Anaesthesia 2002 May;57(5):434-41
Senior Registrar, Consultant and Head of Department and Consultant, Department of Anaesthesia and Surgical Intensive Care, Queen Elizabeth Hospital, Barbados.
[Medline record in process]
The performance of the Acute Physiology and Chronic Health Evaluation II scoring system was prospectively assessed in the surgical intensive care unit at the Queen Elizabeth Hospital, Barbados. A total of 309 patients admitted consecutively during a 2-year period (1999-2001) were evaluated. Demographic data, diagnosis, Acute Physiology and Chronic Health Evaluation II score, duration of stay and hospital outcome were recorded. The predicted mortality for every patient and the costs incurred were also calculated. The overall observed mortality rate was 15.9% while the mean predicted mortality rate for our case-mix was 16.4%, which is comparable to results from developed countries. The cost incurred per patient was much lower at $13 636 (Barbados), compared to the patients' cost in North America ($60 000 Barbados).
PMID: 11966552, UI: 21963373
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Intensive Care Med 2002 Apr;28(4):523
The Intensive Care Unit, University Hospital of Heraklion, Department of Medicine, University of Crete, Heraklion, Crete 711 10, Greece.
PMID: 11967612, UI: 21963978
Intensive Care Med 2002 Apr;28(4):520-2
Department of Intensive Care, Vrije Universiteit Medical Centre, PO Box 7057, 1007 MB Amsterdam, The Netherlands, k.polderman@vumc.nl
OBJECTIVE: Broad spectrum penicillins such as piperacillin are used extensively in the intensive care unit (ICU) because of their wide bacterial spectrum and low level of toxicity. Although some cases of interstitial nephritis induced by piperacillin have been reported, this problem is thought to be rare. However, in view of the large number of other risk factors for renal disorders that are frequently present in ICU patients, we speculated that ICU patients might be more at risk for renal side effects. We therefore decided to measure serum electrolyte levels in patients before and after piperacillin administration. DESIGN: Prospective observational study. SETTING: University teaching hospital. PATIENTS AND PARTICIPANTS: Forty-three consecutive patients with normal renal function treated with piperacillin; 40 patients treated with other antibiotics. RESULTS: Serum levels of magnesium (Mg), potassium (K) and, to a lesser degree, calcium (Ca) decreased significantly in patients treated with piperacillin, but not in patients treated with other antibiotics ( p<0.01). This decrease was especially pronounced in a subgroup of patients concurrently treated with furosemide. CONCLUSIONS: We conclude that treatment with piperacillin may cause or aggravate electrolyte disorders and tubular dysfunction in ICU patients even when serum creatinine levels remain normal.
PMID: 11967611, UI: 21963977
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