RESUMO
OBJECTIVE: To assess length of stay of patients in the surgical intensive care unit (ICU) and to determine risk factors for a long ICU stay. DESIGN: Review of retrospective data. SETTING: University hospital surgical ICU. PATIENTS: Out of a total of 681 admissions to the surgical ICU during a one year period (July 1, 1996 - June 30, 1997), 613 had complete medical data which were analysed. MEASUREMENTS AND MAIN RESULTS: The frequency distribution was skewed to the right. The median and mode were the same (2 days). 35.89 per cent of the ICU admissions had a long stay (>2 days). Independent risk factors for a long ICU stay in the multivariate logistic regression analysis are increasing age, unstable condition, long weaning time, diuretic therapy and re-operation. CONCLUSION: Knowing the length of ICU stay, risk factors for a long ICU stay and how to shorten the ICU stay have potential application in optimizing ICU resource planning and decreasing the health care cost.
Assuntos
Distribuição por Idade , Fatores Etários , Idoso , Agendamento de Consultas , Controle de Custos , Diuréticos/uso terapêutico , Feminino , Pesquisa sobre Serviços de Saúde , Custos Hospitalares/estatística & dados numéricos , Mortalidade Hospitalar , Hospitais Universitários/estatística & dados numéricos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Tailândia/epidemiologia , Desmame do Respirador/estatística & dados numéricosRESUMO
This randomized controlled trial study evaluated the intubating conditions at 1 minute after 0.3, 0.6 and 0.9 mg/kg of rocuronium in 60 Thai elderly patients who enrolled for elective surgery under general anesthesia with fentanyl, thiopental and halothane at King Chulalongkorn Memorial Hospital. Excellent or good conditions were observed in 50 per cent (p<0.05) at rocuronium 0.3 mg/kg, compared with 95 and 85 per cent at 0.6 and 0.9 mg/kg of rocuronium, respectively but the excellent conditions were 5 (p<0.05), 30 and 45 per cent from each dose. Therefore, rocuronium 0.6 or 0.9 mg/kg should be adequate for intubation in elective, elderly patients but was inadequate for emergency case. In addition, rocuronium 0.3 mg/kg is insufficient for intubation at 1 minute in this age group. No serious side effects of the drug nor complications were found in this study.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Androstanóis/administração & dosagem , Determinação da Pressão Arterial , Relação Dose-Resposta a Droga , Método Duplo-Cego , Tratamento de Emergência/métodos , Feminino , Frequência Cardíaca , Hemodinâmica/fisiologia , Humanos , Intubação Intratraqueal/métodos , Masculino , Pessoa de Meia-Idade , Relaxamento Muscular/efeitos dos fármacos , Músculo Liso/efeitos dos fármacos , Fármacos Neuromusculares não Despolarizantes/administração & dosagem , Estudos Prospectivos , Resultado do TratamentoRESUMO
This randomized controlled trial study evaluated the intubating conditions at 1 minute after 0.3, 0.6 and 0.9 mg/kg of rocuronium in 108 Thai patients who were enrolled for elective surgery under general anesthesia with fentanyl, thiopental and isoflurane at King Chulalongkorn Memorial Hospital. Excellent or good conditions were observed in 77.8 per cent (p < 0.05) with rocuronium 0.3 mg/kg compared to 94.4 and 97.2 per cent at 0.6 and 0.9 mg/kg of rocuronium, respectively but the excellent condition was 16.7 (p < 0.05), 52.8 (p < 0.05) and 77.8 per cent (p < 0.05) from each dose. In females, the excellent condition was 33.3 (p < 0.05), 83.3 and 88.9 per cent while it was only 0, 22.2 and 66.7 per cent (p < 0.05) in males. Therefore, rocuronium > or = 0.6 mg/kg should be adequate for intubation. Furthermore, in a situation where an excellent condition is very important, a dose of > or = 0.9 mg/kg of rocuronium is recommended especially in male patients.