Articles: critical-care.
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Critical care medicine · Jul 1995
Comparative StudyFrequency of bacteremia associated with transesophageal echocardiography in intensive care unit patients: a prospective study of 139 patients.
To determine the occurrence rate of bacteremia associated with transesophageal echocardiography in intensive care unit (ICU) patients. ⋯ The overall frequency of bacteremia induced by transesophageal echocardiography in ICU patients was 1.4% (two of 139 patients) (95% confidence interval 0.2% to 5.1%). The frequency did not differ whether patients received antibiotics before transesophageal echocardiography (one [1.2%] of 83 patients) or not (one [1.8%] of 56 patients) (p = .96). Therefore, routine antimicrobial prophylaxis does not appear justified before transesophageal echocardiography in ICU patients.
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Two patients with respiratory distress are described in which the laryngeal mask airway and continuous positive airway pressure were used with good effect. The laryngeal mask airway may be useful in some cases of respiratory distress occurring in the intensive care unit when a patient is unable to tolerate a tracheal tube.
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Critical care nurses' perceptions of appropriate care of the patient with orders not to resuscitate.
To determine critical care nurses' perceptions of appropriate care of patients with and without do-not-resuscitate (DNR) orders. ⋯ Compared with the patient without a DNR order, significantly lower levels of agreement were expressed with interventions involving monitoring for the patient with the DNR order. Agreement with placement of the patient with the DNR order in an intensive care unit may be seen to follow the same pattern. Education of caregivers and communication among them might help to clarify what may be ambiguous policies and orders.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Continuous monitoring of critical patients with a newly developed pulmonary arterial catheter. A cost analysis].
The introduction of flow-directed pulmonary artery (PA) catheters has helped to improve our knowledge of cardiovascular physiology. There have been several developments of this equipment in recent years, including continuous monitoring of mixed-venous O2 saturation (SvO2) and cardiac output (CO). The high purchase price, however, is an obstacle to its use in the critically ill. ⋯ Costs for laboratory analyses can blunt the advantage of lower costs for the standard PA catheter. Intermittent (standard) monitoring of SvO2 and CO was significantly more time-consuming than the continuous methods. It can be summarised that although purchase costs for the more advanced PA catheters are higher than for standard PA catheters, the use of these continuous monitoring devices in the critically ill can be justified from a financial point of view.