Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

2710 patients were admitted during 1988 in 14 ICU of a crowded urban area. We determined OMEGA score at the end of the ICU stay. OMEGA scores the intensity of the treatment and depicts the utilisation of resources giving rise to the variable costs. 2085 patients intensively treated resulted in a higher mean OMEGA score than 625 patients only monitored, the length of ICU stay over 8th day increases the allocation of resources. This was conditioned also by the diagnosis in both groups of patients being liver transplant (OLTX) and chronic obstructive lung diseases (COLD), the most resources-consuming intensive patients and cardiovascular (CARD), and drug intoxication (TS), the least ones. The efficiency of the use of resources (i.e. use in survivors) in ICU treatment was 100% in monitored patients and ranges from 47.3% to 90.9% in intensively treated ones: medical unspecified (Mm), COLD, strokes, surgical unscheduled, cardiac arrest, OLTX, pneumonia and ARDS, pulmonary embolism, surgical scheduled, trauma, neurological diseases, TS. Intensive patients could be divided in a group with a good utilization (26.5%) of employed resources: TS, PE, CARD, SS, TR, PNM, NRL, OLTX) in a group with a mean utilisation (50-65%: CCA, strokes, SU) and finally in a group with a weak utilisation of resources (Mm and COLD). We computed also the mean loss of resources for each diagnosis that ranges from COLD (76.1 OMEGA points) to OLTX, strokes, Mm, SU, PNM, CCA, NRL, TR, CARD, SS, PE, and TS (10.2 points). The implications of these results and the possibilities of improving the utilisation of resources in ICU are discussed.
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PMID:[Efficiency of use of resources in intensive care units in an urban area]. 192 56

Recruitment maneuvers (RM), consisting of sustained inflations at high airway pressures, have been advocated as an adjunct to mechanical ventilation in acute respiratory distress syndrome (ARDS). We studied the effect of baseline ventilatory strategy and RM on end-expiratory lung volume (EELV) and oxygenation in 18 dogs, using three models of acute lung injury (ALI; n = 6 in each group): saline lavage (LAV), oleic acid injury (OAI), and intratracheal instillation of Escherichia coli (pneumonia; PNM). All three models exhibited similar degrees of lung injury. The PNM model was less responsive to positive end-expiratory pressure (PEEP) than was the LAV or OAI model. Only the LAV model showed an oxygenation response to increasing tidal volume (VT). After RM, there were transient increases in Pa(O(2)) and EELV when ventilating with PEEP = 10 cm H(2)O. At PEEP = 20 cm H(2)O the lungs were probably fully recruited, since the plateau airway pressures were relatively high ( approximately 45 cm H(2)O) and the oxygenation was similar to preinjury values, thus making the system unresponsive to RM. Sustained improvement in oxygenation after RM was seen in the LAV model when ventilating with PEEP = 10 cm H(2)O and VT = 15 ml/kg. Changes in EELV correlated with changes in Pa(O(2)) only in the OAI model with PEEP = 10 cm H(2)O. We conclude that responses to PEEP, VT, and RM differ among these models of ALI. RM may have a role in some patients with ARDS who are ventilated with low PEEP and low VT.
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PMID:Recruitment maneuvers in three experimental models of acute lung injury. Effect on lung volume and gas exchange. 1080 43