Abstract:
OBJECTIVE:To study the impact of a clinical pharmacist in a pediatric intensive care unit. The goals of the study were to determine the type and quantity of patient care interventions recommended by a clinical pharmacist and to specifically examine cost savings (or loss) that resulted from clinical pharmacist recommendations. DESIGN:A prospective case series. SETTING:Ten-bed pediatric intensive care unit in a university-affiliated children's hospital. PATIENTS:All patients admitted to the pediatric intensive care unit during the study period. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:During the 24-wk study period, the pediatric clinical pharmacist documented all interventions that occurred during her shift. She rounded with the pediatric intensive care unit team approximately two times a week and reviewed medication lists daily. Drug acquisition costs were used to calculate drug cost savings. Demographic information was collected on all the patients in the pediatric intensive care unit during the study period. There were 35 recommendations per 100 patient days. The most common interventions were dosage changes (28%), drug information (26%), and miscellaneous information (22%). The average time spent per day by the clinical pharmacist in the pediatric intensive care unit was 0.73 hrs or 0.02 full-time equivalent. The total cost direct savings for the study period was $1,977. Extrapolated to direct cost savings per year, the total amount saved was $9,135/year or 0.15 full-time equivalent. Indirect savings from educational activities, avoidance of medication errors, and optimization of medical therapies represent an additional nonquantifiable amount. CONCLUSION:We conclude that a clinical pharmacist is an important and cost-effective member of the pediatric intensive care unit team.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Krupicka MI,Bratton SL,Sonnenthal K,Goldstein Bdoi
10.1097/00003246-200204000-00035subject
Has Abstractpub_date
2002-04-01 00:00:00pages
919-21issue
4eissn
0090-3493issn
1530-0293journal_volume
30pub_type
杂志文章abstract:OBJECTIVE:To describe blood conservation strategies for critically ill patients. DATA SOURCES:By using a predefined strategy, we searched the electronic databases of Medline, EMBASE, CINAHL, the Cochrane database of systematic reviews, Cochrane central register of controlled trials, ACP Journal Club, Database of abstr...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/01.CCM.0000099350.50651.46
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:Sepsis and severe trauma result in endothelial activation and damage. The activated endothelium expresses adhesion receptors that control leukocyte trafficking. After activation, some adhesion molecules are also released into plasma as soluble forms. The present study was designed to compare the expression of...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-200204000-00015
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVES:To describe the most common serious adverse effects and organ toxicities associated with emerging therapies for cancer that may necessitate admission to the ICU. DATA SOURCES AND STUDY SELECTION:PubMed and Medline search of relevant articles in English on the management of adverse effects of immunotherapy f...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/CCM.0000000000004087
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Traumatic brain injury contributes to morbidity and mortality in children and boys are disproportionately represented. Hypotension is common and worsens outcome after traumatic brain injury. Extracellular signal-related kinase mitogen-activated protein kinase is upregulated and reduces cerebral blood flow aft...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181e8ac1a
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Overdoses of calcium channel blocker agents result in hyperglycemia, primarily due to the blockade of pancreatic L-type calcium channels and insulin resistance on the cellular level. The clinical significance of the hyperglycemia in this setting has not previously been described. METHODS:This study is a ret...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.ccm.0000278916.04569.23
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the possible effects of a combination of systemic nitric oxide synthesis inhibition (to increase mean arterial blood pressure) and nitric oxide inhalation (to decrease pulmonary vascular pressure) in porcine endotoxin shock. DESIGN:Prospective trial. SETTING:Laboratory at a large university medi...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199505000-00020
更新日期:1995-05-01 00:00:00
abstract::A commercially available gas-chromatograph (Sentorr Gas Analyzer, Ohio Medical Products, Madison, WI) was tested, featuring continuous measurement of in vivo PaO2 and PaCO2 by means of a thin, heparin-coated catheter, inserted through an indwelling arterial line. Gas tensions are displayed every 4 min. The probes had ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198007000-00011
更新日期:1980-07-01 00:00:00
abstract::Flow rates and pressure recording accuracy were compared for Argyle 14-, 16-, and 18-ga double-lumen and Edwards 7-Fr triple-lumen CVP catheters. Physiologic saline solution was pressure-infused into dogs through one lumen and CVP was measured via the other lumen. CVP accuracy was unaltered by simultaneous rapid infus...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198507000-00017
更新日期:1985-07-01 00:00:00
abstract:OBJECTIVE:To investigate, in restrictive patients, the influence of pressure ramp slope values on the efficacy of pressure support ventilation. DESIGN:Prospective study. SETTING:A university hospital medical intensive care unit. PATIENTS:Twelve intubated restrictive patients. INTERVENTIONS:Patients were randomly as...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00003246-199904000-00023
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVE:To review current knowledge about cell-free hemoglobin solutions. DATA SOURCES:All studies involving cell-free hemoglobin were retrieved from a computerized MEDLINE search from 1980 to 1998. We also reviewed the reference lists of all available review articles and primary studies to identify references not f...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/00003246-200008000-00058
更新日期:2000-08-01 00:00:00
abstract::We investigated clinically the differences in respiratory work of patients imposed by three modes of one ventilator: the flow-by system, the demand valve system, and the pressure support system. Inspiratory work using flow-by and pressure support systems was reduced sufficiently when compared to the demand valve syste...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199006000-00016
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVES:To test the hypothesis that after cecal ligation and puncture in the rat, there is increased expression of the tumor necrosis factor (TNF)/interleukin-1-dependent, acute-phase reactant alpha 1-acid glycoprotein in the liver, and that this change correlates temporally with increased abundance of TNF-alpha in ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199612000-00004
更新日期:1996-12-01 00:00:00
abstract::High frequency positive pressure ventilation (HFPPV) was compared with normal frequency positive pressure ventilation (NFPPV) during diagnostic fiberoptic-bronchoscopy. HFPPV was achieved by a simple modification of the Minivent, and gave satisfactory alveolar ventilation and oxygenation. In all 11 patients and over p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:
更新日期:1982-11-01 00:00:00
abstract:OBJECTIVES:The potential advantages of lowering core temperature during sepsis are to lower energy requirement and to activate various cell-protecting pathways. We experimentally investigated whether postconditioning temperature modifications influence survival duration during experimental sepsis. DESIGN:A prospective...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000240231.76837.DC
更新日期:2006-10-01 00:00:00
abstract::Because an acute coronary thrombotic event may be viewed as the main trigger of sudden cardiac arrest, urgent coronary angiography followed by percutaneous coronary intervention appeared as a promising tool in the early postresuscitation phase. Unfortunately, large randomized trials, which have unequivocally demonstra...
