Abstract：
BACKGROUND:The goal of this study was to explore the ability of professional judgment to predict the need for tracheotomy early among intensive care unit (ICU) patients. METHODS:Prospective study using daily questionnaires among ICU physicians in a mixed medical-surgical ICU. The prediction of tracheotomy was by a visual analogue scale (VAS, from 1 to 10, with 1 representing 'absolutely no need for tracheotomy' and 10 representing 'pertinent need for tracheotomy') during ICU stay until tracheal extubation or tracheotomy. For the purpose of this study, a VAS score ≥ 8 was considered a positive prediction for tracheotomy. RESULTS:A total of 476 questionnaires were retrieved for 75 patients (6.4 ± 5.2 questionnaires per patient), of which 11 patients finally proceeded with a tracheostomy. At first assessment (mean of 2.4 ± 0.8 days after ICU admittance), ICU physicians predicted the need for tracheotomy 3.0 (2.0-6.0) higher VAS points for patients who were finally tracheotomized (P<0.01). Patients with a positive prediction had a 5.4 (1.2-24.1) higher chance of receiving tracheotomy (P=0.03). Considering the median VAS score over a maximum of 10 days before tracheotomy, ICU physicians scored tracheotomized patients significantly higher from day 8 onwards. When comparing ICU physicians, fellows and residents separately, only staff physicians scored a significant difference in the VAS score (P<0.05). CONCLUSION:ICU physicians are able to differentiate between patients in need for tracheotomy from those who do not, within 2 days from admittance. The closer the time to the actual intervention, the better the physicians are able to predict this decision.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Veelo DP,Binnekade JM,Buddeke AW,Dongelmans DA,Schultz MJdoi
10.1111/j.1399-6576.2010.02290.xsubject
Has Abstractpub_date
2010-10-01 00:00:00pages
1083-8issue
9eissn
0001-5172issn
1399-6576pii
AAS2290journal_volume
54pub_type
杂志文章abstract：BACKGROUND:Extracorporeal circulation, such as cardiopulmonary bypass and hemodialysis, has been associated with an activation of the immune system. Continuous veno venous hemodiafiltration (CVVHD) is used in critically ill septic patients. During CVVHD, cytokines are excreted in ultrafiltrate. When the membranes, used...
journal_title：Acta anaesthesiologica Scandinavica
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journal_title：Acta anaesthesiologica Scandinavica
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journal_title：Acta anaesthesiologica Scandinavica
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journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1988-01-01 00:00:00
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journal_title：Acta anaesthesiologica Scandinavica
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journal_title：Acta anaesthesiologica Scandinavica
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journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
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pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：2000-03-01 00:00:00
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pub_type： 杂志文章
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更新日期：1981-12-01 00:00:00
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更新日期：2013-02-01 00:00:00
