Articles: critical-care.
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Intensive care medicine · Dec 1996
Editorial Comment ReviewAspergillosis in the ICU: the glass half-empty?
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To assess the outcome of intensive care treatment in invasive aspergillosis. ⋯ In patients with highly suspected or proven invasive aspergillosis, admission to an ICU and mechanical ventilation should be considered in cases of localized infection and obvious signs of hematologic recovery. In most other circumstances ICU admission for mechanical ventilation does not seem to improve survival.
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There is substantial evidence that with better investment of human and capital resources, better evacuation procedures, and more timely delivery of trauma victims to trauma centres, that mortality and morbidity from trauma will be reduced. The integration of these advances in care, as well as the need to avoid mistakes, requires sound decisions. Thankfully, a clear consensus of the priorities in assessment and intervention is available to guide caregivers as they make these decisions. Repeated examination of the patient and concerted use of these priorities, together with data collection to monitor their use will benefit patients.
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Intensive care medicine · Dec 1996
Multicenter StudyThe performance of SAPS II in a cohort of patients admitted to 99 Italian ICUs: results from GiViTI. Gruppo Italiano per la Valutazione degli interventi in Terapia Intensiva.
To assess the validity of SAPS II (new Simplified Acute Physiology Score) in a cohort of patients admitted to a large sample of Italian intensive care units (ICU). ⋯ SAPS II maintained its validity in an independent sample of patients recruited in a large network of Italian ICUs only after appropriate adaptation (first-level customization). Whether the determinants of this relatively poor performance are related to differences in unmeasured case-mix, methods of application, or quality of care delivered is a matter for discussion that cannot be solved with the data presently available. However, these findings suggest that caution is warranted before implementing the standard SAPS II scoring system parameters outside formal research projects.
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Intensive care medicine · Dec 1996
Measuring health and health state preferences among critically ill patients.
a) to examine the EuroQol instrument's ability to assess a patient's state of health prior to admission to an ICU; b) to describe a patient's health-related quality of life (HRQoL) before the onset of the condition leading to admission to the ICU, and prior to discharge; c) to compare patients' preferences for a "common core" of EuroQol health states with preferences from healthy individuals. ⋯ The EuroQol can be reliably used with proxies to determine the state of health of patients prior to admission to the ICU. Preferences between healthy individuals and ICU patients differed.