multiresistant A. baumannii fecal colonization; colonization was detected in 55 (71%) of the patients within the first week of their ICU stay. ⋯ The reinforcement of isolation measures between study periods reduced both the number of fecal carriers of multiresistant A. baumannii (from 52% to 31%; P < .01) and the number of patients with multiresistant A. baumannii infections (from 17% to 11%; no statistical significance). The digestive tract of ICU patients could be an important epidemiologic reservoir for multiresistant A. baumannii infections in hospital outbreaks. Further prospective studies should be undertaken to define the relative significance of digestive tract colonization compared with other body site colonizations.
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Intensive Crit Care Nurs · Aug 1996
Noise levels in a cardiac surgical intensive care unit: a preliminary study conducted in secret.
Noise in hospitals frequently exceeds recommended levels and has detrimental psychological and physiological effects on patients and staff. The aim of this study was to record the noise levels within the cardiac surgical intensive care unit (CSICU) environment in secret. The device used was a CEL Instruments environmental noise meter concealed in a dummy box featuring temperature and humidity digital displays. ⋯ The continuous background noise was at its lowest at 57.5 dBA 1 min equivalent continuous sound pressure levels (Leq) and at its peak 77.3 dBA 1 min Leq. Noise in the CSICU was above the recommended levels for patients and staff well-being. Future studies will be designed to establish a correlation between sound levels and events.