Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients.Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility.Intensive Care Units, Neonatal: Hospital units providing continuing surveillance and care to acutely ill newborn infants.Intensive Care Units, Pediatric: Hospital units providing continuous surveillance and care to acutely ill infants and children. Neonates are excluded since INTENSIVE CARE UNITS, NEONATAL is available.Intensive Care, Neonatal: Continuous care and monitoring of newborn infants with life-threatening conditions, in any setting.Critical Illness: A disease or state in which death is possible or imminent.Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis.Respiration, Artificial: Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).Length of Stay: The period of confinement of a patient to a hospital or other health facility.Cross Infection: Any infection which a patient contracts in a health-care institution.APACHE: An acronym for Acute Physiology and Chronic Health Evaluation, a scoring system using routinely collected data and providing an accurate, objective description for a broad range of intensive care unit admissions, measuring severity of illness in critically ill patients.Infant, Newborn: An infant during the first month after birth.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Hospital Mortality: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Sepsis: Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by HYPOTENSION despite adequate fluid infusion, it is called SEPTIC SHOCK.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Monitoring, Physiologic: The continuous measurement of physiological processes, blood pressure, heart rate, renal output, reflexes, respiration, etc., in a patient or experimental animal; includes pharmacologic monitoring, the measurement of administered drugs or their metabolites in the blood, tissues, or urine.Patient Admission: The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.Pneumonia, Ventilator-Associated: Serious INFLAMMATION of the LUNG in patients who required the use of PULMONARY VENTILATOR. It is usually caused by cross bacterial infections in hospitals (NOSOCOMIAL INFECTIONS).Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Nursing Staff, Hospital: Personnel who provide nursing service to patients in a hospital.Infant, Premature: A human infant born before 37 weeks of GESTATION.Delirium: A disorder characterized by CONFUSION; inattentiveness; disorientation; ILLUSIONS; HALLUCINATIONS; agitation; and in some instances autonomic nervous system overactivity. It may result from toxic/metabolic conditions or structural brain lesions. (From Adams et al., Principles of Neurology, 6th ed, pp411-2)Hospitals, University: Hospitals maintained by a university for the teaching of medical students, postgraduate training programs, and clinical research.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Hypoglycemic Agents: Substances which lower blood glucose levels.Multiple Organ Failure: A progressive condition usually characterized by combined failure of several organs such as the lungs, liver, kidney, along with some clotting mechanisms, usually postinjury or postoperative.Ventilator Weaning: Techniques for effecting the transition of the respiratory-failure patient from mechanical ventilation to spontaneous ventilation, while meeting the criteria that tidal volume be above a given threshold (greater than 5 ml/kg), respiratory frequency be below a given count (less than 30 breaths/min), and oxygen partial pressure be above a given threshold (PaO2 greater than 50mm Hg). Weaning studies focus on finding methods to monitor and predict the outcome of mechanical ventilator weaning as well as finding ventilatory support techniques which will facilitate successful weaning. Present methods include intermittent mandatory ventilation, intermittent positive pressure ventilation, and mandatory minute volume ventilation.Intubation, Intratracheal: A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.Respiratory Insufficiency: Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed)Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Neonatology: A subspecialty of Pediatrics concerned with the newborn infant.Infection Control: Programs of disease surveillance, generally within health care facilities, designed to investigate, prevent, and control the spread of infections and their causative microorganisms.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Anti-Bacterial Agents: Substances that reduce the growth or reproduction of BACTERIA.Life Support Care: Care provided patients requiring extraordinary therapeutic measures in order to sustain and prolong life.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Tracheostomy: Surgical formation of an opening into the trachea through the neck, or the opening so created.Equipment and Supplies, Hospital: Any materials used in providing care specifically in the hospital.Patient Transfer: Interfacility or intrahospital transfer of patients. Intrahospital transfer is usually to obtain a specific kind of care and interfacility transfer is usually for economic reasons as well as for the type of care provided.Conscious Sedation: A drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway. (From: American Society of Anesthesiologists Practice Guidelines)Outcome Assessment (Health Care): Research aimed at assessing the quality and effectiveness of health care as measured by the attainment of a specified end result or outcome. Measures include parameters such as improved health, lowered morbidity or mortality, and improvement of abnormal states (such as elevated blood pressure).Withholding Treatment: Withholding or withdrawal of a particular treatment or treatments, often (but not necessarily) life-prolonging treatment, from a patient or from a research subject as part of a research protocol. The concept is differentiated from REFUSAL TO TREAT, where the emphasis is on the health professional's or health facility's refusal to treat a patient or group of patients when the patient or the patient's representative requests treatment. Withholding of life-prolonging treatment is usually indexed only with EUTHANASIA, PASSIVE, unless the distinction between withholding and withdrawing treatment, or the issue of withholding palliative rather than curative treatment, is discussed.Hypnotics and Sedatives: Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.Visitors to Patients: Patients' guests and rules for visiting.Ventilators, Mechanical: Mechanical devices used to produce or assist pulmonary ventilation.Infant, Premature, DiseasesAcute Kidney Injury: Abrupt reduction in kidney function. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions.Blood Glucose: Glucose in blood.Postoperative Care: The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed)Clinical Protocols: Precise and detailed plans for the study of a medical or biomedical problem and/or plans for a regimen of therapy.Bed Occupancy: A measure of inpatient health facility use based upon the average number or proportion of beds occupied for a given period of time.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Hospitalization: The confinement of a patient in a hospital.Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Shock, Septic: Sepsis associated with HYPOTENSION or hypoperfusion despite adequate fluid resuscitation. Perfusion abnormalities may include, but are not limited to LACTIC ACIDOSIS; OLIGURIA; or acute alteration in mental status.Gram-Negative Bacterial Infections: Infections caused by bacteria that show up as pink (negative) when treated by the gram-staining method.Terminal Care: Medical and nursing care of patients in the terminal stage of an illness.Nursing Care: Care given to patients by nursing service personnel.Hypoglycemia: A syndrome of abnormally low BLOOD GLUCOSE level. Clinical hypoglycemia has diverse etiologies. Severe hypoglycemia eventually lead to glucose deprivation of the CENTRAL NERVOUS SYSTEM resulting in HUNGER; SWEATING; PARESTHESIA; impaired mental function; SEIZURES; COMA; and even DEATH.Acute Disease: Disease having a short and relatively severe course.Infant, Newborn, Diseases: Diseases of newborn infants present at birth (congenital) or developing within the first month of birth. It does not include hereditary diseases not manifesting at birth or within the first 30 days of life nor does it include inborn errors of metabolism. Both HEREDITARY DISEASES and METABOLISM, INBORN ERRORS are available as general concepts.Catheter-Related Infections: Infections resulting from the use of catheters. Proper aseptic technique, site of catheter placement, material composition, and virulence of the organism are all factors that can influence possible infection.Hand Disinfection: The act of cleansing the hands with water or other liquid, with or without the inclusion of soap or other detergent, for the purpose of destroying infectious microorganisms.Hyperglycemia: Abnormally high BLOOD GLUCOSE level.Hospital Design and Construction: The architecture, functional design, and construction of hospitals.Medical Futility: The absence of a useful purpose or useful result in a diagnostic procedure or therapeutic intervention. The situation of a patient whose condition will not be improved by treatment or instances in which treatment preserves permanent unconsciousness or cannot end dependence on intensive medical care. (From Ann Intern Med 1990 Jun 15;112(12):949)Hospitals, Teaching: Hospitals engaged in educational and research programs, as well as providing medical care to the patients.Cardiac Surgical Procedures: Surgery performed on the heart.