Effectiveness of Fluconazole Prophylaxis in a Targeted High-Risk Group in a Surgical Intensive Care Unit

2021 ◽  
Author(s):  
Subin Sunny ◽  
Briana Episcopia ◽  
Leon Boudourakis ◽  
Geralda Xavier ◽  
John Quale
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Fluconazole Prophylaxis

The Epidemiology of Candida Colonization and Invasive Candidiasis in a Surgical Intensive Care Unit Where Fluconazole Prophylaxis is Utilized

2009 ◽  
Vol 249 (4) ◽  
pp. 657-665 ◽  
Author(s):  
Shelley S. Magill ◽  
Sandra M. Swoboda ◽  
Christine E. Shields ◽  
Elizabeth A. Colantuoni ◽  
Annette W. Fothergill ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Invasive Candidiasis ◽  
Surgical Intensive Care Unit ◽  
Candida Colonization ◽  
Surgical Intensive Care ◽  
Fluconazole Prophylaxis

Biodebridement in the Surgical Intensive Care Unit: Unique Therapy for Unique Patients

2020 ◽  
pp. 000313482094311
Author(s):  
Christopher J. McLaughlin ◽  
Jeffrey M. Fornadley ◽  
Kim Fields ◽  
Scott Armen ◽  
Lacee Laufenberg
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Acute Care ◽  
Chronic Wounds ◽  
Acute Care Surgery ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Care Surgery ◽  
Unique Therapy

Acute care surgery has evolved to encompass the advanced management of complex nonhealing wounds. Biodebridement has the potential to improve the care of chronic wounds for acute care surgery patients, particularly for patients in the surgical intensive care unit (SICU) with hospital-acquired pressure injuries. A case report of biodebridement using larval maggot therapy in the SICU is presented to illustrate real-world application and progression in wound healing. A review of current research involving biodebridement was conducted. A septuagenarian gentleman sustained a fall resulting in cervical spine fractures with neurological deficits. The patient had a prolonged hospital course in the SICU, complicated by myocardial infarction, respiratory failure requiring tracheostomy, and development of a Stage IV sacral pressure ulcer. The wound base was sharply debrided several times and became refractory to conventional mechanical/chemical debridement techniques. The patient had a prohibitively high risk for the operating room but remained too sensate for further effective bedside debridement. Biodebridement was utilized to create a viable wound base, with improved appearance noted within 2 weeks. A review of the current literature shows biodebridement has numerous benefits in the management of chronic wounds. Biodebridement is a unique therapy that possesses great value for select patients in the SICU. In particular, patients who are too high risk for further operative intervention, but too sensate for ongoing bedside debridement and dressing changes, benefit significantly from this underutilized approach. Further research is needed to solidify the place of biodebridement in the surgical management of chronic nonhealing wounds.

scholarly journals Effects of the proportion of high-risk patients and control strategies on the prevalence of methicillin-resistant Staphylococcus aureus in an intensive care unit

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Farida Chamchod ◽  
Prasit Palittapongarnpim
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Risk Group ◽  
Control Strategies ◽  
High Risk Group ◽  
High Risk Patients ◽  
Risk Patients ◽  
Mrsa Infection ◽  
And Control

Abstract Background The presence of nosocomial pathogens in many intensive care units poses a threat to patients and public health worldwide. Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen endemic in many hospital settings. Patients who are colonized with MRSA may develop an infection that can complicate their prior illness. Methods A mathematical model to describe transmission dynamics of MRSA among high-risk and low-risk patients in an intensive care unit (ICU) via hands of health care workers is developed. We aim to explore the effects of the proportion of high-risk patients, the admission proportions of colonized and infected patients, the probability of developing an MRSA infection, and control strategies on MRSA prevalence among patients. Results The increasing proportion of colonized and infected patients at admission, along with the higher proportion of high-risk patients in an ICU, may significantly increase MRSA prevalence. In addition, the prevalence becomes higher if patients in the high-risk group are more likely to develop an MRSA infection. Our results also suggest that additional infection prevention and control measures targeting high-risk patients may considerably help reduce MRSA prevalence as compared to those targeting low-risk patients. Conclusions The proportion of high-risk patients and the proportion of colonized and infected patients in the high-risk group at admission may play an important role on MRSA prevalence. Control strategies targeting high-risk patients may help reduce MRSA prevalence.

Antifungal prophylaxis with azoles in high-risk, surgical intensive care unit patients: A meta-analysis of randomized, placebo-controlled trials*

2006 ◽  
Vol 34 (4) ◽  
pp. 1216-1224 ◽  
Author(s):  
Konstantinos Z. Vardakas ◽  
George Samonis ◽  
Argyris Michalopoulos ◽  
Elpidoforos S. Soteriades ◽  
Matthew E. Falagas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Meta Analysis ◽  
Antifungal Prophylaxis ◽  
Surgical Intensive Care Unit ◽  
Controlled Trials ◽  
Surgical Intensive Care

Hypoglycemia in a Surgical Intensive Care Unit

2021 ◽  
pp. 000313482110249
Author(s):  
Emily Switzer ◽  
Morgan Schellenberg ◽  
Meghan Lewis ◽  
Natthida Owattanapanich ◽  
Lydia Lam ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Blood Glucose ◽  
High Risk ◽  
Soft Tissue ◽  
Surgical Intensive Care Unit ◽  
Subcutaneous Insulin ◽  
Surgical Intensive Care ◽  
Long Acting

Background Glycemic control is an important aspect of critical care because derangements are associated with morbidity and mortality. Patients at highest risk for hypoglycemia in the surgical intensive care unit (SICU) are incompletely described by existing literature. Our objective was to delineate this high-risk patient population in our SICU. Study Design In this single-center, retrospective, observational study, SICU patients admitted from June 1, 2019 to July 31, 2020 with ≥1 episode of hypoglycemia (blood glucose <60 mg/dL) were included. Results There were 41 hypoglycemic events in 27 patients, comprising an incidence of 1.5% among SICU patients. The most common admission diagnoses were cirrhosis (n = 13, 48%), polytrauma (n = 12, 44%), multisystem organ failure (n = 11, 41%), diabetes mellitus (n = 9, 33%), and soft tissue infection (n = 8, 30%). Four high-risk populations were identified: patients in multisystem organ failure (MSOF) (n = 11, 41%); those who were nil per os (NPO) (n = 10, 37%); patients receiving long acting subcutaneous insulin, for example, Lantus (n = 3, 11%); and those on continuous intravenous insulin infusions (n = 3, 11%). After multi-disciplinary peer review, most hypoglycemic events (n = 16, 59%) were deemed iatrogenic. Conclusions Hypoglycemia is rare in surgical critical care. When it does occur, patients are typically in MSOF, NPO, on long acting subcutaneous insulin or continuous insulin infusions, have soft tissue infections, or have acute or chronic liver failure. Increased vigilance with frequent blood glucose monitoring in these high-risk patients may reduce the risk of hypoglycemia in the SICU.

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