Juniper Publishers Journal of Anesthesia and Intensive Care Medicine

Juniper Publishers - Journal of Anesthesia Abstract Objectives: Intensive Care Units (ICU) in Hong Kong incorporated palliative care in the daily practice. We would like to evaluate the quality of end-of-life care (EoLC) in the ICU. Design, setting and participants: Quality indicators consist of 4 domains and 12 indicators were devised. The four domains were early identification of dying patients; communication and information; end-of-life care to the patient and care after death. Next, we applied these indicators to assess the EoLC of patients who died in a 20-beds mixed ICU from 1st Jul to 30th Sep 2012. Main outcome measures: The 12 EoL quality indicators Results: Out of the 38 patient records, 33 were included for analysis. There were no objective criteria to identify dying patients. All the studied families received an EoL physician-family conference. Although high documentation rate (90.9%) of the treatment plan and resuscitation status; only 3.0% of ...

Juniper Publishers - Journal of Anesthesia Abstract Aim: To determine the accuracy of ultrasound in confirming endotracheal tube placement compared with standard techniques in the intensive care unit. Subject and Methods:: This was a prospectively designed study. Eligible patients were 18 years or older, that were admitted to the medical intensive care unit, that required endotracheal intubation due to their underlying clinical condition. An immediate post intubation Ultrasound examination was performed by an intensivist, who was not involved in clinical management of the patient and was blinded to the result of the standard confirmatory methods of endotracheal tube placement. The clinician performing the intubation was blinded to the results of the ultrasound examination findings. Results:: According to the standard method used to confirm proper endotracheal tube position, which includes clinical assessment by chest and epigastric auscultation, and a colome...

Juniper Publishers - Journal of Anesthesia Abstract Background: Pre-existing disease is the most important factor in the prediction of health-related quality of life (HRQoL) after intensive care. We hypothesised that the “inpatient care trajectories” in the years before admission to the ICU is a stronger predictor of HRQoL and mortality after intensive care than pre-existing disease, and that it has significant effects on overall costs. Method: A retrospective investigation in two combined medical and surgical ICUs in Sweden. Inpatient care was assessed from the County administrative registry. HRQoL (SF-36) was measured at 6, 12, 24, and 36 months after discharge. Results: Of 1092 patients, 459 (73%) had pre-existing diseases, and among them 360 (57%) had at least one inpatient episode less than 3 years before the ICU period, during which the group used significantly more hospital resources than the combined cost for all ICU care during the same time. The ...