Articles: critical-care.
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Emphasis is on the mechanical properties of the spontaneously breathing patient. The occasional reference to mechanically ventilated patients is used to clarify and provide additional insight to the topic of spontaneously breathing individuals. Reference to the basic principles of mechanics are to establish the foundation for an integrated description of lung mechanics. Finally, a brief review of the "state of the art" respiratory monitoring parameters shown to have direct clinical applications.
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Ann Fr Anesth Reanim · Jan 1995
[Severity scores underestimate the seriousness of acute renal failure after emergency surgery].
The predictive value of APACHE II and SAPS severity scores were evaluated in a group of patients with acute renal failure admitted in ICU after emergency surgery. The criteria of poor prognosis identified in the 24 hours following admission were also evaluated. ⋯ Conventional severity scores are inaccurate for prediction of mortality in patients with acute renal failure following emergency surgery.
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Eur J Cardiothorac Surg · Jan 1995
Survival and quality of life in patients with protracted recovery from cardiac surgery. Can we predict poor outcome?
Of all the 2256 adult cardiac surgical patients operated upon during a 12-month period from 1st February 1992 in three units, only 162 (7.2%) spent more than 48 h in the intensive care unit (ICU) (median 6 days, range 3-90). There were 47 deaths in ICU, 7 more before hospital discharge, and a further 10 before the study end-point of one year after surgery. All 98 1-year survivors were at home with 86 of them reporting their quality of life, on formal evaluation, to be within the reference range which we have established for a less complicated cohort of cardiac surgical patients. ⋯ The algorithm performs well for cardiac surgery patients with a specificity of 98%. If treatment had been withdrawn when death or poor quality of life became predictable, the maximum number of ICU bed days that could be freed was of the order of 2%. The plight of these patients is distressing, but most survive and do well and they are infrequent compared with the large majority who survive to leave hospital after a short ICU stay.