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請使用永久網址來引用或連結此文件:
http://ir.cmu.edu.tw/ir/handle/310903500/22078
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| 題名: | Gabexalate Mesilate and Heparin Responsiveness in CVVH Patients |
| 作者: | 張家昇(Chang,Chia-Sheng) |
| 貢獻者: | 醫學院醫學系學士班麻醉學科;中國附醫麻醉部 |
| 日期: | 2004-10-09 |
| 上傳時間: | 2009-09-07 11:44:18 (UTC+8) |
| 摘要: | Aim of investigation: To develop and validate an instrument for use in the ICU to accurately diagnose delirium in critically ill patients who are often nonverbal because of mechanical ventilation. Methods: This is a prospective cohort study. Thirty-eight patients admitted to the ICU were enrolled. We tested a modified version of the Confusion Assessment Method for use in ICU (CAM-ICU) patients. Daily ratings from ICU admission to hospital discharge by nurses and an intensivist who used the CAM-ICU were compared against the reference standard, a delirium criteria from the Diagnostic and Statistical Manual of Mental Disorders (fourth edition). Results: A total of 293 paired evaluations were completed, with reference standard diagnoses of delirium in 42% and coma in 27% of all observations. To include only interactive patient evaluations and avoid repeat-observer bias for patients studied on multiple days, we used only the first-alert or lethargic comparison evaluation in each patient. Thirty-three of 38 patients (87%) developed delirium during their ICU stay, mean duration of 4.2 ? 1.7 days. Excluding evaluations of comatose patients because of lack of characteristic delirium features, the two critical care study nurses and intensivist demonstrated high reliability for their CAM-ICU ratings with kappa statistics of 0.84, 0.79, and 0.95, respectively (p < .001). The sensitivities when using the CAM-ICU compared with the reference standard were over 95%, 96%, and 100%, respectively, whereas their specificities were 93%, 93%, and 89%, respectively Conclusions: The CAM-ICU demonstrated excellent reliability and validity when used by nurses and physicians to identify delirium in ICU patients. The CAM-ICU may be a useful instrument for both clinical and research purposes to monitor delirium in this challenging patient population.? |
| 關聯: | 中華民國急救加護醫學會93年年會暨學術研討會 |
| 顯示於類別: | [醫學系] 會議論文
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