Articles: intensive-care-units.
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To review recent revisions of systems for estimating the probability of hospital mortality of adult intensive care unit (ICU) patients. Emphasis on comparison of components of systems and potential uses. ⋯ All models were based on rigorous research and reported performance is good. All can be used to assist in assessing prognosis, to compare ICU performance, and to stratify patients for clinical trials. Direct comparison on a common cohort is needed.
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Neurosurg. Clin. N. Am. · Oct 1994
ReviewThe neurosurgical intensive care unit in an era of health care reform.
Health care reform, public concern, and managed care will create an environment that demands highly creative strategies to deliver quality care while reducing costs. Patient satisfaction and outcomes will take on a high priority. To meet this challenge, the neurosurgical ICU of the future will be designed with a patient-focused theme wherein the physical environment embodies healing and humanism. ⋯ Patient outcomes will be a result of a highly organized collaborative model that includes primary nursing, critical paths, and case management. Partnerships between nurses and unit support staff will create skill-mix changes that allow the nurse to spend less time on nonclinical unit maintenance-type functions and more time with the patient and family. This will have a positive fiscal impact as well as enhance patient satisfaction and outcomes.
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The aim of this study was to review the frequency of decisions to withdraw treatment from neonates who had died in a large neonatal intensive care unit, the reasons for these decisions, and the procedures followed. A 12 month retrospective review of medical and nursing records was undertaken. ⋯ It is concluded that withdrawal of treatment resulting in death occurs frequently in the neonatal intensive care service of National Women's Hospital, Auckland, New Zealand, but is usually a recognition of the inevitable. Truly elective withdrawal of treatment is uncommon in the immature infant, but does occur in the context of multiple abnormalities or severe birth asphyxia, where it follows a formal procedure.
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Sleep can be extremely difficult to achieve in ICUs. Sleep deprivation is a major problem in the ICU and physicians should be aware of the effects of sleep deprivation on physiologic and immune function. Sleep deprivation has been associated with the ICU syndrome. ⋯ Effective means of controlling noise and sensory overload in ICU patients must be developed. Nonpharmacologic options to enhance sleep should be considered in all ICUs. Sleep should never be considered a luxury in the ICU; it is an essential physiologic need.
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Comput Methods Programs Biomed · Oct 1994
TANIT AIM project (A2036): Telematics for ANaesthesia and Intensive Therapy.
On-going work relating to the development of advanced telematics systems for Critical Care environments is described. This work is in part sponsored by the Commission of European Communities under the AIM TANIT project. Two example departments have been selected for piloting in the project: Intensive Care and Anaesthesia. The objective of this paper is to outline the complex issues that need to be addressed when developing such systems.