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Catheterization, Central Venous: Placement of an intravenous CATHETER in the subclavian, jugular, or other central vein.Patients' Rooms: Rooms occupied by one or more individuals during a stay in a health facility. The concept includes aspects of environment, design, care, or economics.Cytarabine: A pyrimidine nucleoside analog that is used mainly in the treatment of leukemia, especially acute non-lymphoblastic leukemia. Cytarabine is an antimetabolite antineoplastic agent that inhibits the synthesis of DNA. Its actions are specific for the S phase of the cell cycle. It also has antiviral and immunosuppressant properties. (From Martindale, The Extra Pharmacopoeia, 30th ed, p472)Resuscitation Orders: Instructions issued by a physician pertaining to the institution, continuation, or withdrawal of life support measures. The concept includes policies, laws, statutes, decisions, guidelines, and discussions that may affect the issuance of such orders.Neonatal Nursing: The nursing specialty that deals with the care of newborn infants during the first four weeks after birth.Respiratory Distress Syndrome, Adult: A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA.Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Hospital Bed Capacity: The number of beds which a hospital has been designed and constructed to contain. It may also refer to the number of beds set up and staffed for use.Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.Tracheotomy: Surgical incision of the trachea.Antineoplastic Combined Chemotherapy Protocols: The use of two or more chemicals simultaneously or sequentially in the drug therapy of neoplasms. The drugs need not be in the same dosage form.Combined Modality Therapy: The treatment of a disease or condition by several different means simultaneously or sequentially. Chemoimmunotherapy, RADIOIMMUNOTHERAPY, chemoradiotherapy, cryochemotherapy, and SALVAGE THERAPY are seen most frequently, but their combinations with each other and surgery are also used.Bacteremia: The presence of viable bacteria circulating in the blood. Fever, chills, tachycardia, and tachypnea are common acute manifestations of bacteremia. The majority of cases are seen in already hospitalized patients, most of whom have underlying diseases or procedures which render their bloodstreams susceptible to invasion.Patient Discharge: The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.Point-of-Care Systems: Laboratory and other services provided to patients at the bedside. These include diagnostic and laboratory testing using automated information entry.Enteral Nutrition: Nutritional support given via the alimentary canal or any route connected to the gastrointestinal system (i.e., the enteral route). This includes oral feeding, sip feeding, and tube feeding using nasogastric, gastrostomy, and jejunostomy tubes.Remission Induction: Therapeutic act or process that initiates a response to a complete or partial remission level.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Acinetobacter Infections: Infections with bacteria of the genus ACINETOBACTER.Coronary Care Units: The hospital unit in which patients with acute cardiac disorders receive intensive care.Hemoglobin A, Glycosylated: Minor hemoglobin components of human erythrocytes designated A1a, A1b, and A1c. Hemoglobin A1c is most important since its sugar moiety is glucose covalently bound to the terminal amino acid of the beta chain. Since normal glycohemoglobin concentrations exclude marked blood glucose fluctuations over the preceding three to four weeks, the concentration of glycosylated hemoglobin A is a more reliable index of the blood sugar average over a long period of time.Insulin: A 51-amino acid pancreatic hormone that plays a major role in the regulation of glucose metabolism, directly by suppressing endogenous glucose production (GLYCOGENOLYSIS; GLUCONEOGENESIS) and indirectly by suppressing GLUCAGON secretion and LIPOLYSIS. Native insulin is a globular protein comprised of a zinc-coordinated hexamer. Each insulin monomer containing two chains, A (21 residues) and B (30 residues), linked by two disulfide bonds. Insulin is used as a drug to control insulin-dependent diabetes mellitus (DIABETES MELLITUS, TYPE 1).Euthanasia, Passive: Failing to prevent death from natural causes, for reasons of mercy by the withdrawal or withholding of life-prolonging treatment.Infant, Very Low Birth Weight: An infant whose weight at birth is less than 1500 grams (3.3 lbs), regardless of gestational age.Patient Care Team: Care of patients by a multidisciplinary team usually organized under the leadership of a physician; each member of the team has specific responsibilities and the whole team contributes to the care of the patient.Disease Outbreaks: Sudden increase in the incidence of a disease. The concept includes EPIDEMICS and PANDEMICS.Diabetes Mellitus, Type 2: A subclass of DIABETES MELLITUS that is not INSULIN-responsive or dependent (NIDDM). It is characterized initially by INSULIN RESISTANCE and HYPERINSULINEMIA; and eventually by GLUCOSE INTOLERANCE; HYPERGLYCEMIA; and overt diabetes. Type II diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop KETOSIS but often exhibit OBESITY.Drug Administration Schedule: Time schedule for administration of a drug in order to achieve optimum effectiveness and convenience.Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Hemofiltration: Extracorporeal ULTRAFILTRATION technique without HEMODIALYSIS for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function.Statistics, Nonparametric: A class of statistical methods applicable to a large set of probability distributions used to test for correlation, location, independence, etc. In most nonparametric statistical tests, the original scores or observations are replaced by another variable containing less information. An important class of nonparametric tests employs the ordinal properties of the data. Another class of tests uses information about whether an observation is above or below some fixed value such as the median, and a third class is based on the frequency of the occurrence of runs in the data. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p1284; Corsini, Concise Encyclopedia of Psychology, 1987, p764-5)Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Randomized Controlled Trials as Topic: Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.Vincristine: An antitumor alkaloid isolated from VINCA ROSEA. (Merck, 11th ed.)Hospital Costs: The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).Respiratory Care Units: The hospital unit in which patients with respiratory conditions requiring special attention receive intensive medical care and surveillance.Gestational Age: The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated as the time from the last day of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization.Medical Staff, Hospital: Professional medical personnel approved to provide care to patients in a hospital.United StatesPneumonia: Infection of the lung often accompanied by inflammation.Health Facility Environment: Physical surroundings or conditions of a hospital or other health facility and influence of these factors on patients and staff.Personnel Staffing and Scheduling: The selection, appointing, and scheduling of personnel.France: A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Acinetobacter baumannii: A species of gram-negative, aerobic bacteria, commonly found in the clinical laboratory, and frequently resistant to common antibiotics.Gram-Negative Bacteria: Bacteria which lose crystal violet stain but are stained pink when treated by Gram's method.Resuscitation: The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed)Renal Replacement Therapy: Procedures which temporarily or permanently remedy insufficient cleansing of body fluids by the kidneys.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Burn Units: Specialized hospital facilities which provide intensive care for burn patients.Pneumonia, Bacterial: Inflammation of the lung parenchyma that is caused by bacterial infections.Academic Medical Centers: Medical complexes consisting of medical school, hospitals, clinics, libraries, administrative facilities, etc.Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.Medical Audit: A detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of medical care.Heptanoic Acids: 7-carbon saturated monocarboxylic acids.Incubators, Infant: Electrically powered devices that are intended to assist in the maintenance of the thermal balance of infants, principally by controlling the air temperature and humidity in an enclosure. (from UMDNS, 1999)Cyclophosphamide: Precursor of an alkylating nitrogen mustard antineoplastic and immunosuppressive agent that must be activated in the LIVER to form the active aldophosphamide. It has been used in the treatment of LYMPHOMA and LEUKEMIA. Its side effect, ALOPECIA, has been used for defleecing sheep. Cyclophosphamide may also cause sterility, birth defects, mutations, and cancer.Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Education, Nursing, Continuing: Educational programs designed to inform nurses of recent advances in their fields.Glasgow Coma Scale: A scale that assesses the response to stimuli in patients with craniocerebral injuries. The parameters are eye opening, motor response, and verbal response.Staphylococcal Infections: Infections with bacteria of the genus STAPHYLOCOCCUS.GermanyDaunorubicin: A very toxic anthracycline aminoglycoside antineoplastic isolated from Streptomyces peucetius and others, used in treatment of LEUKEMIA and other NEOPLASMS.ItalyInfant Care: Care of infants in the home or institution.Patient Isolation: The segregation of patients with communicable or other diseases for a specified time. Isolation may be strict, in which movement and social contacts are limited; modified, where an effort to control specified aspects of care is made in order to prevent cross infection; or reverse, where the patient is secluded in a controlled or germ-free environment in order to protect him or her from cross infection.Candidemia: A form of invasive candidiasis where species of CANDIDA are present in the blood.Cost-Benefit Analysis: A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. Cost effectiveness compares alternative ways to achieve a specific set of results.Injury Severity Score: An anatomic severity scale based on the Abbreviated Injury Scale (AIS) and developed specifically to score multiple traumatic injuries. It has been used as a predictor of mortality.