Knowledge and current practices of ICU nurses regarding aerosol therapy for patients treated with invasive mechanical ventilation: a nationwide cross‐sectional study

Author(s):  
Chuanlin Zhang ◽  
Jie Mi ◽  
Xueqin Wang ◽  
Shunqiao Lv ◽  
Zeju Zhang ◽  
...  
2021 ◽  
Author(s):  
Natanael J Silva ◽  
Rita C Ribeiro-Silva ◽  
Andrea JF Ferreira ◽  
Camila SS Teixeira ◽  
Aline S Rocha ◽  
...  

Objective: To investigate the combined association of obesity, diabetes mellitus (DM), and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients. Design: Cross-sectional study based on registry data from Brazil's influenza surveillance system. Setting: Public and private hospitals across Brazil. Participants: Eligible population included 21,942 inpatients aged 20 years or older with positive RT-PCR test for SARS-CoV-2 until Jun 9th, 2020. Main outcome measures: Severe COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, ICU admission, and death. Multivariate analyses were conducted separately for adults (20-59 years) and elders (>=60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome. Results: A sample of 8,848 adults and 12,925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (PR 3.76, 95%CI 2.82-5.01) and non-invasive mechanical ventilation use (2.06, 1.58-2.69), ICU admission (1.60, 1.40-1.83), and death (1.79, 1.45-2.21) compared with the group without obesity, DM, and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07-1.82) and death (1.67, 1.00-2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose-response association was observed between obesity and death in adults: class I 1.32 (1.05-1.66), class II 1.41 (1.06-1.87), and class III 1.77 (1.35-2.33). Conclusions: The combined association of obesity, diabetes, and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose-response association between degrees of obesity and death in adults. These findings suggest important implications for the clinical care of patients with obesity and severe COVID-19 and support the inclusion of people with obesity in the high-risk and vaccine priority groups for protection from SARS-CoV-2.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e050739
Author(s):  
Natanael de Jesus Silva ◽  
Rita de Cássia Ribeiro-Silva ◽  
Andrêa Jacqueline Fortes Ferreira ◽  
Camila Silveira Silva Teixeira ◽  
Aline Santos Rocha ◽  
...  

ObjectivesTo investigate the combined association of obesity, diabetes mellitus (DM) and cardiovascular disease (CVD) with severe COVID-19 outcomes in adult and elderly inpatients.DesignCross-sectional study based on registry data from Brazil’s influenza surveillance system.SettingPublic and private hospitals across Brazil.ParticipantsEligible population included 21 942 inpatients aged ≥20 years with positive reverse transcription-PCR test for SARS-CoV-2 until 9 June 2020.Main outcome measuresSevere COVID-19 outcomes were non-invasive and invasive mechanical ventilation use, intensive care unit (ICU) admission and death. Multivariate analyses were conducted separately for adults (20–59 years) and elders (≥60 years) to test the combined association of obesity (without and with DM and/or CVD) and degrees of obesity with each outcome.ResultsA sample of 8848 adults and 12 925 elders were included. Among adults, obesity with DM and/or CVD showed higher prevalence of invasive (prevalence ratio 3.76, 95% CI 2.82 to 5.01) and non-invasive mechanical ventilation use (2.06, 1.58 to 2.69), ICU admission (1.60, 1.40 to 1.83) and death (1.79, 1.45 to 2.21) compared with the group without obesity, DM and CVD. In elders, obesity alone (without DM and CVD) had the highest prevalence of ICU admission (1.40, 1.07 to 1.82) and death (1.67, 1.00 to 2.80). In both age groups, obesity alone and combined with DM and/or CVD showed higher prevalence in all outcomes than DM and/or CVD. A dose–response association was observed between obesity and death in adults: class I 1.32 (1.05 to 1.66), class II 1.41 (1.06 to 1.87) and class III 1.77 (1.35 to 2.33).ConclusionsThe combined association of obesity, diabetes and/or CVD with severe COVID-19 outcomes may be stronger in adults than in elders. Obesity alone and combined with DM and/or CVD had more impact on the risk of COVID-19 severity than DM and/or CVD in both age groups. The study also supports an independent relationship of obesity with severe outcomes, including a dose–response association between degrees of obesity and death in adults.


2021 ◽  
Vol 76 (1) ◽  
Author(s):  
Xavier SERRA-ARACIL ◽  
Arturo DOMÍNGUEZ ◽  
Laura MORA-LÓPEZ ◽  
José HIDALGO ◽  
Anna PALLISERA-LLOVERAS ◽  
...  

2019 ◽  
Vol 2 (1) ◽  
pp. 52-59
Author(s):  
Sunil Kumar Yadav ◽  
SP Yadav ◽  
P Kanodia ◽  
N K Bhatta ◽  
R R Singh ◽  
...  

Introduction: Nosocomial sepsis is a common and serious infection of neonates who are admitted in intensive care unit. They lead to significant morbidity and mortality in both developed and resource limited countries. The neonatal intensive care unit (NICU) is a suitable environment for disseminating the infections and, hence, needs preventive intervention. The study was carried out to determine the risk factors for nosocomial sepsis in neonatal intensive care unit. Material and Methods: This was a cross-sectional study conducted in a seven bedded teaching and referral hospital NICU. All neonates in NICU who did not have any sign of infection at admission and remained hospitalized for at least 48 hours were observed. Nosocomial sepsis was diagnosed according to the CDC criteria. Risk factors for nosocomial sepsis were analyzed with Chi-square test and Logistic regression model. P-value of <0.05 was considered significant. Results: Low birth weight (both preterm and IUGR) and mechanical ventilation were found to be related with nosocomial sepsis. Conclusions: Low birth weight and mechanical ventilation were the most important risk factors fornosocomial sepsis.


