The effect of an algorithm-based sedation guideline on the duration of mechanical ventilation in an Australian intensive care unit

To examine the effect of an algorithm-based sedation guideline developed in a North American intensive care unit (ICU) on the duration of mechanical ventilation of patients in an Australian ICU. The intervention was tested in a pre-intervention, post-intervention comparative investigation in a 14-bed adult intensive care unit. Adult mechanically ventilated patients were selected consecutively (n =322) The pre-intervention and post-intervention groups were similar except for a higher number of patients with a neurological diagnosis in the pre-intervention group. An algorithm-based sedation guideline including a sedation scale was introduced using a multifaceted implementation strategy. The median duration of ventilation was 5.6 days in the post-intervention group, compared with 4.8 days for the pre-intervention group (P = 0.99). The length of stay was 8.2 days in the post-intervention group versus 7.1 days in the pre-intervention group (P = 0.04). There were no statistically significant differences for the other secondary outcomes, including the score on the Experience of Treatment in ICU 7 item questionnaire, number of tracheostomies and number of self-extubations. Records of compliance to recording the sedation score during both phases revealed that patients were slightly more deeply sedated when the guideline was used. The use of the algorithm-based sedation guideline did not reduce duration of mechanical ventilation in the setting of this study.

Investigating the performance of MIMO systems from an electromagnetic perspective

Multiple input multiple output (MIMO) wireless systems use multiple element antennas (MEAs) tit the transmitter (TX) and the receiver (RX) in order to offer improved information rates (capacity) over conventional single antenna systems in rich scattering environments. In this paper, an example of a simple MIMO system is considered in which both antennas and scattering objects is are formed by wire dipoles. Such it system can be analyzed in the strict electromagnetic (EM) sense and its capacity can be determined for varying array size, interelement spacing, and distributions of scatterers. The EM model of this MIMO system can be used to assess the validity of single- or double-bounce scattering models for mixed line of sight (LOS) and non-line of sight (NLOS) signal-propagation conditions. (c) 2006 Wiley Periodicals, Inc.