Articles: mortality.
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To review the techniques and long term complications of the various techniques of percutaneous tracheostomy in the critically ill patient. ⋯ In the critically ill patient who requires a tracheostomy, the percutaneous tracheostomy has become the method of choice as it can be performed at the bedside, leaves a smaller scar after decannulation and may be associated with fewer complications compared with the standard surgical technique.
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Sedative drugs are used routinely in critically ill patients to reduce both physical and psychological stresses imposed by the hostile intensive care unit environment. However, drug accumulation, particularly during prolonged administration, often poses difficulties. Sedation scales chart the physiological effect of sedation although many surveys have revealed that few units use them to monitor the effect of sedative agents hence oversedation is common. ⋯ Our study demonstrates that the use of a sedation scale lead to a decrease in sedative, analgesic and inotrope use with a trend to less ventilated hours in critically ill patients.
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Despite the equivocal outcomes of randomized controlled trials, general clinical opinion favors screening and treatment of elderly individuals with subclinical thyroid disorders. ⋯ In the general population of the oldest old, elderly individuals with abnormally high levels of thyrotropin do not experience adverse effects and may have a prolonged life span. However, evidence for not treating elderly individuals can only come from a well-designed, randomized placebo-controlled clinical trial.
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The mortality of severe sepsis is growing due to increased incidense of the syndrome. The speed and appropriateness of therapy administered in the initial hours is likely to influence outcome. Thus, eleven organizations of experts have developed guidelines, evidence based as far as possible, for the bedside management of patients, aimed at improving diagnosis and outcome in sepsis. The guidelines are a part of a campaign named ?surviving sepsis campaign?, see www.survivingsepsis.org The present article is aimed at introducing the guidelines to icelandic doctors.
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Croatian medical journal · Dec 2004
Alcohol consumption and mortality in Serbia: twenty-year follow-up study.
To investigate the connection between alcohol consumption and general and specific mortality in the Serbian population. ⋯ Among Serbian middle-aged population moderate alcohol consumption reduced mortality from all causes, myocardial infarction and other causes of death, and increased the probability of survival in a twenty year follow-up period. Heavy drinking increased mortality rates from all causes and reduced the twenty year-survival probability in comparison with non-drinkers.