Acute Physiology and Chronic Health Evaluation

The outcome from intraabdominal infection is not determined solely by what transpires in the abdomen. Unsatisfactory outcomes in patients with intraabdominal infections may result from complications that arise in other organ systems. A complication commonly associated with mortality after intraabdominal infection is pneumonia.26 A high APACHE (Acute Physiology And Chronic Health Evaluation) II score, a low serum albumin, and a high New York Heart Association cardiac function status were significantly and independently associated with increased mortality from intraabdominal infection.27... 

APACHE II Acute Physiology and Chronic Health Evaluation II a severity of disease classification system using a point score based on initial values of 12 routine physiologic measurements, age, and previous health status used to provide a general measure of disease severity. 

Administration of activated protein C (drotrecogin) to promote fibrinolysis and associated antiinflammatory mechanisms may be beneficial in patients with an APACHE II (Acute Physiology and Chronic Health Evaluation II) score greater than 25. This agent reduced mortality in severe sepsis but poses an increased risk of serious bleeding. 

AMS acute myocardial syndrome ANC absolute neutrophil count ANS autonomic nervous system APACHE Acute Physiologic and Chronic Health Evaluation ICU illness severity scoring system APAP acetaminophen [N-acetyl-p-aminof enol] aPTT activated partial thromboplastin time ARB angiotensin 11 receptor blocker ARDS adult respiratory distress syndrome... 

B. Indications and use Xigrix is indicated for the reduction of mortahty in adult patients with severe sepsis (sepsis associated with acute organ dysfunction) who have a high risk of death [as determined by the acute physiology and chronic health evaluation (APACHE) score, the most widely used method of assessing the severity of illness in acutely ill patients in intensive care units]. 

APACHE Acute physiology and chronic health evaluation... 

The Acute Physiology and Chronic Health Evaluation (APACHE II) system (K12) is another scoring system, which was validated in a number of prospective clinical studies on acute pancreatitis (D6, K10, M7, 03, W8). A score of at least... 

Patients should be categorized into either prognostically mild or severe disease using any one of a number of validated multiple-factor scoring systems (Table 39 ). " Two widely used measures include Ranson s criteria and the Acute Physiology and Chronic Health Evaluation (APACHE II). The APACHE II (>8 points) system is more sensitive and specific than Ranson s criteria (>3 criteria), but it is also more complex. The APACHE II system uses 14 indicators of physiological and biochemical function that can be readily calculated upon admission to an intensive care unit. Ranson s criteria includes 11 variables that must be monitored at the time of admission and during the initial 48 hours of hospitalization. Patients with fewer than three Ranson criteria have a mortality rate of less than 1%, while... 

APACHE Acute Physiology and Chronic Health Evaluation ARDS acute respiratory distress syndrome CARS compensatory anti-inflammatory response syndrome Cl cardias index... 

The prevalence of PMV depends upon the definition used. Most patients (65-85%) are easily weaned from ventilatory support after less than one week. In a multicenter observational study of >5000 medical and surgical ICU patients, 25% required greater than seven days of MV (23). In the acute physiology and chronic health evaluation III (APACHE III) database of medical and surgical ICUs, one in five patients remained ventilated for at least seven days (24). When the definition of PMV is extended to >21 days, the incidence predictably falls. In a cohort of nearly 600 medical patients admitted to a tertiary care medical intensive care unit, approximately 10% remained invasively ventilated at day 21... 

Abbreviations. APACHE II, acute physiology and chronic health evaluation II SAPS, simplified acute physiology score. 

A three-month prospective cohort study of 26 Italian RICUs reported on 756 patients (14). Of all patients receiving invasive mechanical ventilation, 61% were tracheotomized and therefore considered ventilator dependent. According to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score, the predicted mortality was 22%, while the actual mortality rate was 16%. The results indicate that units with a level of care below ICU can successfiilly manage patients with acute-on-chronic respiratory failure. 

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