scholarly journals Postanoxic Burst Suppression Electroencephalogram in a Comatose Child Associated with Spontaneous Eyelid Opening

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
John R. Crawford
Keyword(s):  
Intensive Care ◽  
Poor Prognosis ◽  
Burst Suppression ◽  
Pathophysiological Mechanism ◽  
Rare Phenomenon ◽  
Anoxic Injury ◽  
Eye Opening ◽  
Insight Into

Spontaneous eye opening associated with burst suppression electroencephalogram has been reported in adults following postanoxic injury. Previous reports have correlated the onset of epileptiform bursts with the eye opening and attribute it to a brainstem-release phenomenon associated with poor prognosis. The author presents a case of a 12-year-old boy with burst suppression electroencephalogram following severe anoxic injury where the eye opening occurred at the conclusion of the bursts that has never been previously reported. These electroencephalographic findings are important for intensive care physicians to recognize and may provide further insight into the pathophysiological mechanism of this rare phenomenon.

scholarly journals Clinical approach to burst-suppression pattern in intensive care unit: basic and updates

2020 ◽  
Vol 8 (36) ◽  
pp. 61-65
Author(s):  
Jie Pan ◽  
Amputch Karukote ◽  
Eri Shoji
Keyword(s):  
Intensive Care ◽  
Poor Prognosis ◽  
High Amplitude ◽  
Refractory Status Epilepticus ◽  
Burst Suppression ◽  
Clinical Approach ◽  
General Anesthetics ◽  
Refractory Status ◽  
Clinical Conditions ◽  
Eeg Pattern

A burst-suppression pattern is an electroencephalographic pattern characterized by a quasi-periodic high amplitude “burst” alternating with periods of low or flatline “suppression.” Recognizing and understanding this pattern is helpful for clinical management in intensive care units. Pathological burst-suppression is commonly seen in post cardiac arrest comatose patients. It can also be induced by anesthetics or hypothermia. A burst-suppression pattern in anoxic brain injury generally predicts a poor prognosis; however, exceptions do occur. Inducing burst-suppression by general anesthetics can be used to abort super-refractory status epilepticus. This article will discuss this unique EEG pattern, including basic mechanisms, related clinical conditions, and recent research updates.

Adapting the Six-Part Storymaking Method for use with siblings of infants on the neonatal intensive care unit

2020 ◽  
Vol 7 (2) ◽  
pp. 223-242
Author(s):  
Rebecca Ann Versaci
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Emotional Expression ◽  
Neonatal Intensive Care ◽  
Well Being ◽  
Hospital Staff ◽  
Case Vignette ◽  
Profound Influence ◽  
Insight Into

When an infant is hospitalized on the neonatal intensive care unit (NICU) it can have a profound influence on the psychosocial well-being of the infant and their older sibling(s). This article presents a case vignette of the use of the Six-Part Storymaking Method with the sibling of an infant hospitalized on the NICU. The article reviews the therapeutic aims and benefits of the intervention, including: supporting emotional expression, providing opportunity for the sibling to be deeply witnessed by caregivers, therapist and hospital staff, empowering the sibling to inhabit the big sibling role and fostering insight into the sibling’s thoughts, feelings and behaviours as related to their infant’s hospitalization. Considerations for facilitation and assessment are also discussed.

A promising predictor of mortality— A cohort study (Preprint)

2021 ◽  
Author(s):  
Ji Ha Ling
Keyword(s):  
Intensive Care ◽  
Poor Prognosis ◽  
Medical Information ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Hazards Model ◽  
Clinical Biomarker ◽  
Secondary Result

UNSTRUCTURED Severe inflammation leads to poor prognosis for intensive care unit hospitalized patients. The is a biomarker used to monitor inflammation and immune response, which can predict poor prognosis of various diseases. However, it is unclear whether NLR is associated with all-cause mortality in ICU patients. This study investigated the correlation between MLR and ICU results. Extract clinical data from Medical Information Mart for Intensive Care III (MIMIC-III) database, which contains health data of more than 50,000 patients. The main result was 30-day mortality, and the secondary result was 90-day mortality. Use the Cox proportional hazards model to reveal the association between MLR and results. Multivariable analyses were used to control for confounders. NLR is a promising clinical biomarker, which can be used as a available predictor of ICU mortality.

scholarly journals P012: Mortality rate of cancer patients by type presenting to the intensive care unit with sepsis.

