Optimizing outcomes in ventilator-dependent patients: challenging critical care practice.

This article examines the structure and process of a collaborative practice team established specifically to improve the quality and financial outcomes of ventilator-dependent patients in a tertiary care teaching hospital. A brief overview of descriptors regarding ventilator-dependent patients is synthesized from the literature and compared with the population at St. Luke's Episcopal Hospital in Houston, Tex. An analysis of statistically significant physiologic variances that have been found to increase mechanical ventilation time or length of stay is detailed. Focused quality initiatives are discussed. Specific criteria indicative of improved outcomes are presented along with recommendations for future improvements.

Nutrition, physical activity, and blood pressure in the elderly.

Forty noninstitutionalized elderly subjects, ages 65-86 years, were recruited for a study to determine relationships between nutritional status, physical activity, and blood pressure. A 24-hour recall of dietary intake and activities, health history, skinfolds, circumferences, height, weight, and blood pressure were obtained. Obesity was associated with hypertension in this group of elderly subjects. Truncal skinfolds (abdomen and subscapula) were positively correlated (P less than .05) with systolic blood pressure while body mass index, dietary magnesium and dietary calcium to magnesium ratio were directly related (P less than .05) to diastolic blood pressure. Physical activity and energy expenditure were not correlated (P greater than .05) with blood pressure in this study; however, the level of activity did not include strenuous exercise.