Articles: intensive-care-units.
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The Journal of pediatrics · Sep 1993
Editorial CommentProspective payment and pediatric intensive care.
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To examine the impact of pulse oximetry on the use of arterial blood gas and other laboratory determinations and to examine predictors of the use of arterial blood gas measurements. ⋯ The implementation of pulse oximetry in this manner gives an idea how effective the technology will be in reducing the use of arterial blood gas determinations without guidelines for the use of pulse oximetry. As only a marginal decrease was observed in the total population of medical and surgical patients, and only on the night shift, formal and standardized guidelines for the most efficient use of pulse oximetry should be considered. If these were considered, pulse oximetry may indeed make a significant contribution to improving the efficiency of care services.
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The APACHE II scoring system was applied to 301 surgical intensive care admissions over a 9-month period. The mean age of patients admitted was 52.39 years (SD 19.3) and the mean duration of stay was 5.37 days (SD 8.93). The overall mortality was 17.27%. ⋯ Using a predicted risk criterion of 0.5 to distinguish between those predicted to survive and die, of the 45 patients predicted to die, only 30 actually did so. No patient survived with an APACHE II score of more than 40 and with a predicted risk of death greater than 0.87. We found the APACHE II system useful for evaluating ICU performance and risk stratification for the purpose of therapeutic trials but not as a triage tool.
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Bol Med Hosp Infant Mex · Aug 1993
[Validity of a scale of vital prognosis in multiorgan failure syndrome: experience at a pediatric ICU].
In order to evaluate the utility of modified score index for multiple organ failure syndrome (MOFS) detection, we studied 31 critically ill pediatric patients at University Hospital of Puebla. They had a critical illness and they were successfully animated and developed two or more organ failure other than initial lesion. ⋯ Were assessed that scale for know its predictive value and results were significant: sensitivity 81%, specificity 30% and accuracy, 54.5%. Finally we recommended caution to use anyone score system in evaluating MOFS.