Esko Ruokonen

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CONTEXT Long-term sedation with midazolam or propofol in intensive care units (ICUs) has serious adverse effects. Dexmedetomidine, an α(2)-agonist available for ICU sedation, may reduce the duration of mechanical ventilation and enhance patient comfort. OBJECTIVE To determine the efficacy of dexmedetomidine vs midazolam or propofol (preferred usual care)(More)
UNLABELLED Organ dysfunction and multiple organ failure are the main causes of prolonged hospital stay after cardiac surgery, which increases resource use and health care costs. Increased levels of oxygen delivery and consumption are associated with improved outcome in different groups of postoperative patients. Cardiac surgical patients are at risk of(More)
BACKGROUND The administration of growth hormone can attenuate the catabolic response to injury, surgery, and sepsis. However, the effect of high doses of growth hormone on the length of stay in intensive care and in the hospital, the duration of mechanical ventilation, and the outcome in critically ill adults who are hospitalized for long periods is not(More)
Objective: To assess (1) the long-term outcome of patients requiring renal replacement therapy (RRT) in terms of 6-month and 5-year mortality, (2) quality of life and (3) costs of the intensive care. Design: A retrospective observational cohort study. Setting: Twenty-three-bed multidisciplinary intensive care unit (ICU) in a tertiary care center. Patients(More)
We aimed to determine the incidence, risk factors and outcome of acute kidney injury (AKI) in Finnish ICUs. This prospective, observational, multi-centre study comprised adult emergency admissions and elective patients whose stay exceeded 24 h during a 5-month period in 17 Finnish ICUs. We defined AKI first by the Acute Kidney Injury Network (AKIN) criteria(More)
To determine the incidence and outcome of severe sepsis in the adult Finnish population and to evaluate how treatment guidelines in severe sepsis are applied in clinical practice. A prospective study in 24 closed multidisciplinary ICUs in 21 hospitals (4 university and 17 tertiary hospitals) in Finland. All 4,500 consecutive ICU admission episodes were(More)
OBJECTIVE To study long-term mortality, quality of life (QOL), quality-adjusted life years (QALYs), and costs per QALY in an unselected intensive care unit (ICU) patient population with severe sepsis. DESIGN Prospective observational cohort study. SETTING Twenty-four ICUs in Finland. PATIENTS A total of 470 adult patients with severe sepsis who were(More)
BACKGROUND Heart rate variability (HRV) has been used for assessment of depth of anesthesia. Alterations in respiratory rate and tidal volume modulate the sympatovagal neural drive to the heart. The changes in PaCO2 that accompany changes in breathing pattern may, through chemoreceptors in the brainstem, independently influence the autonomic control of the(More)
Hospital mortality increases if acutely ill patients are admitted to hospitals on weekends as compared with weekdays. Night discharges may increase mortality in intensive care unit (ICU) patients but the effect of ICU admission time on mortality is not known. We studied the effects of ICU admission and discharge times on mortality and the time of death in(More)
PURPOSE The aim of the study was to investigate predictors of post-intensive care unit (ICU) in-hospital mortality with special emphasis on the impact of sepsis and organ system failure. METHODS This study is a subanalysis of the database from the observational Sepsis Occurrence in Acutely Ill Patients study conducted in 198 ICUs in 24 European countries(More)