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Derivation and validation of a prognostic model for postoperative risk stratification of critically ill patients with faecal peritonitis

Julian Bion 2 Gary H. Mills 1 Anthony C. Gordon 8 Geraldine. M. Clarke 7 Andrew Walden 6 Paula Hutton 5 Paul A. H. Holloway 8 Jean‑Daniel Chiche 10 Frank Stuber 9 Christopher Garrard 5 Charles Hinds 3 On

Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort

Geraldine M Clarke 2 Andrew Walden 7 Anthony C Gordon 6 Paula Hutton 5 Jean-Daniel Chiche 4 Paul AH Holloway 6 Gary H Mills 0 9 Julian Bion 8 Frank Stber 3 Christopher Garrard 5 Charles Hinds 10 on behalf of

Do earplugs stop noise from driving critical care patients into delirium?

Quality sleep is a problem for the critically ill who are cared for in an environment where interventions night and day are common, staff members are constantly present in relatively high numbers, and treatment is accompanied by a range of changing warning tones and alarms and lights. These critical care units are generally designed without a focus on patient comfort, sleep, and ...

Clinical review: The impact of noise on patients' sleep and the effectiveness of noise reduction strategies in intensive care units

Excessive noise is becoming a significant problem for intensive care units (ICUs). This paper first reviews the impact of noise on patients' sleep in ICUs. Five previous studies have demonstrated such impacts, whereas six other studies have shown other factors to be more important. Staff conversation and alarms are generally regarded as the most disturbing noises for patients' ...

Melatonin therapy to improve nocturnal sleep in critically ill patients: encouraging results from a small randomised controlled trial

Introduction Sleep disturbances are common in critically ill patients and when sleep does occur it traverses the day-night periods. The reduction in plasma melatonin levels and loss of circadian rhythm observed in critically ill patients receiving mechanical ventilation may contribute to this irregular sleep-wake pattern. We sought to evaluate the effect of exogenous melatonin on ...

Clinical review: Sleep measurement in critical care patients: research and clinical implications

Sleep disturbances are common in critically ill patients and have been characterised by numerous studies using polysomnography. Issues regarding patient populations, monitoring duration and timing (nocturnal versus continuous), as well as practical problems encountered in critical care studies using polysomnography are considered with regard to future interventional studies on ...

Implications of ICU triage decisions on patient mortality: a cost-effectiveness analysis

Introduction Intensive care is generally regarded as expensive, and as a result beds are limited. This has raised serious questions about rationing when there are insufficient beds for all those referred. However, the evidence for the cost effectiveness of intensive care is weak and the work that does exist usually assumes that those who are not admitted do not survive, which is ...