scholarly journals ‘I want to get back!’ A qualitative study of long‐term critically ill patients’ inner strength and willpower: Back home after long‐term intensive care

2021 ◽  
Author(s):  
Ingeborg Alexandersen ◽  
Hege Selnes Haugdahl ◽  
Berit Stjern ◽  
Tove Engan Paulsby ◽  
Stine Borgen Lund ◽  
...  
Keyword(s):  
Intensive Care ◽  
Qualitative Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Inner Strength

scholarly journals Cystatin C predicts long term mortality better than creatinine in a nationwide study of intensive care patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Johanna Helmersson-Karlqvist ◽  
Miklos Lipcsey ◽  
Johan Ärnlöv ◽  
Max Bell ◽  
Bo Ravn ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Risk Prediction ◽  
Cystatin C ◽  
Mortality Risk ◽  
Critically Ill Patients ◽  
Cox Regression ◽  
Sample Tube ◽  
Long Term Mortality

AbstractDecreased glomerular filtration rate (GFR) is linked to poor survival. The predictive value of creatinine estimated GFR (eGFR) and cystatin C eGFR in critically ill patients may differ substantially, but has been less studied. This study compares long-term mortality risk prediction by eGFR using a creatinine equation (CKD-EPI), a cystatin C equation (CAPA) and a combined creatinine/cystatin C equation (CKD-EPI), in 22,488 patients treated in intensive care at three University Hospitals in Sweden, between 2004 and 2015. Patients were analysed for both creatinine and cystatin C on the same blood sample tube at admission, using accredited laboratory methods. During follow-up (median 5.1 years) 8401 (37%) patients died. Reduced eGFR was significantly associated with death by all eGFR-equations in Cox regression models. However, patients reclassified to a lower GFR-category by using the cystatin C-based equation, as compared to the creatinine-based equation, had significantly higher mortality risk compared to the referent patients not reclassified. The cystatin C equation increased C-statistics for death prediction (p < 0.001 vs. creatinine, p = 0.013 vs. combined equation). In conclusion, this data favours the sole cystatin C equation rather than the creatinine or combined equations when estimating GFR for risk prediction purposes in critically ill patients.

ICU admissions: Consequences after discharge

2020 ◽  
Vol 13 (9) ◽  
pp. 550-556
Author(s):  
Minal Karavadra ◽  
Ricky Bell
Keyword(s):  
Intensive Care ◽  
Cognitive Decline ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Psychiatric Disturbance ◽  
Intensive Care Department ◽  
Previous Level ◽  
The Uk

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

Early Intensive Care Sedation Predicts Long-Term Mortality in Ventilated Critically Ill Patients

2012 ◽  
Vol 186 (8) ◽  
pp. 724-731 ◽  
Author(s):  
Yahya Shehabi ◽  
Rinaldo Bellomo ◽  
Michael C. Reade ◽  
Michael Bailey ◽  
Frances Bass ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Intensive Care Sedation ◽  
Long Term Mortality

scholarly journals “Never in my mind to give up!” A qualitative study of long‐term intensive care patients’ inner strength and willpower—Promoting and challenging aspects

2019 ◽  
Vol 28 (21-22) ◽  
pp. 3991-4003 ◽  
Author(s):  
Ingeborg Alexandersen ◽  
Berit Stjern ◽  
Regina Eide ◽  
Hege Selnes Haugdahl ◽  
Tove Engan Paulsby ◽  
...  
Keyword(s):  
Intensive Care ◽  
Qualitative Study ◽  
Intensive Care Patients ◽  
Inner Strength

scholarly journals Physicians' Acceptance of Triage Guidelines in the Context of the COVID-19 Pandemic: A Qualitative Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Federica Merlo ◽  
Mattia Lepori ◽  
Roberto Malacrida ◽  
Emiliano Albanese ◽  
Marta Fadda
Keyword(s):  
Intensive Care ◽  
Qualitative Study ◽  
End Of Life ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Collective Responsibility ◽  
Intensive Care Treatment ◽  
Ethical Challenges ◽  
Life Issues ◽  
End Of Life Issues

Aims: One of the major ethical challenges posed by the Covid-19 pandemic comes in the form of fair triage decisions for critically ill patients in situations where life-saving resources are limited. In Spring 2020, the Swiss Academy of Medical Sciences (SAMS) issued specific guidelines on triage for intensive-care treatment in the context of the Covid-19 pandemic. While evidence has shown that the capacities of intensive care medicine throughout Switzerland were sufficient to take care of all critically ill patients during the first wave of the outbreak, no evidence is available regarding the acceptance of these guidelines by ICU staff. The aim of this qualitative study was to explore the acceptance and perceived implementation of the SAMS guidelines among a sample of senior physicians involved in the care of Covid-19 patients in the Canton of Ticino. Specific objectives included capturing and describing physicians' attitudes toward the guidelines, any challenges experienced in their application, and any perceived factors that facilitated or would facilitate their application.Methods: We conducted face-to-face and telephone interviews with a purposive sample of nine senior physicians employed as either head of unity, deputy-head of unit, or medical director in either one of the two Covid-19 hospitals in the Canton of Ticino during the peak of the outbreak. Interviews were transcribed verbatim and thematically analyzed using an inductive approach.Results: We found that participants held different views regarding the nature of the guidelines, saw decisions on admission as a matter of collective responsibility, argued that decisions should be based on a medical futility principle rather than an age criterion, and found that difficulties to address end-of-life issues led to a comeback of paternalism.Conclusions: Results highlight the importance of clarifying the nature of the guidelines, establishing authority, and responsibility during triaging decisions, recognizing and addressing sources of interference with patients' autonomy, and the need of a cultural shift in timely and efficiently addressing end-of-life issues.

scholarly journals No impact of weather conditions on the outcome of intensive care unit patients

2021 ◽  
Author(s):  
Raphael Romano Bruno ◽  
Bernhard Wernly ◽  
Maryna Masyuk ◽  
Johanna M. Muessig ◽  
Rene Schiffner ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Weather Conditions ◽  
Air Pressure ◽  
Different Seasons ◽  
Weather Changes ◽  
Long Term Mortality

SummaryGlobal warming leads to increased exposure of humankind to meteorological variation, including short-term weather changes. Weather conditions involve changes in temperature, heat and cold, in air pressure and in air humidity. Every single condition influences the incidence and mortality of different diseases such as myocardial infarction and stroke. This study investigated the impact of weather conditions on short- and long-term mortality of 4321 critically ill patients (66 ± 14 years, 2638 men) admitted to an intensive care unit (ICU) over a period of 5 years. Meteorological information (air temperature, air pressure and humidity) for the same period was retrieved. The influence of absolute weather parameters, different seasons, sudden weather changes including “warm” and “cold” spells on ICU and long-term mortality was analyzed. After correction for Simplified Acute Physiology Score (SAPS-2), no impact of meteorological conditions on mortality was found. Different seasons, sudden weather changes, “warm spells” or “cold spells” did not affect the outcome of critically ill patients.

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