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Tertiary Care Centers: A medical facility which provides a high degree of subspecialty expertise for patients from centers where they received SECONDARY CARE.Hospitals, Pediatric: Special hospitals which provide care for ill children.Drug Therapy, Combination: Therapy with two or more separate preparations given for a combined effect.Outcome and Process Assessment (Health Care): Evaluation procedures that focus on both the outcome or status (OUTCOMES ASSESSMENT) of the patient at the end of an episode of care - presence of symptoms, level of activity, and mortality; and the process (ASSESSMENT, PROCESS) - what is done for the patient diagnostically and therapeutically.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Bacterial Infections: Infections by bacteria, general or unspecified.Diabetes Mellitus, Type 1: A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence.Early Ambulation: Procedure to accelerate the ability of a patient to walk or move about by reducing the time to AMBULATION. It is characterized by a shorter period of hospitalization or recumbency than is normally practiced.Insulin Infusion Systems: Portable or implantable devices for infusion of insulin. Includes open-loop systems which may be patient-operated or controlled by a pre-set program and are designed for constant delivery of small quantities of insulin, increased during food ingestion, and closed-loop systems which deliver quantities of insulin automatically based on an electronic glucose sensor.Candidiasis, Invasive: An important nosocomial fungal infection with species of the genus CANDIDA, most frequently CANDIDA ALBICANS. Invasive candidiasis occurs when candidiasis goes beyond a superficial infection and manifests as CANDIDEMIA, deep tissue infection, or disseminated disease with deep organ involvement.Parenteral Nutrition: The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously).Brain Death: A state of prolonged irreversible cessation of all brain activity, including lower brain stem function with the complete absence of voluntary movements, responses to stimuli, brain stem reflexes, and spontaneous respirations. Reversible conditions which mimic this clinical state (e.g., sedative overdose, hypothermia, etc.) are excluded prior to making the determination of brain death. (From Adams et al., Principles of Neurology, 6th ed, pp348-9)Hospital Bed Capacity, 500 and overCosts and Cost Analysis: Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to WATER-ELECTROLYTE BALANCE. Fluids may be administered intravenously, orally, by intermittent gavage, or by HYPODERMOCLYSIS.Reproducibility of Results: The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.Candidiasis: Infection with a fungus of the genus CANDIDA. It is usually a superficial infection of the moist areas of the body and is generally caused by CANDIDA ALBICANS. (Dorland, 27th ed)Netherlands: Country located in EUROPE. It is bordered by the NORTH SEA, BELGIUM, and GERMANY. Constituent areas are Aruba, Curacao, Sint Maarten, formerly included in the NETHERLANDS ANTILLES.Coma: A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION.Nursing Assessment: Evaluation of the nature and extent of nursing problems presented by a patient for the purpose of patient care planning.Microbial Sensitivity Tests: Any tests that demonstrate the relative efficacy of different chemotherapeutic agents against specific microorganisms (i.e., bacteria, fungi, viruses).Infusions, Intravenous: The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.Analysis of Variance: A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.Fatal Outcome: Death resulting from the presence of a disease in an individual, as shown by a single case report or a limited number of patients. This should be differentiated from DEATH, the physiological cessation of life and from MORTALITY, an epidemiological or statistical concept.Wounds and Injuries: Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.Trauma Severity Indices: Systems for assessing, classifying, and coding injuries. These systems are used in medical records, surveillance systems, and state and national registries to aid in the collection and reporting of trauma.Respiratory Therapy: Care of patients with deficiencies and abnormalities associated with the cardiopulmonary system. It includes the therapeutic use of medical gases and their administrative apparatus, environmental control systems, humidification, aerosols, ventilatory support, bronchopulmonary drainage and exercise, respiratory rehabilitation, assistance with cardiopulmonary resuscitation, and maintenance of natural, artificial, and mechanical airways.Precursor Cell Lymphoblastic Leukemia-Lymphoma: A neoplasm characterized by abnormalities of the lymphoid cell precursors leading to excessive lymphoblasts in the marrow and other organs. It is the most common cancer in children and accounts for the vast majority of all childhood leukemias.Great BritainDrug Resistance, Multiple, Bacterial: The ability of bacteria to resist or to become tolerant to several structurally and functionally distinct drugs simultaneously. This resistance may be acquired through gene mutation or foreign DNA in transmissible plasmids (R FACTORS).Catheterization, Swan-Ganz: Placement of a balloon-tipped catheter into the pulmonary artery through the antecubital, subclavian, and sometimes the femoral vein. It is used to measure pulmonary artery pressure and pulmonary artery wedge pressure which reflects left atrial pressure and left ventricular end-diastolic pressure. The catheter is threaded into the right atrium, the balloon is inflated and the catheter follows the blood flow through the tricuspid valve into the right ventricle and out into the pulmonary artery.Feasibility Studies: Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.Systemic Inflammatory Response Syndrome: A systemic inflammatory response to a variety of clinical insults, characterized by two or more of the following conditions: (1) fever >38 degrees C or HYPOTHERMIA 90 beat/minute; (3) tachypnea >24 breaths/minute; (4) LEUKOCYTOSIS >12,000 cells/cubic mm or 10% immature forms. While usually related to infection, SIRS can also be associated with noninfectious insults such as TRAUMA; BURNS; or PANCREATITIS. If infection is involved, a patient with SIRS is said to have SEPSIS.Hospitals: Institutions with an organized medical staff which provide medical care to patients.BrazilNutrition Therapy: Improving health status of an individual by adjusting the quantities, qualities, and methods of nutrient intake.Fungemia: The presence of fungi circulating in the blood. Opportunistic fungal sepsis is seen most often in immunosuppressed patients with severe neutropenia or in postoperative patients with intravenous catheters and usually follows prolonged antibiotic therapy.Asparaginase: A hydrolase enzyme that converts L-asparagine and water to L-aspartate and NH3. EC 3.5.1.1.TurkeyFamily Nursing: The provision of care involving the nursing process, to families and family members in health and illness situations. From Lippincott Manual of Nursing Practice. 6th ed.Gram-Positive Bacterial Infections: Infections caused by bacteria that retain the crystal violet stain (positive) when treated by the gram-staining method.Equipment Contamination: The presence of an infectious agent on instruments, prostheses, or other inanimate articles.Etoposide: A semisynthetic derivative of PODOPHYLLOTOXIN that exhibits antitumor activity. Etoposide inhibits DNA synthesis by forming a complex with topoisomerase II and DNA. This complex induces breaks in double stranded DNA and prevents repair by topoisomerase II binding. Accumulated breaks in DNA prevent entry into the mitotic phase of cell division, and lead to cell death. Etoposide acts primarily in the G2 and S phases of the cell cycle.Palliative Care: Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)Infant, Low Birth Weight: An infant having a birth weight of 2500 gm. (5.5 lb.) or less but INFANT, VERY LOW BIRTH WEIGHT is available for infants having a birth weight of 1500 grams (3.3 lb.) or less.Infant Mortality: Postnatal deaths from BIRTH to 365 days after birth in a given population. Postneonatal mortality represents deaths between 28 days and 365 days after birth (as defined by National Center for Health Statistics). Neonatal mortality represents deaths from birth to 27 days after birth.EnglandHeart Arrest: Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.Enterobacteriaceae Infections: Infections with bacteria of the family ENTEROBACTERIACEAE.Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Patient Selection: Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.Multiple Trauma: Multiple physical insults or injuries occurring simultaneously.Nutritional Support: The administration of nutrients for assimilation and utilization by a patient by means other than normal eating. It does not include FLUID THERAPY which normalizes body fluids to restore WATER-ELECTROLYTE BALANCE.Pyrroles: Azoles of one NITROGEN and two double bonds that have aromatic chemical properties.Nurse's Role: The expected function of a member of the nursing profession.ROC Curve: A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.

