For critically ill adults and children in intensive care units (ICUs), how does automated compare with non-automated weaning from mechanical ventilation?

2018 ◽  
Author(s):  
Amanda Ullman
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Weaning From Mechanical Ventilation ◽  
Adults And Children ◽  
Critically Ill Adults ◽  
Ill Adults

scholarly journals Caring for critically ill adults in paediatric intensive care units in England during the COVID-19 pandemic: planning, implementation and lessons for the future

2021 ◽  
pp. archdischild-2020-320962
Author(s):  
Ruchi Sinha ◽  
Angela Aramburo ◽  
Akash Deep ◽  
Emma-Jane Bould ◽  
Hannah L Buckley ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Clinical Care ◽  
Adult Patients ◽  
Paediatric Intensive Care ◽  
Critically Ill Adults ◽  
Care Capacity ◽  
Ill Adults ◽  
Paediatric Intensive Care Units

ObjectiveTo describe the experience of paediatric intensive care units (PICUs) in England that repurposed their units, equipment and staff to care for critically ill adults during the first wave of the COVID-19 pandemic.DesignDescriptive study.SettingSeven PICUs in England.Main outcome measures(1) Modelling using historical Paediatric Intensive Care Audit Network data; (2) space, staff, equipment, clinical care, communication and governance considerations during repurposing of PICUs; (3) characteristics, interventions and outcomes of adults cared for in repurposed PICUs.ResultsSeven English PICUs, accounting for 137 beds, repurposed their space, staff and equipment to admit critically ill adults. Neighbouring PICUs increased their bed capacity to maintain overall bed numbers for children, which was informed by historical data modelling (median 280–307 PICU beds were required in England from March to June). A total of 145 adult patients (median age 50–62 years) were cared for in repurposed PICUs (1553 bed-days). The vast majority of patients had COVID-19 (109/145, 75%); the majority required invasive ventilation (91/109, 85%). Nearly, a third of patients (42/145, 29%) underwent a tracheostomy. Renal replacement therapy was provided in 20/145 (14%) patients. Twenty adults died in PICU (14%).ConclusionIn a rapid and unprecedented effort during the first wave of the COVID-19 pandemic, seven PICUs in England were repurposed to care for adult patients. The success of this effort was underpinned by extensive local preparation, close collaboration with adult intensivists and careful national planning to safeguard paediatric critical care capacity.

scholarly journals ICU and ventilator mortality among critically ill adults with COVID-19

2020 ◽  
Author(s):  
Sara C. Auld ◽  
Mark Caridi-Scheible ◽  
James M. Blum ◽  
Chad Robichaux ◽  
Colleen Kraft ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Preliminary Data ◽  
Early Experience ◽  
Mortality Rates ◽  
Critically Ill Adults ◽  
Ill Adults ◽  
Overall Mortality

SummaryWe report preliminary data from a cohort of adults admitted to COVID-designated intensive care units from March 6 through April 17, 2020 across an academic healthcare system. Among 217 critically ill patients, mortality for those who required mechanical ventilation was 29.7% (49/165), with 8.5% (14/165) of patients still on the ventilator at the time of this report. Overall mortality to date in this critically ill cohort is 25.8% (56/217), and 40.1% (87/217) patients have survived to hospital discharge. Despite multiple reports of mortality rates exceeding 50% among critically ill adults with COVID-19, particularly among those requiring mechanical ventilation, our early experience indicates that many patients survive their critical illness.

scholarly journals Association of multiple glycemic parameters at intensive care unit admission with mortality and clinical outcomes in critically ill patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Priscila Bellaver ◽  
Ariell F. Schaeffer ◽  
Diego P. Dullius ◽  
Marina V. Viana ◽  
Cristiane B. Leitão ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Glycemic Variability ◽  
Stress Hyperglycemia ◽  
Critically Ill Adults ◽  
Ill Adults

AbstractThe aim of the present study was to investigate the association of multiple glycemic parameters at intensive care unit (ICU) admission with outcomes in critically ill patients. Critically ill adults admitted to ICU were included prospectively in the study and followed for 180 days until hospital discharge or death. Patients were assessed for glycemic gap, hypoglycemia, hyperglycemia, glycemic variability, and stress hyperglycemia ratio (SHR). A total of 542 patients were enrolled (30% with preexisting diabetes). Patients with glycemic gap >80 mg/dL had increased need for renal replacement therapy (RRT; 37.7% vs. 23.7%, p = 0.025) and shock incidence (54.7% vs. 37.4%, p = 0.014). Hypoglycemia was associated with increased mortality (54.8% vs. 35.8%, p = 0.004), need for RRT (45.1% vs. 22.3%, p < 0.001), mechanical ventilation (MV; 72.6% vs. 57.5%, p = 0.024), and shock incidence (62.9% vs. 35.8%, p < 0.001). Hyperglycemia increased mortality (44.3% vs. 34.9%, p = 0.031). Glycemic variability >40 mg/dL was associated with increased need for RRT (28.3% vs. 14.4%, p = 0.002) and shock incidence (41.4% vs.31.2%, p = 0.039). In this mixed sample of critically ill subjects, including patients with and without preexisting diabetes, glycemic gap, glycemic variability, and SHR were associated with worse outcomes, but not with mortality. Hypoglycemia and hyperglycemia were independently associated with increased mortality.

Pain and Delirium in Critical Illness: An Exploration of Key 2018 SCCM PADIS Guideline Evidence Gaps

2019 ◽  
Vol 40 (05) ◽  
pp. 604-613 ◽  
Author(s):  
Margaret A. Pisani ◽  
John W. Devlin ◽  
Yoanna Skrobik
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critical Care Medicine ◽  
Sleep Disruption ◽  
Future Research ◽  
Critically Ill Adults ◽  
Ill Adults

AbstractManaging pain and delirium are crucial to patients, families, and caregivers in intensive care units. The Society of Critical Care Medicine 2018 Pain, Agitation/Sedation, Delirium, Immobility, and Sleep disruption (PADIS) guidelines reviewed literature until October 2015 and made its recommendations for critically-ill adults. This chapter addresses evidence gaps, identified during the guideline process, most relevant to clinicians, adds newer evidence published after the PADIS 2018 guidelines were produced, describes hindsight-driven PADIS process or content-related gaps, and reflects on how these considerations may help inform future research investigations and new guideline efforts.

scholarly journals Resuscitation fluid use in critically ill adults: an international cross sectional study in 391 intensive care units

Critical Care ◽  
2010 ◽  
Vol 14 (5) ◽  
pp. R185 ◽  
Author(s):  
Simon Finfer ◽  
Bette Liu ◽  
Colman Taylor ◽  
Rinaldo Bellomo ◽  
Laurent Billot ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Resuscitation Fluid ◽  
Critically Ill Adults ◽  
Ill Adults
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