Articles: critical-care.
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Clinics in chest medicine · Sep 1993
ReviewOutcome assessment in elderly patients with critical illness and respiratory failure.
Although elderly patients tend to have diminished physiologic reserve, the independent impact of age on outcome from critical illness is controversial. Physiologic status is perhaps a more important measure of a patient's underlying health and anticipated response to critical illness. Age, therefore, should not be used as a sole determinant for intensive care department admission.
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Minerva anestesiologica · Sep 1993
Comparative Study Clinical Trial Controlled Clinical Trial[Propofol-midazolam in continuous infusion for sedation in intensive care].
Two groups of 11 ICU respiratory patients ventilated with PSV have been sedated with propofol (group I) or with midazolam (group II). After the endovenous administration of the induction dose (propofol 1.5 mg/kg; midazolam 0.15 mg/kg) sedation was obtained with continuous infusion of the drugs (propofol 2 mg/kg/h; midazolam 0.24 mg/kg/h). ⋯ At induction midazolam caused a reduction of tidal volume for some minutes and a greatest sedation in comparison with propofol, while propofol caused reduction of MAP (p < 0.01) and transitory apnoea. Even if during the infusion of propofol the level of sedation decreased with time (p < 0.05; y = -0.0357 x + 3.07) it was more stable in comparison with that registered during continuous infusion of midazolam (p < 0.01; y = -0.2018 x + 5.19.
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To describe pediatric critical care nurses' knowledge of dysrhythmias in critically ill pediatric patients and relate this knowledge level to certain demographic variables (education, nursing experience, certification, supplemental training, area of employment and geographic region of residence). ⋯ Pediatric critical care nurses' overall knowledge of dysrhythmias was low. Knowledge strengths included recognition of basic and life-threatening dysrhythmias and calculation of basic ECG measurements. Knowledge deficits included importance of sinus bradycardia in the neonate, appropriate intervention for life-threatening dysrhythmias and calculation of an irregular heart rate. These deficits should be considered when planning continuing education programs for pediatric critical care nurses.
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Anesthesia and analgesia · Sep 1993
Attitudes of anesthesiology residents toward critical care medicine training.
The number of anesthesiology residents pursuing critical care medicine (CCM) fellowship training has been decreasing in recent years. A significant number of training positions remain unfilled each year. Possible causes of this decline were evaluated by surveying residents regarding their attitudes toward practice and training in CCM. ⋯ Written responses to open-ended questions suggested resident concerns with the following: stress of chronic care, financial consequences of additional year of training, ICU call frequency and load, ICU role ambiguity, and shared decision-making in the ICU. A recurring question was, "Are there jobs (outside of academics) for anesthesiologist intensivists?" Most residents knew a CCM anesthesiologist they admired and knew that there were unfilled fellowship positions available. Defining the job market, improving curriculum and teaching, supporting deferment of student loans, and introducing residents and medical students to the ICU earlier may increase the interest in CCM practice among anesthesiology residents.