The impact of a multidisciplinary approach on caring for ventilator-dependent patients. (1/1550)

OBJECTIVE: To determine the clinical and financial outcomes of a highly structured multidisciplinary care model for patients in an intensive care unit (ICU) who require prolonged mechanical ventilation. The structured model outcomes (protocol group) are compared with the preprotocol outcomes. DESIGN: Descriptive study with financial analysis. SETTING: A twelve-bed medical-surgical ICU in a non-teaching tertiary referral center in Ogden, Utah. STUDY PARTICIPANTS: During a 54 month period, 469 consecutive intensive care patients requiring mechanical ventilation for longer than 72 hours who did not meet exclusion criteria were studied. INTERVENTIONS: A multidisciplinary team was formed to coordinate the care of ventilator-dependent patients. Care was integrated by daily collaborative bedside rounds, monthly meetings, and implementation of numerous guidelines and protocols. Patients were followed from the time of ICU admission until the day of hospital discharge. MAIN OUTCOME MEASURES: Patients were assigned APACHE II scores on admission to the ICU, and were divided into eight diagnostic categories. ICU length of stay, hospital length of stay, costs, charges, reimbursement, and in-hospital mortality were measured. RESULTS: Mortality in the preprotocol and protocol group, after adjustment for APACHE II scores, remained statistically unchanged (21-23%). After we implemented the new care model, we demonstrated significant decreases in the mean survivor's ICU length of stay (19.8 days to 14.7 days, P= 0.001), hospital length of stay (34.6 days to 25.9 days, P=0.001), charges (US$102500 to US$78500, P=0.001), and costs (US$71900 to US$58000, P=0.001). CONCLUSIONS: Implementation of a structured multidisciplinary care model to care for a heterogeneous population of ventilator-dependent ICU patients was associated with significant reductions in ICU and hospital lengths of stay, charges, and costs. Mortality rates were unaffected.  (+info)

