Prognosis in Acute Organ-System Failure

Knaus, William A.; Draper, Elizabeth A.; Wagner, Douglas P.; Zimmerman, Jack E.

doi:10.1097/00000658-198512000-00004

Cited by 971 publications

(387 citation statements)

References 22 publications

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“…12 The presence of organ system failure (OSF) during each unit admission was noted using the definitions developed by Knaus et al 12 FIGURE 1 A schematic representing the functions of the "audit cycle" which involves administrative responsibility, data collection. management, and the analysis procedure (primary analysis with report generation and secondary analysis with revisions to policy and procedure).…”

Section: Diagnoses Complications and Severity Of Illnessmentioning

confidence: 99%

Audit of critical care: aims, uses, costs and limitations of a Canadian system

Byrick

Caskennette

1992

Can J Anaesth

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Section: Diagnoses Complications and Severity Of Illnessmentioning

confidence: 99%

Audit of critical care: aims, uses, costs and limitations of a Canadian system

Byrick

Caskennette

1992

Can J Anaesth

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“…The sequential/sepsi organ failure assessment score (SOFA score), showed a score = 7 (predominantly mild renal and bilirubin modifications). The APACHE II (''acute physiology and chronic health evaluation II''), another important ICU scoring system [5] showed 16 points with a calculated predicted death rate of 23.5%.…”

Section: Dr G Pepementioning

confidence: 99%

A 64-year-old man admitted to the Emergency Department with an unusual case of intestinal obstruction: decision-making in the Emergency Department

et al. 2008

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“…The period between extubation and diagnosis of hypercapnic respiratory insufficiency was 20 14 h. In both groups, all patients with a GCS score of #8, inconsistent with NIPSV use, and requiring immediate endotracheal ventilation were excluded. Haemodynamic instability with a sustained systolic arterial blood pressure of <80 mmHg or failure of more than two organs [17] were also exclusion criteria.…”

Section: Subjectsmentioning

confidence: 99%

Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

et al. 2000

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Methods of noninvasive pressure support ventilation (NIPSV) are not always easy to apply in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD).The assistance time spent by nurses in relation to ventilatory time was prospectively studied, when NIPSV was used, in a sequential mode, in COPD patients with either acute exacerbations (58 patients, group I) or postextubation hypercapnic respiratory insufficiency (42 patients, group II) in a medical intensive care unit.During the first 24 h after enrolment, NIPSV was used for 6.7 3.2 h (mean SD) in group I and 5.6 3.1 h in group II; the duration of NIPSV sessions and the nurse time consumption per session were respectively 47 12 and 11 7 min in group I, and 46 12 and 11 6 min in group II. After the first 24 h of the study, the duration of NIPSV was 4.7 3.2 h . day -1 in group I and 4.9 3.5 h . day -1 in group II, and the nurse time consumption dropped significantly: the duration of NIPSV sessions and the nurse time consumption per session were respectively 44 10 and 7 4 min in group I, and 47 14 and 7 3 min in group II. Between the first 24 h and the subsequent period of 24 h, the nursing time dropped significantly (98 versus 59 min in group I (p<0.05), and 85 versus 52 min in group II (p<0.05)). There was no difference in the duration of NIPSV sessions, or in the overall assistance time per session, between the two groups of patients.In conclusion, the study seems to favour a quite low assistance time spent by nurses in relation to ventilatory time when noninvasive pressure support ventilation is used in chronic obstructive pulmonary disease patients with either acute exacerbations or postextubation hypercapnic respiratory insufficiency. Methods of noninvasive pressure support ventilation (NIPSV) are being proposed more and more for patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure [1±6]. NIPSV can avoid the need for endotracheal intubation and its increasingly documented complications [7]. Nevertheless, this method of ventilation requires the presence of nurses familiar with the technique, and this may be time-consuming [3,8]. Moreover, according to certain reports [2, 4, 9, 10], some patients do not tolerate noninvasive ventilatory support, and side-effects of these techniques occur quite frequently [3,11].Three articles have demonstrated that the institution of noninvasive mechanical ventilation is not significantly more time-consuming for personnel than traditional medical therapy [4,12] or invasive mechanical ventilation [13]. However, two of these studies [12,13] were performed in respiratory intensive care units (ICUs) with a specialized activity, and where patient/staff ratios are generally lower than in general ICUs [13]. The authors consider that the problem lies not in comparing the workload linked to utilization of NIPSV with that linked to standard treatment or invasive mechanical ventilation, since it is advisable to use NIPSV to avoid intubation. It is more a question of know...

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Prognosis in Acute Organ-System Failure

Cited by 971 publications

References 22 publications

Audit of critical care: aims, uses, costs and limitations of a Canadian system

Audit of critical care: aims, uses, costs and limitations of a Canadian system

A 64-year-old man admitted to the Emergency Department with an unusual case of intestinal obstruction: decision-making in the Emergency Department

Noninvasive ventilation for acute respiratory failure. Quite low time consumption for nurses

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