Articles: critical-care.
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Critical care medicine · Dec 1997
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialProtocol-guided diuretic management: comparison of furosemide by continuous infusion and intermittent bolus.
To evaluate the safety and relative effectiveness of two diuretic protocols in the intensive care unit (ICU). ⋯ Protocol-guided diuretic management, with individualized titration of dosage to defined physiologic endpoints can be readily and safely implemented in the ICU. Both continuous and bolus diuretic regimens appear equally effective in achieving negative fluid balance. Larger studies with a randomized control arm are needed before these protocols can be recommended as routine practice.
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Journal of critical care · Dec 1997
Randomized Controlled Trial Clinical TrialFewer interventions in the immediate post-extubation management of pediatric intensive care unit patients: safety and cost containment.
The purpose of this article was to compare the safety and patient charges of two postextubation treatment regimens. ⋯ A modified postextubation management protocol, consisting of fewer interventions, resulted in significant patient charge savings with no increased risk to the patient.
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To review the clinical characteristics and outcomes of critically ill obstetrical patients and to determine the outcome predictability using the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system. ⋯ When applying the Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system in predicting the final outcome in this group of obstetric patients, we found that our obstetric patients requiring intensive care had a better outcome than predicted, as expressed by a low mortality ratio (0.25).
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James' adaptation of the Glasgow coma scale (JGCS) was designed for young children. Intubated patients are not allocated a verbal score, however, so important changes in a patient's conscious level may be missed. A grimace score was therefore developed and assessed for use in intubated children. ⋯ Seventy three children had 104 sets of observations. Interobserver reliability was moderate to good for all components, with the grimace score better than the verbal score. It is concluded that the grimace score is more reliable than the verbal score and may be useful in intubated patients in whom the verbal score cannot be used.