Outcome for cancer patients requiring mechanical ventilation. (2/1550)

PURPOSE: To describe hospital survival for cancer patients who require mechanical ventilation. MATERIALS AND METHODS: A prospective, multicenter observational study was performed at five academic tertiary care hospitals. Demographic and clinical variables were obtained on consecutive cancer patients at initiation of mechanical ventilation, and information on vital status at hospital discharge was acquired. RESULTS: Our analysis was based on 782 adult cancer patients who met predetermined inclusion criteria. The overall observed hospital mortality was 76%, with no statistically significant differences among the five study centers. Seven variables (intubation after 24 hours, leukemia, progression or recurrence of cancer, allogeneic bone marrow transplantation, cardiac arrhythmias, presence of disseminated intravascular coagulation, and need for vasopressor therapy) were associated with an increased risk of death, whereas prior surgery with curative intent was protective. The predictive model based on these variables had an area under the receiver operating characteristic curve of 0.736, with Hosmer-Lemeshow goodness-of-fit statistics of 7.19; P = .52. CONCLUSION: This model can be used to estimate the probability of hospital survival for classes of adult cancer patients who require mechanical ventilation and can help to guide physicians, patients, and families in deciding goals and direction of treatment. Prospective independent validation in different medical settings is warranted.  (+info)

Effect of intensive therapy for heart failure on the vasodilator response to exercise. (3/1550)

OBJECTIVES: The purpose of the study was to evaluate the lower extremity vascular responsiveness to metabolic stimuli in patients with heart failure and to determine whether these responses improve acutely after intensive medical therapy. BACKGROUND: Metabolic regulation of vascular tone is an important determinant of blood flow, and may be abnormal in heart failure. METHODS: The leg blood flow responses were measured in 11 patients with nonedematous class III-IV heart failure before and after inpatient medical therapy and in 10 normal subjects. Venous occlusion plethysmography was used to measure peak blood flow and total hyperemia in the calf after arterial occlusion and also after isotonic ankle exercise. Measurements were repeated following short-term inpatient treatment with vasodilators and diuretics administered to decrease right atrial pressure (18+/-2 to 7+/-1 mm Hg), pulmonary wedge pressure (32+/-3 to 15+/-2 mm Hg), and systemic vascular resistance (1581+/-200 to 938+/-63 dynes.s.cm(-5), all p < 0.02). RESULTS: Leg blood flow at rest, after exercise, and during reactive hyperemia was less in heart failure patients than in control subjects. Resting leg blood flow did not increase significantly after medical therapy, but peak flow after the high level of exercise increased by 59% (p = 0.009). Total hyperemic volume in the recovery period increased by 73% (p = 0.03). Similarly, the peak leg blood flow response to ischemia increased by 88% (p = 0.04), whereas hyperemic volume rose by 98% (p = 0.1). CONCLUSIONS: The calf blood flow responses to metabolic stimuli are blunted in patients with severe heart failure, and improve rapidly with intensive medical therapy.  (+info)

Randomised controlled trial of aminophylline for severe acute asthma. (4/1550)

OBJECTIVES: To determine whether children with severe acute asthma treated with large doses of inhaled salbutamol, inhaled ipratropium, and intravenous steroids are conferred any further benefits by the addition of aminophylline given intravenously. STUDY DESIGN: Randomised, double blind, placebo controlled trial of 163 children admitted to hospital with asthma who were unresponsive to nebulised salbutamol. RESULTS: The placebo and treatment groups of children were similar at baseline. The 48 children in the aminophylline group had a greater improvement in spirometry at six hours and a higher oxygen saturation in the first 30 hours. Five subjects in the placebo group were intubated and ventilated after enrollment compared with none in the aminophylline group. CONCLUSIONS: Aminophylline continues to have a place in the management of severe acute asthma in children unresponsive to initial treatment.  (+info)

Gastric tonometry: in vivo comparison of saline and air tonometry in patients with cardiogenic shock. (5/1550)

Measurement of gastric intramucosal pH (pHi) has been advocated to assess gastric perfusion. Regional PCO2 (rPCO2) values are measured using saline tonometry (rsPCO2) and more recently using air tonometry (raPCO2). We compared 237 measurements of saline and air tonometry in 19 consecutive, severely ill patients (mean age 59 (range 31-76) yr, 19 males, APACHE II 22 +/- 7) with cardiogenic shock. Equilibration period was set to 90 min. Nineteen independent paired samples of mean raPCO2 and mean rsPCO2 of each patient showed good correlation (r = 0.93, P < 0.001). Mean raPCO2 was 6.5 (1.8) kPa and mean rsPCO2 6.8 (2.4) kPa. PCO2 measured by saline was significantly higher than that measured by air (P < 0.05). Bland and Altman analysis showed a bias (mean rsPCO2-mean raPCO2) of 0.3 kPa and a precision of 1.2 kPa. Agreement between the two methods decreased with increasing rPCO2 concentrations. Although air tonometry of rPCO2 is a promising technique, a systematic disagreement with saline tonometry at high rPCO2 values requires further investigation and cautious interpretation of these values.  (+info)

Withdrawal and limitation of life support in paediatric intensive care. (6/1550)

OBJECTIVES: To compare the modes of death and factors leading to withdrawal or limitation of life support in a paediatric intensive care unit (PICU) in a developing country. METHODS: Retrospective analysis of all children (< 12 years) dying in the PICU from January 1995 to December 1995 and January 1997 to June 1998 (n = 148). RESULTS: The main mode of death was by limitation of treatment in 68 of 148 patients, failure of active treatment including cardiopulmonary resuscitation in 61, brain death in 12, and withdrawal of life support with removal of endotracheal tube in seven. There was no significant variation in the proportion of limitation of treatment, failure of active treatment, and brain death between the two periods; however, there was an increase in withdrawal of life support from 0% in 1995 to 8% in 1997-98. Justification for limitation was based predominantly on expectation of imminent death (71 of 75). Ethnic variability was noted among the 14 of 21 patients who refused withdrawal. Discussions for care restrictions were initiated almost exclusively by paediatricians (70 of 75). Diagnostic uncertainty (36% v 4.6%) and presentation as an acute illness were associated with the use of active treatment. CONCLUSIONS: Limitation of treatment is the most common mode of death in a developing country's PICU and active withdrawal is still not widely practised. Paediatricians in developing countries are becoming more proactive in managing death and dying but have to consider sociocultural and religious factors when making such decisions.  (+info)

Pharmacokinetics of a clarithromycin suspension administered via nasogastric tube to seriously ill patients. (7/1550)

