Articles: intensive-care-units.
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Revista médica de Chile · Jan 1993
Comparative Study[Mortality in an intensive care unit: predictive value of APACHE II severity score versus maximum APACHE].
Patients admitted to intensive care units (ICU) experience constant changes in their general condition. Therefore, the determination of Apache score within the first 24 hours of admission may not be a reliable index of severity. The aim of this study was to measure daily Apache scores in ICU patients, and to determine if the maximum score (Maximum Apache) attained during hospitalization had a better prognostic value than that of admission. ⋯ Only 78.3% of patients attained their maximum apache score during the first 24 hours of admission, whereas 21.7% attained it during the rest of ICU hospitalization. Excluding subjects with less than one day of ICU stay, 33% of patients attained maximum Apache score after 24 hours of ICU admission. Statistical analysis showed that maximum Apache score was a better predictor of mortality than that of admission.
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Critical care clinics · Jan 1993
ReviewEthical considerations in the treatment of AIDS patients in the intensive care unit.
The treatment of patients with AIDS in the ICU presents the clinician with special challenges. The admission policies of ICUs are examined, and the authors suggest ways in which ethical difficulties may be minimized. A new concept of futility is suggested, which considers both the patient's holistic needs together with his or her immediate medical prognosis. Changes in the law regarding patient choice are discussed.
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To examine the behavioral and emotional responses of the child and of the nonhospitalized adult family member (NHAFM) to facilitated child visitation in the critical care setting. ⋯ Facilitated child visitation may help children deal with the critical illness of an adult family member and deserves further study.
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Comparative Study
Cross infection in an intensive care unit by Klebsiella pneumoniae from ventilator condensate.
Klebsiella pneumoniae serotype K28 was cultured from six patients over 5 weeks in a general Intensive Care Unit. Colonized condensate in the ventilator expiratory water traps was the probable source of the organism, and hand carriage the vehicle of transmission. Although the cross-infection hazard of ventilator tubing condensate is recognized, there is no report in the literature of an outbreak caused by such fluid. Ventilator tubing condensate should be viewed as contaminated clinical waste and dealt with accordingly.