Articles: critical-illness.
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Critical care medicine · May 1996
Meta AnalysisDoes selective decontamination of the digestive tract reduce mortality for severely ill patients?
To investigate the relationship between baseline risk of death and reduced mortality after selective decontamination of the digestive tract in intensive care unit patients. ⋯ Mortality reduction from selective decontamination of the digestive tract appears related to the mortality risk of patients at the time of study entry. Future trials should consider using baseline risk assessment as part of trial design and outcome analysis.
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Pediatric intensive care units (PICUs) have been developed to provide intensive care for children between post-neonatal age and adolescence. These units have largely been developed in North America, mainly in tertiary hospitals. In Italy, critically ill children are still often nursed on adult ICU's, where medical and nursing staff often lack pediatric training. Here we report the first 5-year experience of the multidisciplinary PICU developed at the Department of Pediatrics, University of Padua, focusing on PICU and patients characteristics, as well as on the evaluation of outcome by means of the Pediatric Risk of Mortality (PRISM) score.
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Multicenter Study Clinical Trial Controlled Clinical Trial
Pharmacodynamics and pharmacokinetics of milrinone administration to increase oxygen delivery in critically ill patients.
The positive inotropic and vasodilator actions of phosphodiesterase (PDE) inhibitor drugs may offer therapeutic alternatives to beta-agonists in critically ill patients. We hypothesized that milrinone administration would increase cardiac index (CI) and oxygen delivery (Do2) in ICU patients, and that a pharmacokinetic model previously developed in cardiac surgery patients may be used to predict milrinone plasma concentrations in a medical-surgical ICU population. ⋯ Our study confirms that a milrinone loading dose of 50 micrograms/kg/min followed by an infusion of 0.5 microgram/kg/min achieves adequate plasma concentrations of 100 ng/mL or greater, which significantly increases both CI and Do2. In addition, a previously established pharmacokinetic model of milrinone disposition is confirmed in this mixed ICU population.
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Critical care medicine · May 1996
Risk factors for nosocomial infection in critically ill children: a prospective cohort study.
To identify factors in pediatric intensive care unit (ICU) patients that are associated with an increased risk of nosocomial infections. ⋯ Patients at risk for developing nosocomial infection can be identified using a multivariate logistic regression model with a high degree of sensitivity and specificity. These data indicate that institutional nosocomial rates need to be adjusted for risk factors. This model could help target patients at high risk for developing nosocomial infections for preventive strategies.
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Intensive care medicine · May 1996
Relationship of changes in cardiac output to changes in heart rate in medical ICU patients.
To determine whether changes in cardiac output are correlated with changes in other commonly measured covariables (heart rate, respiratory rate, mean arterial pressure, mean pulmonary artery pressure, pulmonary artery occlusion pressure, and temperature). ⋯ Changes in cardiac output were best correlated with changes in heart rate. Changes in pulmonary artery occlusion pressure were not correlated with changes in cardiac output in this population of medical ICU patients. A change in any of the covariables (alone or in combination) cannot be reliably used to indicate a simultaneous change in cardiac output.