[The TISS-28 scoring system for assessment of cardiac surgical postoperative intensive care]. / Zastosowanie skali TISS-28 w intensywnej opiece pooperacyjnej w kardiochirurgii.

BACKGROUND: The TISS-28 scoring system, commonly used in Poland in general intensive care, relies mostly on nursing activities in individual patient care. It is not known, however, whether this system can also be useful in specialised intensive care. The aim of this study was to assess the usefulness of the TISS-28 scoring system in cardiac surgical intensive care. METHODS: Clinical records of three hundred and fifty-nine consecutive patients, treated in a cardiac surgical intensive care unit, were retrospectively analyzed. The records were analyzed overall, and in subgroups according to various ranges of operative risk according to the EuroSCORE (a scoring system commonly used in the preoperative assessment of cardiac surgical patients). The TISS-28 scores for each individual day of treatment were calculated. Additionally, individual real costs of treatment were calculated for each patient. RESULTS: One hundred and four patients (28.9%) were preoperatively allocated to the EuroSCORE low-risk group, 158 (44.0%) to the medium-risk group, and 97 (27.1%) to the high-risk group. The overall mean TISS-28 score was high (39.2+/-7.6). Patients in the high-risk group had the highest TISS-28 scores. Overall costs of treatment, calculated for individual patients, were closely correlated to the TISS-28 scores (r=0.76, p<0.0001). CONCLUSIONS: The TISS-28 scoring system may be useful in prediction of treatment costs and in planning of nursing staff allocation in a specialized cardiac surgical intensive care.

[Radiographic assessment of accuracy of tracheal tube placement in children]. / Ocena prawidlowego polozenia rurki dotchawiczej u dzieci na podstawie radiogramu klatki piersiowej.

BACKGROUND: Accidental migration of endotracheal tubes has been recognized by the European Resuscitation Council (ERC) as an important morbidity factor in ventilated children. Several equations have been proposed for prediction of the ideal position of the endotracheal tube, but none of them was found to be ideal. METHODS: We have retrospectively assessed the positions of endotracheal tubes in 108 intubated children. Infants were nasally intubated and oral intubation was used in older children. We compared the measured distances with theoretical lengths, obtained from various equations. RESULTS: We found that if the tube was placed according to the Lau equation (age/2+13 mm) or the ALS group equation (age/2+12 mm), the estimation was correct in 83% (Lau equation) and in 94.7% (ALS recommendations). CONCLUSION: Since results depended very much on the age and route of intubation, we suggest that extended studies may be recommended.