Articles: intensive-care-units.
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Comparative Study
Outcome from intensive care. I. A 5-year study of 1308 patients: methodology and patient population.
During a 5-year period, from 1979 to 1983, demographic and disease-related data were collected prospectively on 1308 adult patients from 1555 admissions to a multidisciplinary intensive care unit (ICU) in a Danish university hospital. The patients were followed during the stay in ICU, the ensuing hospital stay, and up to 8 years after discharge from hospital. The male: female ratio was 1:1. ⋯ The APACHE- and TISS-systems were simultaneously applied to a representative sample of 216 consecutive admissions. The average APACHE score was 14.9 +/- 8.2 and the average TISS score 28.3 +/- 11.1 points. The ICU patients presented in this paper do not differ much from ICU patients in other outcome studies.
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Impedance cardiography has not achieved popularity in the Intensive Care Unit (ICU) to date probably because of the limitations in technique and interpretation associated with the altered physiology of critically ill patients, and also because of interference from other machinery in the ICU. The current climate of questioning the existing technology for bedside cardiovascular assessment however spurs the need to evaluate impedance cardiography as a noninvasive alternative. Validation in noncritically ill patients is good when compared to other technologies (e.g., thermodilution, Fick, dye dilution (r greater than 0.9)). ⋯ This is thought to be a measure of contractility that is independent of preload and afterload. The ultimate test in the ICU for impedance cardiography is whether clinical outcome of critically ill patients is altered by the use of this technology. Such outcome testing is essential before the true value of impedance cardiography in the management of critically ill patients can be determined.
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Matern Child Nurs J · Jan 1989
The pediatric intensive care unit environment as a source of stress for parents.
Parents of children hospitalized in one of five midwestern pediatric intensive care units (ICU) were interviewed about the stress experienced from aspects of the ICU environment. Subjects were 324 mothers and 186 fathers of 350 children. Data were collected using the Parental Stressor Scale: Pediatric ICU which assesses seven dimensions of the environment: Child's Behavior and Emotions, Child's Appearance, Sights and Sounds, Procedures, Staff Communication, Anomie, and Parental Role Alteration. ⋯ The items from the Parental Role Alteration dimension with the highest stress scores were: feeling unable to protect my child and not knowing how to best help my child. Findings suggest that alterations in the parent-child relationship are more stressful than aspects of the physical environment. In particular, feeling helpless in the parenting role is a great source of stress for parents.
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Intensive care medicine · Jan 1989
Intensive care for children after orthotopic liver transplantation.
We report our experience in the management of children after orthotopic liver transplantation (OLT). From 03/84 to 04/87 50 patients (pts) were transplanted. Mean age was 4 3/12 years (8/12 to 13 2/12) and mean body weight 14.7 kg (5.8 to 40). ⋯ Problems related to the functioning of the graft included: Primary non-function of the graft (4 pts), hepatic artery thrombosis (8 pts) and severe acute rejection unresponsive to therapy (1 pt); these situations needed to be recognised early in order to organize a second OLT. Other causes of hepatic dysfunction were: portal vein thrombosis (1 pt), biliary tract obstruction (2 pts), angiocholitis (3 pts), right hepatic lobe necrosis (2 pts). Acute hepatic insufficiency in 7 children.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Burn Care Rehabil · Jan 1989
Registered nurses and burn care facilities. Factors associated with turnover rates.
The health care system in the United States is suffering from a severe shortage of registered nurses. Burn treatment facilities are no exception to this phenomenon. ⋯ The purpose of this paper is to determine the magnitude of the registered nurse shortage in burn care facilities. A second purpose is to identify factors associated with high turnover rates and to document the reasons why registered burn nurses are leaving their positions.