The pharmacokinetics of clarithromycin and its 14-(R)-hydroxylated metabolite were studied on two separate occasions after nasogastric administration of 500 mg of a clarithromycin suspension to 16 seriously ill adults in an intensive care unit. The clarithromycin suspension appeared to be adequately absorbed, and the pharmacokinetics of neither clarithromycin nor 14-(R)-hydroxyclarithromycin differed significantly between the two dosing periods. No substantial differences in pharmacokinetics were observed compared to previously published studies of other adult populations. Minimal intrapatient variability of pharmacokinetic parameters was observed in these seriously ill patients.  (+info)

Adrenal insufficiency in septic shock. (8/1550)

BACKGROUND: Functional adrenal insufficiency has been documented in critically ill adults. OBJECTIVE: To document the incidence of adrenal insufficiency in children with septic shock, and to evaluate its effect on catecholamine requirements, duration of intensive care, and mortality. SETTING: Sixteen-bed paediatric intensive care unit in a university hospital. METHODS: Thirty three children with septic shock were enrolled. Adrenal function was assessed by the maximum cortisol response after synthetic adrenocorticotropin stimulation (short Synacthen test). Insufficiency was defined as a post-Synacthen cortisol increment < 200 nmol/l. RESULTS: Overall mortality was 33%. The incidence of adrenal insufficiency was 52% and children with adrenal insufficiency were significantly older and tended to have higher paediatric risk of mortality scores. They also required higher dose vasopressors for haemodynamic stability. In the survivor group, those with adrenal insufficiency needed a longer period of inotropic support than those with normal function (median, 3 v 2 days), but there was no significant difference in duration of ventilation (median, 4 days for each group) or length of stay (median, 5 v 4 days). Mortality was not significantly greater in children with adrenal insufficiency than in those with adequate adrenal function (6 of 17 v 5 of 16, respectively). CONCLUSION: Adrenal insufficiency is common in children with septic shock. It is associated with an increased vasopressor requirement and duration of shock.  (+info)

