1,720,977 research outputs found
Evaluation of the disability of ventilated patients
No full textObjective: It is very important to investigate the patient's disability and pain. Interviews of intubated and tracheotomised patients were neglected because of inadequate measuring methods. This is the first prospective study that evaluates the disability and pain of intubated and tracheotomised patients. Methods: Disability, Hospital Anxiety and Depression Scale, Visuelle Analogue Scale, Glasgow Coma Scale and structured questions were used to investigate the disability and pain of ventilated patients. 26 patients of an interdisciplinary operative intensive care unit took part in the study. Sociodemographic parameters, ventilation, sedation and pain were evaluated. Doctors and nurses were asked to assess the patient's pain and disability. Results: 17 intubated and 9 tracheotomised patients were included in the study. Mean intensity of pain was 30.3 (SD = 31.4), anxiety 40.8 (SD = 31.4), disability 30.0 (SD = 11.5) and disability caused by ventilation 61.9 (SD = 28.5). 46.2% of the patients had a pathological subscale of anxiety and 50% of depression in the Hospital Anxiety and Depression Scale. Nurses assessed the patient's disability and pain better than the doctors. Conclusion: A high disability has to be taken in account in the therapy of intubated and tracheotomised patients
Outcome prediction in critical care: physicians' prognoses vs. scoring systems.
No full textBACKGROUND AND OBJECTIVE: To compare the accuracy of prognoses made by intensive care physicians with the performance of two indicators, the original Simplified Acute Physiology Score (SAPS) II and a modified version optimized to the patient sample. METHODS: Data from 412 patients consecutively admitted to intensive care units of Göttingen University Hospital, Germany, were collected according to the original score criteria. Information necessary for the computation of SAPS II and the vital status on hospital discharge was recorded. To customize the original SAPS II in our cohort, the database was randomly divided into two subgroups. Logistic regression analysis with physiological values as explanatory variables was used. A bootstrap procedure completed the process. Furthermore, physicians were asked to indicate their prognostic judgement concerning the patients' hospital mortality. RESULTS: Discrimination analysis showed the following areas under receiver operating characteristic curves: physicians' prognoses 0.84 (confidence interval (CI): 0.79-89), SAPS II 0.75 (CI: 0.69-0.80) and customized SAPS 0.72 (CI: 0.66-0.78). The physician's forecast was significantly better, while the customized and the original SAPS were not substantially different as regards their accuracy. CONCLUSIONS: Prognoses made by physicians are superior to objective models. This may result from more extensive knowledge and other kinds of information available to clinicians. A clinician's action also depends on his/her prognosis at the beginning of the treatment, giving raise to a possible correlation between medical outcome and the clinician's prognosis. Our findings indicate that physicians do not limit their prognosis to the objective factors at their disposal, but indicate that they base their decisions on experience and individual observations
Studies on the utility of interviewing intubation and ventilation patients in intensive care units
No full textGoing Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Studies on the utility of interviewing intubation and ventilation patients in intensive care units
No full textAre physicians Bayesian learners? Information processing and decision making in Intensive Care Units
No full textPost-dural puncture headache and magnesium concentrations in cerebrospinal fluid, erythrocytes and plasma
No full textSimilar symptoms of migraine and post-dural puncture headache suggest common pathophysiological correlates. This study first investigates whether magnesium concentrations in cerebrospinal fluid, plasma and erythrocytes in patients with post-dural puncture headache are lower than in patients who do not develop a post-dural puncture headache. Subject numbering 214 (75 women, 139 men) who were treated with spinal anesthesia because of an operating procedure participated in the study. Total plasma, cerebrospinal fluid and intracellular magnesium and calcium concentrations were evaluated; 6.1 % (2 women, I I men) of the 214 patients had a post-dural puncture headache. Total plasma, cerebrospinal fluid and intracellular magnesium as well as calcium concentrations an Ca++/Mg++ ratios were not different between the patients with and without post-dural puncture headache. The magnesium concentration in cerebrospinal fluid of male patients with post-dural puncture headache who were younger than 45 years, were higher than the concentration of magnesium in cerebrospinal fluid of male patients with post-dural puncture headache who were older than 45 years. Further studies are needed to confirm these results
Do intracellular, extracellular or urinary magnesium concentrations predict renal retention of magnesium in critically ill patients?
No full textBackground and objective: Magnesium disorders are common in hospitalized patients. In patients with low or normal magnesium, the intravenous magnesium loading test has been demonstrated to be a sensitive test to assess magnesium deficiency in critically ill patients. However, it is more time consuming and more difficult than the measurement of intracellular or extracellular magnesium concentrations. This study evaluated whether erythrocyte, plasma and urinary magnesium concentrations predict renal magnesium retention measured by the magnesium loading test. Methods: One-hundred-and-three intensive care patients (36 females, 67 males) in a tertiary care centre and 41 healthy subjects (13 females, 28 males) took part in this prospective study. Intracellular, total plasma, ionized extracellular and urinary magnesium concentrations were measured and also magnesium retention by intravenous magnesium loading test. Results: Total plasma magnesium concentration was poorly correlated with magnesium retention (r = 0.36, r(2) = 0.13) and was the only parameter that significantly predicted magnesium retention in intensive care patients (P < 0.01). However, only 10% of the magnesium retention data were linked to the total plasma magnesium concentration. Conclusions: Total plasma magnesium concentration predicts magnesium retention in critically ill intensive care patients but not intracellular and urinary magnesium concentrations. Only a small proportion of the magnesium retention was due to the total plasma magnesium concentration
Are physicians Bayesian learners? Information processing and decision making in Intensive Care Units
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