Vitacca M, Clini E, Scalvini S, Foglio K, Quadri A, Levi G
Department of Medical Rehabilitation, Cardiopulmonary Intermediate Intensive Care Unit, Gussago, BS, Italy.
Monaldi Arch Chest Dis. 1993 Aug;48(4):296-300.
Intermediate intensive care may be defined as a post comprehensive programme, where monitoring, combined with necessary treatment, improves and maintains physiological functions to complete the cure of underlying diseases. The aims of this paper are: 1) to describe the caring activity that patients admitted to our 12 bed Cardiopulmonary Intermediate Intensive Unit (CPIIU) experience and, 2) to demonstrate that a noninvasive choice does not worsen mortality and the quality of care needed to improve patient outcome. From September 1st 1990 to September 30th 1992, 775 patients (135 respiratory subjects) were admitted. The majority of these patients came from Coronary Intensive Units or Medical and Surgical Intensive Care Units. Noninvasive cardiorespiratory monitoring was assessed in these patients, to obtain their clinical improvement. After this post acute observance, our patients were followed during a stabilization programme in the cardiopulmonary rehabilitation division until a day-hospital or home care programme was carried out. By implementing the CPIIU principles in our department we have reduced the number of deaths and the necessity for Intensive Care Unit admission (from 19 to 9.6%). The estimated risk of death proposed by Apache score was higher than that recorded in our patients (estimated Apache = 25 and 6% for respiratory and cardiac patients, respectively; actual Apache = 10.4 and 3.1% for the same patients, respectively). Average hospitalisation days in our CPIIU was 18 +/- 9. Our CPIIU showed a mean daily cost for each patient of $370.6.(ABSTRACT TRUNCATED AT 250 WORDS)
中级重症监护可定义为一种综合治疗后的方案,即监测与必要的治疗相结合,改善并维持生理功能以完成基础疾病的治愈。本文的目的是:1)描述入住我们拥有12张床位的心肺中级重症监护病房(CPIIU)的患者所经历的护理活动,以及2)证明非侵入性选择不会增加死亡率,也不会降低改善患者预后所需的护理质量。从1990年9月1日至1992年9月30日,共收治了775例患者(其中135例为呼吸系统疾病患者)。这些患者大多数来自冠心病重症监护病房或内科及外科重症监护病房。对这些患者进行了非侵入性心肺监测,以观察其临床改善情况。在急性后期观察之后,我们的患者在心肺康复科的稳定治疗方案中接受随访,直到实施日间医院或家庭护理方案。通过在我们科室实施CPIIU原则,我们降低了死亡率以及重症监护病房的收治率(从19%降至9.6%)。阿帕奇评分所预估的死亡风险高于我们患者的实际死亡风险(呼吸系统和心脏疾病患者的预估阿帕奇评分分别为25分和6%;同一患者的实际阿帕奇评分分别为10.4分和3.1%)。我们CPIIU的平均住院天数为18±9天。我们CPIIU显示每位患者的日均费用为370.6美元。(摘要截选至250字)