  • Provision of 28 intensive care/high dependency beds. (fgould.com)
  • Intensive care units cater to patients with severe or life-threatening illnesses and injuries, which require constant care, close supervision from life support equipment and medication in order to ensure normal bodily functions . (wikipedia.org)
  • In 1950, anesthesiologist Peter Safar established the concept of "Advanced life support", keeping patients sedated and ventilated in an intensive care environment. (wikipedia.org)
  • Their competencies include the administration of high-risk medications, management of high-acuity patients requiring ventilator support, surgical care, resuscitation, advanced interventions such as extracorporeal membrane oxygenation or hypothermia therapy for neonatal encephalopathy procedures, as well as chronic-care management or lower acuity cares associated with premature infants such as feeding intolerance, phototherapy , or administering antibiotics. (wikipedia.org)
  • Intensive care units represent a natural and expected extension in the care of critically ill patients who require close medical and nursing observation because of rapidly changing physiological variables or are in need of advanced monitoring. (springer.com)
  • Continuous and closely monitored health care that is provided to critically ill patients. (dictionary.com)
  • Apply an in depth knowledge of anatomy, physiology and pathology to the techniques employed when caring for patients with critical care needs. (southampton.ac.uk)
  • Critically evaluate the roles and responsibilities of bedside practitioners in the delivery of health care interventions to a broad range of critical care patients. (southampton.ac.uk)
  • Patients requiring intensive care may require support for cardiovascular instability ( hypertension / hypotension ), potentially lethal cardiac arrhythmias , airway or respiratory compromise (such as ventilator support), acute renal failure , or the cumulative effects of multiple organ failure , more commonly referred to now as multiple organ dysfunction syndrome . (wikipedia.org)
  • Medical studies suggest a relation between ICU volume and quality of care for mechanically ventilated patients. (wikipedia.org)
  • ICU delirium , formerly and inaccurately referred to as ICU psychosis, is a syndrome common in intensive care and cardiac units where patients who are in unfamiliar, monotonous surroundings develop symptoms of delirium (Maxmen & Ward, 1995). (wikipedia.org)
  • It reviews the state of the art in issues concerning both intensive care medicine and anesthesia, such as perioperative coagulation management, neuroaxial blockade and complications, postoperative pain management, pediatric airway management, septic shock and hemodynamic management, diagnosis and management of acute respiratory distress syndrome, and antifungal treatments for critically ill patients. (springer.com)
  • The PICU also tends to have a higher nurse-to-patient ratio than other parts of the hospital (in other words, each nurse cares for fewer patients, which gives them more time with your child). (kidshealth.org)
  • Respiratory therapists are experienced with ventilators and other breathing equipment, and are often involved in the care of PICU patients with breathing problems. (kidshealth.org)
  • Intensive and Critical Care Medicine is a distinct branch of medicine specifically organized for the management of patients with immediate life-threatening pathophysiological conditions. (wikibooks.org)
  • As enrollment in coverage under the Affordable Care Act becomes available on Tuesday, the rules underlying mental health coverage in general - for both private insurers and the new health care exchanges - are still unclear, mental-health patient advocates say, leaving patients and families to grind through the process as best they can. (nytimes.com)
  • But when patients need months of residential care, for example, or meetings with a therapist several times a week, insurers balk. (nytimes.com)
  • With a specially trained ICU team and tele-sitters for patients who need extra support, we make sure to provide the best in critical care within a comfortable and family centered environment. (providence.org)
  • A new therapy programme designed to give former intensive care patients the best possible chance of returning to work and pursuing their previous interests has been introduced at West Suffolk Hospital in Bury St Edmunds. (heart.co.uk)
  • NCH is the only hospital in the northwest suburbs to staff their critical care department with around-the-clock intensivists-board certified physicians with special training in the needs of critically ill patients. (nch.org)
  • Assessors agreed that 20 patients were well managed (group 1) and 54 patients received suboptimal care (group 2). (bmj.com)
  • Admission to intensive care was considered late in 37 (69%) patients in group 2. (bmj.com)
  • The management of airway, breathing, and circulation, and oxygen therapy and monitoring in severely ill patients before admission to intensive care units may frequently be suboptimal. (bmj.com)
  • Suboptimal management of oxygen therapy, airway, breathing, circulation, and monitoring before admission to intensive care occurred in over half of a consecutive cohort of acute adult emergency patients. (bmj.com)
  • Critical care patients benefit from the attention of nursing personnel with a high competence level. (hindawi.com)
  • There are approximately 30 intensive care units (ICUs) in Finland in which over 28,000 patients are cared for annually [ 1 ]. (hindawi.com)
  • Obstetricians and other health-care providers should offer influenza vaccination to their pregnant patients. (cdc.gov)
  • As a regional referral center for high-risk maternal and fetal care, Magee provides physicians and hospitals across the tri-state area with access to the highest level of resources, resulting in the best combination of care possible for patients. (upmc.com)
  • The staff in our CVICU is dedicated to providing our patients the very specialized care they need around the clock. (choc.org)
  • Patients who have undergone complex, cardiovascular procedures at the CHOC Children's Heart Institute require specialized care and attention. (choc.org)
  • Like the DIGAMI studies, the goal of the Hyperglycemia: Intensive Insulin Infusion In Infarction (HI-5) study was to determine whether tight glycemic control improves outcomes for hyperglycemic patients with AMI. (diabetesjournals.org)
  • Her duties include working with staff to improve the quality of care for patients and families at the end of life. (nhpco.org)
  • Since hemodynamic changes during PPCM can vitally jeopardize the mother and the fetus, patients with severe forms of PPCM require a multidisciplinary approach in intensive care units. (frontiersin.org)
  • Maximum care at the end of life for cancer patients has increased. (npr.org)
  • The patients' family members responded to questions about how frequently patients had signed durable power of attorney documents or living wills or participated in end-of-life care conversations. (npr.org)
  • Researchers then examined the association between those advance-care-planning activities and the treatment patients received at the end of life. (npr.org)
  • At the same time, the proportion of patients who were reported to have received "all care possible" at the end of their lives increased substantially over the study period, from 7 percent to 58 percent, even though such intensive treatment may have been counter to their stated wishes. (npr.org)
  • A durable power of attorney allows consumers to appoint someone to make health care decisions for them if patients are unable to do so. (npr.org)
  • If patients "haven't discussed their preferences with that person the proxy may default to 'all care necessary,'" Narang says. (npr.org)
  • The issue is front and center these days as policy makers debate the recent federal proposal to reimburse physicians for conversations with Medicare patients about advance care planning. (npr.org)
  • Former patients, most of them dressed in Halloween costumes, will attend the annual celebration for "alumni" of the UCSF Children's Hospital Neonatal Intensive Care Nursery (NICN), where they started life as premature or otherwise fragile infants. (ucsf.edu)
  • One of the nation's top children's hospitals, UCSF Children's Hospital creates an environment where children and their families find compassionate care at the healing edge of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. (ucsf.edu)
  • Additionally, medical personnel treating patients in intensive care would not have the time to teach a computer as well. (phys.org)
  • Intensive care medicine or critical care medicine is a branch of medicine concerned with the provision of life support or organ support systems in patients who are critically ill and who usually require intensive monitoring. (thefullwiki.org)
  • Patients requiring intensive care may require support for hemodynamic instability ( hypertension / hypotension ), airway or respiratory compromise (such as ventilator support), acute renal failure , potentially lethal cardiac arrhythmias , or the cumulative effects of multiple organ system failure . (thefullwiki.org)
  • Anaesthesiology and intensive care: investigation and assessment of critically ill patients (Glasgow, APACHE II, SOFA, and other scales). (rsu.lv)
  • Coma patients and practical intensive care for them. (rsu.lv)
  • Some facilities also have specialized pediatric cardiac intensive care units, where patients with congenital heart disease are cared for. (wikipedia.org)
  • These units also typically handle cardiac transplantation and postop care of cardiac catheterization patients if those services are offered at the hospital. (wikipedia.org)
  • The Intensive Care Foundation is a charity that is dedicated to improving the care of critically ill patients by raising funds for vital clinical research as well as educating health professionals responsible for intensive care. (wikipedia.org)
  • Intensive care teams rely on the latest research to ensure they can give the best life saving treatment to their patients. (wikipedia.org)
  • Possible solutions include improved teaching, establishment of medical emergency teams, and widespread debate on the structure and process of acute care. (bmj.com)
  • Toxicology: introduction, general principles of diagnosis and treatment, poison information centre, intensive care in acute poisoning, poisoning by alcohol and surrogate alcohol. (rsu.lv)
