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Items 1 - 3 of 3 |
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Characteristics and outcome of long-stay patients in a paediatric intensive care unit: a case-control study.
van der Heide P, Hassing MB, Gemke RJ.
Department of Paediatric Intensive Care, VU University Medical Centre, Amsterdam, The Netherlands. p.a.vanderheide@amc.uva.nl
AIM: To identify differences in baseline characteristics and outcome between long-stay and other patients admitted to a paediatric intensive care unit with the same diagnosis. METHODS: Over a period of 6 y, data of paediatric intensive care unit patients with a length of stay of 30 or more days (long-stay patients) and aged 1 to 18y were retrospectively collected. Long-stay patients were matched with the next patient who was admitted to the paediatric intensive care unit with the same diagnosis. Evaluated characteristics on admission included: age, sex, presence of chronic morbidity, functional status, Pediatric Risk of Mortality score, presence of multiple organ system failure and complications during admission. Outcome (survival and functional status) was assessed 2.5 to 8.5 y after admission. RESULTS: Of 19 long-stay patients identified, 15 could be matched with a control patient admitted with the same diagnosis. No significant difference in baseline characteristics was found between long-stay patients and the matched controls. The mean number of complications per long-stay patient was 2.9, compared to 1.2 per control patient (p = 0.02). Infection accounted for half of the complications. Mortality rate in long-stay patients was not higher than in the matched controls (36.8 vs 26.7%, p = 0.54). Paediatric intensive care unit stay did not change functional status in either long-stay patients or controls. CONCLUSION: Long-stay patients in the paediatric intensive care unit had more complications, but baseline characteristics, mortality and functional outcome were not different from a control group admitted with the same diagnosis.
PMID: 15456198 [PubMed - in process]
Corticosteroids for septic shock--a standard of care?
Bloomfield R, Noble DW.
Publication Types:
PMID: 15251993 [PubMed - indexed for MEDLINE]
Aerosolized antibiotics in mechanically ventilated patients.
Smaldone GC.
Pulmonary/Critical Care Medicine, Health Sciences Center, T-17, 040, State University of New York at Stony Brook, Stony Brook, NY 11794-8172, USA. gsmaldone@notes.cc.sunysb.edu.
Aerosolized antibiotics are potentially useful in intensive care. At State University of New York at Stony Brook we developed a human model of tracheobronchitis in intubated patients. The model provides daily specimens of airway secretions, allowing serial studies of airway inflammation and testing of therapy modes. The presence of local infection is defined by a unique method of quantified sputum collection. Bench models have been developed that illustrate the factors that limit aerosol delivery to intubated patients. With those models clinical trials have defined possible indications for targeted aerosol therapy to patients at risk for deep lung infection. An efficient aerosolized-antibiotics method that delivers the aerosol past the endotracheal tube has been established, and with that method the drug levels in pulmonary secretions exceed by several orders of magnitude the levels expected with intravenous therapy. Potential end points of therapy are being evaluated, including the rate of bacterial resistance and the incidence and definition of deep lung infection.
Publication Types:
PMID: 15165298 [PubMed - indexed for MEDLINE]
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