Physicians' estimates of cardiac index and intravascular volume based on clinical assessment versus transesophageal Doppler measurements obtained by critical care nurses.

Objectives: To compare physicians' estimates of cardiac index and intravascular volume with transesophageal Doppler measurements obtained by critical care nurses, to assess the overall safety of transesophageal Doppler imaging by critical care nurses, and to compare hemodynamic measurements obtained via transesophageal Doppler imaging with those obtained via pulmonary artery catheterization.

Methods: Data were collected prospectively on 106 patients receiving mechanical ventilation. Physicians estimated cardiac index and intravascular volume status by using bedside clinical assessment; critical care nurses, by using transesophageal Doppler imaging.

Ambulatory care-sensitive conditions: clinical outcomes and impact on intensive care unit resource use.

Background: We identified risk factors and clinical outcomes associated with ambulatory care-sensitive conditions requiring intensive care unit (ICU) admission.

Methods: This prospective cohort study included 4,144 patients admitted to the medical ICU of an urban teaching hospital during a 3-year period.

Results: A total of 627 patients were classified as having ambulatory care-sensitive conditions (ie, potentially preventable ICU admissions).

Clinical utility of blood cultures drawn from central vein catheters and peripheral venipuncture in critically ill medical patients.

Study Objective: To determine the sensitivity, specificity, and positive and negative predictive values of blood cultures obtained through a central vein catheter compared with peripheral venipuncture.

Design: Prospective cohort study.

Setting: A medical ICU (19 beds) from a university-affiliated urban teaching hospital.

Clinical importance of delays in the initiation of appropriate antibiotic treatment for ventilator-associated pneumonia.

Study Objectives: To determine the influence of initially delayed appropriate antibiotic treatment (IDAAT) on the outcomes of patients with ventilator-associated pneumonia (VAP).

Setting: Medical ICU of Barnes-Jewish Hospital, St. Louis, a university-affiliated urban teaching hospital.

Early versus late enteral feeding of mechanically ventilated patients: results of a clinical trial.

Background: This study sought to compare 2 strategies for the administration of enteral feeding to mechanically ventilated medical patients.

Methods: The prospective, controlled, clinical trial was carried out in a medical intensive care unit (19 beds) in a university-affiliated, urban teaching hospital. Between May 1999 and December 2000, 150 patients were enrolled.

Deep vein thrombosis during prolonged mechanical ventilation despite prophylaxis.

Objective: To determine the prevalence of deep vein thrombosis (DVT) among patients requiring prolonged mechanical ventilation in the intensive care unit.

Design: Prospective cohort study.

Setting: Medical intensive care unit of a university-affiliated urban teaching hospital.