  • Our CARF-certified intensive acute inpatient rehab programs provide the highest level of care. (regionshospital.com)
  • In a first survey, the attitudes and arguments for and against active treatment (operation) were compared between neurosurgeons (112 of which 70 per cent responded), anaesthesiologist and intensive care physicians (298 of which 70 per cent responded), and the general public (998 of which 50 per cent responded). (medicalnewstoday.com)
  • But anaesthesiologist and intensive care physicians also pointed particularly at the importance of the patient's previous desires. (medicalnewstoday.com)
  • The survey was submitted to anaesthesiologist and intensive care physicians (299 of which 63 per cent responded), paediatricians and neonatologists (329 of which 67 per cent responded) as well as the general public (585 of which 46 per cent responded). (medicalnewstoday.com)
  • Numerous physicians may care for your child, but the attending physicians are in charge. (kidshealth.org)
  • On the battlefield, military physicians sometimes face demanding critical care situations and the use of advanced control technologies is essential for extending the capabilities of the health care system to handle large numbers of injured soldiers. (scienceblog.com)
  • Our specialists are available around the clock to provide the nurturing environment and expert care you and your newborn require. (johnmuirhealth.com)
  • NICORE aims to work towards improved outcomes for newborn infants admitted to neonatal care and their families in Northern Ireland under the guidance of the newly established Neonatal Network for Northern Ireland (NNNI). (qub.ac.uk)
  • Author and dog breeder Myra Savant Harris applies her experience from more than 20 years of labor and delivery and neonatal nursing to caring for newborn puppies. (revivalanimal.com)
  • FILE - This is a Jan. 22, 2018 file photo of sick baby Isaiah Haastrup's mother Takesha Thomas and father Lanre Haastrup outside the High Court in London, A British judge on Monday Jan. 29, 2018 ruled that intensive care treatment can be withdrawn for a brain-damaged 11-month-old boy despite his parents' wishes for continued intervention. (nydailynews.com)
  • Increasingly, nonphysician providers are playing innovative roles in the ICU, and care provided by teams including nurse practitioners or physician assistants appears to be safe and comparable to that provided by other staffing models. (wikipedia.org)
  • Your child might be cared for by a pediatric intensivist, who is a doctor who did a 3-year residency in pediatrics after medical school, followed by 3 more years of subspecialty fellowship training in intensive care. (kidshealth.org)
  • The conditions of ICU staffing will continue to change under the stresses of shortages of a variety of health care workers relevant to ICU care, and increasing duty hour limitations for physician trainees. (wikipedia.org)
  • During that year, critical care medicine accounted for 0.56% of GDP , 4.2% of national health expenditure and about 13% of hospital costs. (wikipedia.org)
  • In an attempt to improve the quality and increase the value of their services, health care organizations are adopting a variety of process improvement tools originally developed for use in other industries. (aappublications.org)
  • The student, whilst developing these skills, will also need to be alert to future developments in the role of the professional carer to promote health and the necessity of working with other members of the health care team. (bangor.ac.uk)
  • Their insurer ultimately was forced to pay for the mental health care for Melissa that it initially denied. (nytimes.com)
  • Mental health accounts for a small part of total health care spending - by one estimate, $113 billion annually, or less than 6 percent of the $2.6 trillion overall health care bill. (nytimes.com)
  • If you're looking for extraordinary health care for you and your family, look no further. (providence.org)
  • Called FIT (Following Intensive Therapy), the programme runs over six weeks and involves health professionals giving advice and education alongside a fitness regime specially tailored to each person. (heart.co.uk)
  • To characterize the severity of 2009 H1N1 infection in pregnant women, the New York City Department of Health and Mental Hygiene (DOHMH) conducted active and passive surveillance for cases of 2009 H1N1 infection in pregnant women requiring intensive care. (cdc.gov)
  • Health departments and health-care providers should educate pregnant and postpartum women regarding the risks posed by influenza and highlight the effectiveness and safety of influenza vaccination. (cdc.gov)
  • In these difficult situations, it's reassuring to know that we provide specialized medical care and the latest in technology and advanced therapies for babies born prematurely or with serious health conditions. (sutterhealth.org)
  • She is a nurse with a PhD in Health Care Administration, Policy and Ethics and has attended the Institute for Healthcare Improvement's Breakthrough College Series and completed the Improvement Advisor Professional Development course at IHI in January 2007. (nhpco.org)
  • She has over twenty years experience working in community health care settings providing adult day care, home based respite and assisted living activities to people with dementia and their families. (nhpco.org)
  • Prior to NHPCO, John was founding director of Palliative Care and Hospice Services at Summa Health System, an integrated healthcare system northeastern Ohio. (nhpco.org)
  • Therefore, although neonatal care provision is relatively low volume it represents a substantial cost within the health service and can be associated with significant mortality and long-term morbidity particularly for very immature babies. (qub.ac.uk)
  • Whether you need walk-in care or have a medical emergency, Samaritan Health Services is here to help with five hospitals and eight clinics offering walk-in care for urgent needs. (samhealth.org)
  • Samaritan Health Services continuously reviews its performance in the areas of quality care and patient safety. (samhealth.org)
  • Wanless also confirmed he would not produce any interim findings ahead of the white paper on health and social care, expected in December, saying his review would be hard-pressed to meet its target of reporting next March. (communitycare.co.uk)
  • Over the study period, the use of durable power of attorney assignment, sometimes called a health care proxy, grew from 52 percent to 74 percent among participants. (npr.org)
  • In other words, lacking clear guidance, the health care proxy may choose to err on the safe side and approve more care rather than limit or withhold it. (npr.org)
  • UCSF is a leading university dedicated to defining health worldwide through advanced biomedical research, graduate level education in the life sciences and health professions, and excellence in patient care. (ucsf.edu)
  • TechSpring, a collaborative workspace for health care innovators, opened last year at 1350 Main St. after receiving a $5.5 million grant from the Massachusetts Life Science Center. (massdevelopment.com)
  • It's partnering with local health care companies like BayState Health. (massdevelopment.com)
  • In the United States estimates of the 2000 expenditure for critical care medicine ranged from US$15-55 billion accounting for about 0.5% of GDP and about 13% of national health care expenditure (Halpern, 2004). (thefullwiki.org)
  • Although this was not the case, her experiences during the war formed the foundation for her later discovery of the importance of sanitary conditions in hospitals, a critical component of intensive care. (wikipedia.org)
  • It is widely presumed that the preferred course of action for most children in foster care is a quick reunification with the child's biological family, for several reasons. (hhs.gov)
  • Most people will introduce themselves and tell you how they're involved in your child's care, but if they don't, feel free to ask. (kidshealth.org)
  • Also, physical therapists , occupational therapists , nutritionists, and pharmacists may play a role in your child's care. (kidshealth.org)
  • Our compassionate and caring child life specialists support each patient and his or her parents and siblings by providing guidance on what to expect as the patient recovers. (choc.org)
  • The tele-ICU use has spread rapidly, the benefits vary widely, and little is known about the specific characteristics of tele-ICU that provide benefits to patient care. (openpr.com)
  • We ask that you identify one family 'spokesperson' at the time of the patient's admission to the ICU, to aid in communication flow and maximize the time we spend providing patient care. (rochester.edu)
  • The study, reported in "Candles in the Snow: Ritual and Memory for Siblings of Infants Who Died in the Intensive Care Nursery" by Joanna H. Fanos, PhD, George A. Little, MD, and William H. Edwards, MD, appears in The Journal of Pediatrics , DOI 10.1016/j.jpeds.2008.11.053, published by Elsevier. (elsevier.com)
  • Opinions of two external assessors on quality of care especially recognition, investigation, monitoring, and management of abnormalities of airway, breathing, and circulation, and oxygen therapy and monitoring. (bmj.com)
  • Intensive therapy in the event of shock. (rsu.lv)
  • Upon completion of the inpatient phase, an outpatient therapist is assigned to help develop a continuing care plan, while allowing the patient to pursue work and other responsibilities. (prweb.com)
  • It became rapidly evident, however, that a fixed location where intensive care resources and dedicated personnel were available provided better care than ad hoc provision of intensive care services spread throughout a hospital. (wikipedia.org)
  • It became rapidly evident, though, that a fixed location where intensive care resources and personnel were available provided better care than ad hoc provision of intensive care services spread throughout a hospital. (thefullwiki.org)
  • Anaesthesiology and intensive care: general stages and types of anaesthesia, its practical provision, medications to be used. (rsu.lv)
  • Recorded in Robbie Williams' bedroom high in the Hollywood Hills, Intensive Care was co-written with Stephen Duffy over the course of 24 months. (robbiewilliams.com)
  • For the album by pop singer Robbie Williams, see Intensive Care (album) . (thefullwiki.org)