Articles: critical-illness.
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Nephrol. Dial. Transplant. · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of lactate and bicarbonate buffered haemofiltration fluids: use in critically ill patients.
To compare acid-base balance, lactate concentration, and haemodynamic and O2 transport variables during haemofiltration with replacement fluid containing 44.5 mmol/l Na+ lactate or 40 mmol/l Na+ HCO3- and 3 mmol/l lactic acid. ⋯ The degree of correction of acidosis during the first 24 h of haemofiltration was determined by patients outcome but was not affected by the substitution of bicarbonate- for lactate-containing replacement fluids.
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This paper highlights hazards involved in moving critically ill patients between locations, discusses minimalisation of risks involved and the advantages of specialist teams. ⋯ Critically ill patients are moved within the hospital because of the need for surgical procedures or to have fixed facilities investigations performed. Interhospital movement of patients is necessary for specialised care available elsewhere. This has increased with centralisation of specialist services. This paper adopts a practical approach to the transfer process. It establishes the goals of conducting a safe transfer, highlights the deleterious effects of moving an ill patient, the risks and pitfalls of a transfer, and how to minimise them. Attention is drawn to the need for proper resuscitation and stabilisation of a patient before transport. The quality and outcome of the transfer depend on the experience of the transferring team and on adequate monitoring facilities. The benefits of a specialist transfer team is suggested.
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Two hundred one consecutive adult admissions to a 3-bed Special Care Unit in a 25-bed military hospital were scored using APACHE II (Acute Physiology and Chronic Health Evaluation). Outcome measures included APACHE II scores and mortality predictions; active intensive care interventions; transfers for specialized care; and mortality. ⋯ APACHE II scoring can be applied in small intensive care settings. Scoring criteria and logistic regression equations may need to be customized accordingly.
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Otolaryngol Head Neck Surg · Jun 1997
Otolaryngic manifestations in children presenting with apparent life-threatening events.
Apparent life-threatening event (ALTE) is a term used to characterize an event of unknown cause after an infant is found limp, cyanotic, bradycardic, and/or requiring resuscitation. Like sudden infant death syndrome (SIDS), ALTE is a general term used until a precise diagnosis can be established. The relationship between ALTE and SIDS has not been clearly defined, although 7 to 15 percent of children with ALTE die of SIDS. ⋯ Thirteen percent of the children had nonotolaryngic anomalies identified during evaluation. Surgical intervention was required in 10 patients and medical treatment was used in 18. When evaluating a child with ALTE, a complete history and physical examination, evaluation for gastroesophageal reflux, assessment for upper airway obstruction by radiographs and endoscopy, and a multidisciplinary approach are recommended.
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Intensive care medicine · Jun 1997
Validation of the simplified therapeutic intervention scoring system on an independent database.
To evaluate the performance of the Simplified Therapeutic Intervention Scoring System on an independent database and determine its relation with the Therapeutic Intervention Scoring System in the quantification of nursing workload in intensive care. ⋯ TISS-28 was validated on this independent population. The results indicate that TISS-28 can replace TISS-76 for the measurement of the nursing workload in Portuguese ICUs.