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Author Hata, J. Steven ♦ Stotts, Corey ♦ Shelsky, Constance ♦ Bayman, Emine O. ♦ Frazier, Anita ♦ Wang, Jenny ♦ Nickel, Ellen J.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Pathological Conditions, Signs and Symptoms ♦ Diseases ♦ Diagnosis ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Circulatory and Respiratory Physiological Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Discipline Critical Care ♦ Hemodynamics ♦ Monitoring, Physiologic ♦ Methods ♦ Shock ♦ Mortality ♦ Physiopathology ♦ Adult ♦ Aged ♦ Catheterization, Central Venous ♦ Catheterization, Swan-ganz ♦ Female ♦ Hospital Mortality ♦ Humans ♦ Intensive Care Units ♦ Male ♦ Middle Aged ♦ Respiration, Artificial ♦ Retrospective Studies ♦ Risk Factors ♦ Severity Of Illness Index ♦ Survival Analysis ♦ Journal Article ♦ Research Support, Non-u.s. Gov't
Abstract PURPOSE: This study compared clinical outcomes associated with exposure to pulmonary artery catheters (PACs), central venous catheters (CVCs), arterial pressure waveform analysis for cardiac output (APCO), or no central monitoring (NCM) in patients with shock. MATERIALS AND METHODS: We assessed 6929 consecutive patients from 2003 to 2006 within a surgical intensive care unit of a university hospital, identifying 237 mechanically ventilated patients with shock. RESULTS: Adjusted for severity of illness, use of APCO monitoring, compared with other options, was associated with reduced intensive care unit mortality (odds ratio [OR], 0.37; 95% confidence interval [CI], 0.18-0.77) and 28-day mortality (OR, 0.43; 95% CI, 0.22-0.85). Other monitors were not associated with changes of 28-day mortality (CVC: OR, 0.63; 95% CI, 0.34-1.17; PAC: OR, 0.78; 95% CI, 0.36-1.69) or were associated with increased risk (NCM: OR, 2.29; 95% CI, 1.14-4.61). There were significant differences in the fluid and vasoactive drug prescriptions among the groups. CONCLUSIONS: This study supports an association between the use of APCO monitoring and reduction in mortality in shock compared with traditional methods of monitoring. Although it is impossible to exclude the role of unrecognized/unrecorded differences among the groups, these findings may result from differences in supportive care, directed by monitor technology.
Description Country affiliation: United States
Author Affiliation: Hata JS ( Division of Critical Care in the Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. steven-hata@uiowa.edu)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2011-04-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 26
Issue Number 2


Source: WHO-Global Index Medicus