journal_title:Critical care medicine
pub_type: 杂志文章,评审
doi:10.1097/ccm.0b013e31818a8ae6
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN:A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING:Heart Institute of São Paulo University. PATIENTS:High-ri...
journal_title:Critical care medicine
pub_type: 杂志文章,随机对照试验
doi:10.1097/CCM.0000000000003185
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To examine the association between the performance of a tracheostomy and intensive care unit and postintensive care unit mortality, controlling for treatment selection bias and confounding variables. DESIGN:Prospective, observational, cohort study. SETTING:Twelve French medical or surgical intensive care un...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/01.CCM.0000251134.96055.A6
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that the mortality rate of acutely ill patients admitted to a medical ward or medical ICU is higher for those patients who present with hypomagnesemia than for those patients who do not present with hypomagnesemia. DESIGN:Prospective, observational study. SETTING:Emergency Department ...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-199302000-00010
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVES:Most knowledge related to the pathophysiology of microcirculation in ischemic stroke comes from experimental research. Unfortunately, data on microcirculation in the human brain are limited, partially as a result of the lack of appropriate investigational techniques. The objective of our study was to test th...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e31820ead5e
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:Treatment options to ameliorate brain damage following cardiopulmonary resuscitation from cardiac arrest are limited. DESIGN:In a porcine model, we evaluated the effects of xenon treatment on neuropathologic and functional outcomes after cardiopulmonary resuscitation. SETTING:Prospective, randomized laborat...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181802874
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to test the hypothesis that the right ventricle is more dilated during resuscitation from cardiac arrest caused by pulmonary embolism, compared with hypoxia and primary arrhythmia. DESIGN:Twenty-four pigs were anesthetized and cardiac arrest was induced using three different method...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0000000000002334
更新日期:2017-07-01 00:00:00
abstract::Ventricular fibrillation (VF) can masquerade as asystole. We report a 54-yr-old male in cardiac arrest who, on surface ECG, appeared to be in VF or asystole. A bedside intracardiac recording using a transmyocardial pacing wire showed the true rhythm to be atrial fibrillation (AF) with high grade atrioventricular block...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198704000-00013
更新日期:1987-04-01 00:00:00
abstract::We found that altering aspirating flow rate (ASR) and sample tubing length (STL) affected the response time and capnogram of 2 different side-stream capnometers. Increased flow rate shortened rise time, transit time, and total delay time (TDT), whereas increased STL increased transit and TDTs but not rise time. Increa...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198408000-00015
更新日期:1984-08-01 00:00:00
abstract::Many clinical conditions are associated with an increase in abdominal pressure. While the effects on venous return have been studied in the past, little attention has been given to the effect of abdominal pressure on left-sided hemodynamic events. The effects of acute changes in abdominal pressure (Pab) on left ventri...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198510000-00006
更新日期:1985-10-01 00:00:00
abstract::Clinically, asystole or a bradyarrhythmia may follow countershock of ventricular fibrillation (VF) in up to 40% of attempts. This study evaluated the effects of artificial cardiac pacing, calcium chloride (CaCl2), and epinephrine in postcountershock asystole/bradycardia. Micromanometer catheters were positioned in the...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198509000-00001
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:To study the impact of diabetes mellitus on the relationship between glycemia and mortality in critically ill patients. DESIGN:Retrospective observational study. SETTING:Intensive care units of two university hospitals. PATIENTS:Cohort of 4946 critically ill patients including 728 patients with diabetes me...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e318181039a
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:Phenylephrine is often used for management of cerebral perfusion pressure after traumatic brain injury, but can have undesirable actions. Few studies have evaluated alternatives. The hypothesis was that arginine vasopressin was as effective as phenylephrine for maintaining tissue oxygenation during cerebral p...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/CCM.0b013e3181847af3
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVES:To determine plasma aluminum concentrations and 24-hr urine aluminum excretion rate in long-term mechanically ventilated patients treated with 6 g of sucralfate daily for stress ulcer prophylaxis. DESIGN:Prospective study in long-term mechanically ventilated critically ill patients. SETTING:A surgical inte...
journal_title:Critical care medicine
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:To identify factors associated with granting or refusing intensive care unit (ICU) admission, to analyze ICU characteristics and triage decisions, and to describe mortality in admitted and refused patients. DESIGN:Observational, prospective, multiple-center study. SETTING:Four university hospitals and seven...
journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究
doi:10.1097/01.ccm.0000157752.26180.f1
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:Our understanding of the acute respiratory distress syndrome in children is limited, and literature is dominated by investigations in adult patients. Recent preclinical studies suggest that the susceptibility to and severity of acute respiratory distress syndrome in children could differ from that in adults....
journal_title:Critical care medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1097/CCM.0000000000001388
更新日期:2016-04-01 00:00:00