Articles: critical-illness.
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Paediatric anaesthesia · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialA randomized controlled trial of sedation in the critically ill.
A randomized controlled trial comparing: a) a combination of oral chloral hydrate and promethazine to b) a continuous intravenous midazolam infusion, for maintenance sedation in critically ill children, was carried out. The level of sedation was assessed four hourly using a specifically devized sedation scale. Forty-four children entered the study of whom two were subsequently excluded. ⋯ The total number of satisfactory assessments in the two groups were only 61 and 48% respectively, suggesting that sedation can be considerably improved. Chloral hydrate and promethazine are more effective than midazolam as maintenance sedation in critically ill children. It is possible to prospectively study the efficacy of sedative drugs in critically ill children.
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Am. J. Respir. Crit. Care Med. · Jan 1997
Multicenter StudyIntensive care of patients with HIV infection: utilization, critical illnesses, and outcomes. Pulmonary Complications of HIV Infection Study Group.
To examine intensive care unit (ICU) admission rates and diagnoses of patients with HIV infection, and to determine the outcomes of different critical illnesses, we analyzed data derived from the 63 patients who were admitted to an ICU from among the 1,130 adults with HIV infection who did not have AIDS at the time of enrollment in a multicenter prospective study. Patients were admitted and treated according to the judgment of their physicians. During 4,298 patient-years of follow-up for the entire cohort, there were 1,320 hospital admissions, of which 68 (5%) included admission to an ICU. ⋯ In conclusion, the range of indications for critical care in patients with HIV infection is diverse. PCP accounted for only 16% of the ICU admissions, and mechanical ventilation for PCP and other pulmonary disorders was associated with a high mortality rate. In contrast, mechanical ventilation for nonpulmonary disorders, and admission to the ICU for nonpulmonary diagnoses was associated with a more favorable outcome.
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Am. J. Respir. Crit. Care Med. · Jan 1997
Comparative StudyNoninvasive monitoring of cardiac output in critically ill patients with thoracocardiography.
Thoracocardiography noninvasively estimates changes in cardiac output by recording ventricular volume curves from an inductive plethysmographic transducer placed around the chest near the xiphoid process. We evaluated performance of thoracocardiography for estimation of cardiac output in 21 critically ill patients in comparison to thermodilution. A total of 201 paired cardiac output measurements were obtained over periods of 35 to 254 min. ⋯ The mean difference (bias) of cardiac output (thoracocardiography - thermodilution) was 0.0 L/min, the limits of agreement (bias +/- 2 SD) included a range from -1.5 to +1.6 L/min. For estimations of relative changes in cardiac output by thoracocardiography and thermodilution the bias was 0%, and the limits of agreement -21 and +22%. We conclude that thoracocardiography is a promising noninvasive technique for monitoring cardiac output in critically ill patients.