2014 ◽  
Vol 24 (3) ◽  
pp. 230-238 ◽  
Author(s):  
Shi Cong ◽  
Atsuko Araki ◽  
Shigekazu Ukawa ◽  
Yu Ait Bamai ◽  
Shuji Tajima ◽  
...  

2021 ◽  
Author(s):  
Seyed Alireza Mousavi ◽  
Reyhaneh Sadat Mousavi-Roknabadi ◽  
Fateme Nemati ◽  
Somaye Pourteimoori ◽  
Arefeh Ghorbani ◽  
...  

Abstract Background Since December 2019, a type of coronavirus has emerged in Wuhan, China, which has become the focus of global attention due to an epidemic of pneumonia of unknown cause, called COVID-19. This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospital in central Iran. Methods This retrospective cross-sectional study (February 2019-May 2020) was conducted on patients with confirmed diagnosis COVID-19, who were admitted in Yazd Shahid Sadoughi Hospital, in middle of Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extracted from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results Totally, 573 patients were enrolled, that 356 (62.2%) were male. The mean ± SD of age was 56.29 ± 17.53 years, and 93 (16.23%) were died. All the complications were more in non-survivors. Intensive care unit (ICU) admission was in 20.5% of the patients which was more in non-survivors (P < 0.001). The results of multivariate logistic regression test showed that plural effusion in lung computed tomography (CT) scan (OR = 0.055, P = 0.009), white blood cell (WBC) (OR = 1.417, P = 0.022), serum albumin (OR = 0.009, P < 0.001), non-invasive mechanical ventilation (OR = 34.315, P < 0.001), and acute respiratory distress syndrome (ARDS) (OR = 66.039, P = 0.001) were achieved as the predictive factors for in-hospital mortality were the predictive factors for in-hospital mortality. Conclusion In-hospital mortality in patients with COVID-19 was about 16%. Plural effusion in lung CT scan, WBC, albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality.


2020 ◽  
Author(s):  
Fang Gong ◽  
Yuhang Ai ◽  
Lina Zhang ◽  
Qianyi Peng ◽  
Quan Zhou ◽  
...  

Abstract Background: Studies investigating the association of delirium with ratio of partial pressure of arterial oxygen to fraction of inspired oxygen (PaO2/FiO2) have been limited. The main purpose of the our study was to explore the relationship between PaO2/FiO2 and the risk of delirium in intensive care units (ICUs). Methods: This was a cross-sectional study that involved the collection of data from patients admitted to the Xiang Ya Hospital Cardiothoracic Surgical Care Unit and Comprehensive Intensive Care Unit from September 1st, 2016, to December 10th, 2016. Delirium was diagnosed by the simplified version of the Chinese Confusion Assessment Method for the ICU (CAM-ICU). The PaO2/FiO2 of each patient was recorded at the first 24 h after admission to the ICU. Results: There was a non-linear relationship between the PaO2/FiO2 and delirium, after adjusting for the following potential confounders: gender, age, hypertension, heart disease, history of a cerebral vascular accident, diabetes, smoking habits, drinking habits, chronic pulmonary dysfunction, blood pressure at admission, postoperative surgery, mechanical ventilation, mechanical ventilation time, PaCO2, sedation, APACHE II score, and SOFA score. We used a two-piecewise linear regression model to calculate the threshold of 247 mmHg. On the left side of the threshold, the odds ratio (OR) was 0.91 (95% CI [0.84, 0.98]), while the OR on the right side was 1.03 (95% CI [1.00, 1.06]).Conclusions: The relationship between PaO2/FiO2 and risk of delirium was non-linear. The PaO2/FiO2 was negatively associated with the risk of delirium when the PaO2/FiO2 was less than 247 mmHg. As a readily available laboratory indicator, PaO2/FiO2 has potential value in the clinical evaluation risk of delirium in ICU patients. Of course, our conclusions need further confirmation from other studies, especially large prospective studies.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254987
Author(s):  
Hyang Sook Kim ◽  
Chung Eun Lee ◽  
Yong Sook Yang

Background The number of patients on home mechanical ventilation (HMV) worldwide has been steadily rising as medical technological advanced. To ensure the safety and quality care of the patients receiving HMV with tracheostomy, caring behavior of family caregivers is critical. However, studies on caring behavior of family caregivers and its associated factors were remained unexplored. This study aimed to describe the caring behaviors of family caregivers for patients receiving home mechanical ventilation with tracheostomy and to identify factors associated with their caring behaviors. Methods This was a cross-sectional study for 95 family caregivers for patients with invasive home mechanical ventilation in South Korea. Caring behaviors were assessed by the Caring Behavior Scale with 74 items with 5-point Likert scale. Data were analyzed using multiple regression analysis. Results Caring behaviors score of caregivers was 304.68±31.05 out of 370. They were significantly associated with knowledge on emergency care (β = 0.22, p = .011), number of required instruments for care (β = 0.21, p = .010), frequency of home visit care (β = 0.19, p = .017), experience of emergency situation for the last six months (β = 0.19, p = .009) and activities of daily living of patient (β = 0.27, p = .002). Conclusion Development of standardized multidisciplinary discharge education for improving the caring capacity of caregivers is required for successful and healthy application of home mechanical ventilation.


Sign in / Sign up

Export Citation Format

Share Document