Impact of standard procedures and clinical standards on cost-effectiveness and intensive care unit performance in adult patients after cardiac surgery

1999 ◽  
Vol 25 (12) ◽  
pp. 1367-1373 ◽  
Author(s):  
H. Kern ◽  
W. J. Kox
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Adult Patients ◽  
Clinical Standards ◽  
Standard Procedures ◽  
Unit Performance

Topical Lidocaine Patch for Postthoracotomy and Poststernotomy Pain in Cardiothoracic Intensive Care Unit Adult Patients

2019 ◽  
Vol 39 (5) ◽  
pp. 51-57 ◽  
Author(s):  
Michael Liu ◽  
Mabel Wai ◽  
James Nunez
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Standard Care ◽  
Academic Medical Center ◽  
Adult Patients ◽  
Control Group ◽  
Lidocaine Group ◽  
Lengths Of Stay ◽  
Topical Lidocaine

Background Transdermal lidocaine patches have few systemic toxicities and may be useful analgesics in cardiac surgery patients. However, few studies have evaluated their efficacy in the perioperative setting. Objective To compare the efficacy of topical lidocaine 5% patch plus standard care (opioid and nonopioid analgesics) with standard care alone for postthoracotomy or poststernotomy pain in adult patients in a cardiothoracic intensive care unit. Methods A single-center, retrospective cohort evaluation was conducted from January 2015 through December 2015 in the adult cardiothoracic intensive care unit at a tertiary academic medical center. Cardiac surgery patients with new sternotomies or thoracotomies were included. Patients in the lidocaine group received 1 to 3 topical lidocaine 5% patches near sternotomy and/or thoracotomy sites daily. Patches remained in place for 12 hours daily. Patients in the control group received standard care alone. Results The primary outcome was numeric pain rating for sternotomy/thoracotomy sites. Secondary outcomes were cardiothoracic intensive care unit and hospital lengths of stay and total doses of analgesics received. Forty-seven patients were included in the lidocaine group; 44 were included in the control group. Mean visual analogue scores for pain did not differ between groups (lidocaine, 2; control, 1.9; P = .58). Lengths of stay were similar for both groups (cardiothoracic intensive care unit: lidocaine, 3.06 days; control, 3.11 days; P = .86; hospital: lidocaine, 8.26 days; control, 7.61 days; P = .47). Conclusions Adjunctive lidocaine 5% patches did not reduce acute pain in postthoracotomy and post-sternotomy patients in the cardiothoracic intensive care unit.

scholarly journals A cost-effectiveness analysis of propofol versus midazolam for the sedation of adult patients admitted to the intensive care unit

2021 ◽  
Vol 33 (3) ◽  
Author(s):  
Teresa Raquel Andrade ◽  
Jorge Ibrain Figueira Salluh ◽  
Raphaela Garcia ◽  
Daniela Farah ◽  
Paulo Sérgio Lucas da Silva ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Adult Patients ◽  
Effectiveness Analysis

Infectious Complications and Cost-Effectiveness of Open Resuscitation in the Surgical Intensive Care Unit after Cardiac Surgery

1985 ◽  
Vol 40 (4) ◽  
pp. 388-392 ◽  
Author(s):  
Robert L. McKowen ◽  
George J. Magovern ◽  
George A. Liebler ◽  
Sang B. Park ◽  
John A. Burkholder ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Infectious Complications ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care

Abstract 105: 24/7 In-House Consultant Staffing for Cardiac Surgical ICU Patients: A Cost-Effective Model

2012 ◽  
Vol 5 (suppl_1) ◽  
Author(s):  
Kanwal Kumar ◽  
Brett Hiebert ◽  
Hilary P Grocott ◽  
Dean D Bell ◽  
Ryan Zarychanski ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Cohort Analysis ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Operative Care ◽  
Tertiary Center ◽  
The Cost

Introduction: Intensive care staffing models vary amongst institutions. There is increasing evidence that in-house consultant care is beneficial in the intensive care unit. We have previously published beneficial results associated with 24-hour / 7-days a week in-house consultants working in a dedicated post-cardiac surgical unit. The cost-effectiveness of employing 24-hour / 7-days a week in-house consultants (both in the postoperative cardiac surgery and the general systems intensive care unit settings) remains largely unknown. The objective of this study was to analyze the cost implications of such a model. Methods: Using a prospectively collected database, an observational before and after cohort analysis of consecutive patients undergoing a cardiac surgical procedure at a single tertiary center was performed. The control cohort (n=1425) consisted of patients admitted to a traditional mixed surgical intensive care unit (SICU) from Jan.2005 - Jan.2007. The intervention cohort (n=1824) consisted of patients admitted to a newly created cardiac surgery ICU (CICU) from Jan.2007 - Sept.2008, which was staffed by 24/7 in-house consultants. Cost estimates were calculated for each patient from time of ICU admission to hospital discharge. For comparison purposes, propensity analysis was performed matching both cohorts on over twenty clinical, physiological, and surgical variables. Results: 1,182 patients (83%) per cohort were matched. Pre-operative demographics and surgical variables were similar between both cohorts. The CICU model was associated with a significant decrease in mean hospital bed, laboratory, and blood transfusion costs (Table 1). A higher mean ICU consultant salary cost offset this. Total estimated median cost was ∼14% lower in the CICU model relative to the SICU model (Table 1). Conclusions: We present a large before-after observational study examining the cost-effectiveness of 24/7 ICU consultant staffing. Our data suggests that the greater savings associated with improvement in post-operative care offsets the salary costs associated with 24/7 in-house consultants.

Interacting risk factors determine the outcome of patients with a prolonged intensive care unit stay after cardiac surgery

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
J Schöttler ◽  
C Grothusen ◽  
T Attmann ◽  
C Friedrich ◽  
S Freitag-Wolf ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay

Survival after cardiac surgery and long-term intensive care unit stay

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
C Schimmer ◽  
K Hamouda ◽  
M Özkur ◽  
SP Sommer ◽  
I Aleksic ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay
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