ABSTRACT
BACKGROUND: Cost reduction is an important issue in medicine today, especially when considering ICUs, since they account for a large percentage of all hospital expenditure. Through a retrospective analysis of the data regarding the expenses incurred during the years 1996-97, we have been able to evaluate the total costs of our ICU and the influence that each component had on the final costs, thus gathering the necessary information for the improvement of the unit itself. METHODS: Retrospective analysis of a 5-bedded multidisciplinary ICU activity over a two-year period (1996-1997). Cost-related data have been supplied by the Hospital Administration as to wages, infrastructures, equipment buying and maintenance; by Hospital Pharmacy as to drugs and devices supplies; and by Laboratory and Radiology as to diagnostic investigations. RESULTS: According to our experience, physicians and non-medical staff account for more than 50% of the total expenditure--the latter slightly prevailing. Furthermore, we have assessed that the cost distribution is hardly comparable to that reported by other authors. CONCLUSIONS: It is useful to analyse the total distribution and to evaluate their nature only to gain the necessary data that will lead to a more effective management of the unit. Nevertheless, this methodology is valid within the cost analysis of our ICUs but the ICUs of other countries show great differences in the way they are structured and some of the use more reliable activity-based costing methodology.
Subject(s)
Intensive Care Units/economics , Drug Costs , Equipment and Supplies, Hospital/economics , Intensive Care Units/organization & administration , Italy , Retrospective Studies , Salaries and Fringe BenefitsABSTRACT
INTRODUCTION: To evaluate the effect of giving diazepam and midazolam, respectively 0.1 mg/kg and 0.03 mg/kg on: PAS, PAD, PAM, HR, SaO2 and sedation level at 10, 30, and 50 minutes from injection. These drugs were utilized as sedatives during retrobulbar blockade as anaesthetics technique in cataract surgery. Randomized double blind in operating room for opthalmic surgery in general hospital. MATERIALS AND METHODS: 40 patients (ASA II, III) with mean age 78 +/- 7 divided in two groups with homogeneous morphological and clinic parameters, scheduled for elective cataract surgery. During retrobulbar blockade as anaesthetic technique the patients received diazepam and midazolam in equipotent quantities. Serial measurements of PAS, PAD, PAM, HR, SaO2 and sedation level. RESULTS: Both drugs proved significantly depressant on PAS, PAD, PAM, HR, SaO2. Midazolam proved more depressant than diazepam on SaO2 at 10 minutes from injection; the depression was the same for both drugs at 50 minutes. Sedation level seems higher for midazolam group than diazepam at 10 and 30 minutes, approximately the same for both groups at 50 minutes. CONCLUSIONS: Our results agree with there in the literature. The data show that midazolam is more depressant than diazepam on SaO2 at 10 minutes from injection and the necessity of a controlled "tritation" in small doses for intravenous use of midazolam.
Subject(s)
Cataract Extraction , Conscious Sedation , Diazepam , Midazolam , Aged , Double-Blind Method , Female , Humans , MaleABSTRACT
The Authors have studied the effects of propofol on coagulation in 15 patients admitted to ICU. Propofol was used for long-term sedation (therapeutic range 3 mg/kg/h). Variables monitored included: platelets, PTT, PT, Fibrinogen, FDP, AT III. The effects on coagulation has been investigated in three groups of patients: group I) 5 patients that received propofol for 1-3 days; group II) 5 patients that received propofol for 4-10 days; group III) 5 patients that received propofol for 11-35 days. No difference were found about blood coagulation in this groups of patients before and after administration of propofol.
Subject(s)
Blood Coagulation Disorders/chemically induced , Critical Care , Propofol/adverse effects , Adult , Aged , Conscious Sedation , Female , Humans , Intensive Care Units , Male , Middle Aged , Time FactorsABSTRACT
The authors studied four patients in ICU suffering from Candida infections who were treated with a new bis-triazole antimycotic, fluconazole. Various parameters of blood chemistry and blood and urine drug levels were monitored. After treatment all microbiological tests had become negative and clinical conditions had improved considerably within 30 to 60 days. No significant side effects were observed.