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S67
Author(s):  
S. Beckett ◽  
E. Karreman ◽  
R. Hughes
Keyword(s):  
Logistic Regression ◽  
Intensive Care ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Solid Tumors ◽  
Predictive Factors ◽  
Poor Prognosis ◽  
Solid Tumours ◽  
Icu Mortality ◽  
Icu Admission

Introduction: Sepsis in cancer patients is associated with higher mortality rates than non-cancer patients. As a whole, hematological or solid tumor cancers have not demonstrated a prognostic link to sepsis survival rates in intensive care units (ICU), however poor-prognosis solid tumours (less than 25% 5-year survival) have not been investigated. This study examined ICU mortality rate and its predictive factors of patients with sepsis and poor-prognosis solid tumors in comparison to patients with higher prognosis solid tumours. Methods: A 6-year retrospective chart review of 79 patients with sepsis and solid tumour cancers and/or metastatic cancers admitted to the ICU was conducted. Information regarding mortality rate within 14 days, length of ICU stay, incidence of intubation, and other primary reasons for ICU admission was collected. Data was analysed using logistic regression. Results: Logistic regression results showed intubation as the only significant factor contributing to patient mortality (p < .001), with the odds of mortality being 12.3 times higher for intubated than non-intubated patients. Five-year cancer survival rate was the second best predictor (p = .082), while age, sex, and metastasis were also not significant predictive factors for survival. Intubated patients with poor prognosis cancers had the lowest survival chance as further indicated by the 16 patients who met this criterion, of which 14 died within two weeks of ICU admission. Conclusion: The fact that poor prognosis cancers in sepsis were not significantly predictive of ICU mortality supports current literature regarding solid tumors in general, while intubation being a significant predictor for mortality in patients with sepsis and cancer regardless of type builds on previous research. A limitation of this study is the relative low number of included cases with poor-prognosis cancer types. Further evaluation is needed to understand the implications of our results for end-of-life care and ICU admission for patients with these characteristics.

Coping with Poor Prognosis in the Pediatric Intensive Care Unit

1984 ◽  
pp. 221-234
Author(s):  
David A. Waller ◽  
I. David Todres ◽  
Ned H. Cassem ◽  
Ande Anderten
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Poor Prognosis ◽  
Pediatric Intensive Care

scholarly journals Behavioral Pain Indicators in Patients with Traumatic Brain Injury Admitted to an Intensive Care Unit

2018 ◽  
Vol 7 (4) ◽  
pp. 197-203 ◽  
Author(s):  
Roghieh Nazari ◽  
Saeed Pahlevan Sharif ◽  
Kelly A Allen ◽  
Hamid Sharif Nia ◽  
Bit-Lian Yee ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Injury Severity ◽  
Repeated Measure ◽  
Neck Stiffness ◽  
Significant Difference ◽  
Eye Opening ◽  
Different Levels

Introduction: A consistent approach to pain assessment for patients admitted to intensive care unit (ICU) is a major difficulty for health practitioners due to some patients’ inability, to express their pain verbally. This study aimed to assess pain behaviors (PBs) in traumatic brain injury (TBI) patients at different levels of consciousness. Methods: This study used a repeated-measure, within-subject design with 35 patients admitted to an ICU. The data were collected through observations of nociceptive and non-nociceptive procedures, which were recorded through a 47-item behavior-rating checklist. The analyses were performed by SPSS ver.13 software. Results: The most frequently observed PBs during nociceptive procedures were facial expression levator contractions (65.7%), sudden eye openings (34.3%), frowning (31.4%), lip changes (31.4%), clear movement of extremities (57.1%), neck stiffness (42.9%), sighing (31.4%), and moaning (31.4%). The number of PBs exhibited by participants during nociceptive procedures was significantly higher than those observed before and 15 minutes after the procedures. Also, the number of exhibited PBs in patients during nociceptive procedures was significantly greater than that of exhibited PBs during the non-nociceptive procedure. The results showed a significant difference between different levels of consciousness and also between the numbers of exhibited PBs in participants with different levels of traumatic brain injury severity. Conclusion: The present study showed that most of the behaviors that have been observed during painful stimulation in patients with traumatic brain injury included facial expressions, sudden eye opening, frowning, lip changes, clear movements of extremities, neck stiffness, and sighing or moaning.

scholarly journals Early Plasma Osmolality Levels and Clinical Outcomes in Children Admitted to the Pediatric Intensive Care Unit: A Single-Center Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Huabin Wang ◽  
Zhongyuan He ◽  
Jiahong Li ◽  
Chao Lin ◽  
Huan Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Regression Model ◽  
Clinical Outcomes ◽  
Poor Prognosis ◽  
Logistic Regression Model ◽  
Plasma Osmolality ◽  
Pediatric Intensive Care ◽  
Linear Spline

Objective: Identifying high-risk children with a poor prognosis in pediatric intensive care units (PICUs) is critical. The aim of this study was to assess the predictive value of early plasma osmolality levels in determining the clinical outcomes of children in PICUs.Methods: We retrospectively assessed critically ill children in a pediatric intensive care database. The locally weighted-regression scatter-plot smoothing (LOWESS) method was used to explore the approximate relationship between plasma osmolality and in-hospital mortality. Linear spline functions and stepwise expansion models were applied in conjunction with a multivariate logistic regression to further analyze this relationship. A subgroup analysis by age and complications was performed.Results: In total, 5,620 pediatric patients were included in this study. An approximately “U”-shaped relationship between plasma osmolality and mortality was detected using LOWESS. In the logistic regression model using a linear spline function, plasma osmolality ≥ 290 mmol/L was significantly associated with in-hospital mortality [odds ratio (OR) 1.020, 95% confidence interval (CI) 1.010–1.031], while plasma osmolality <290 mmol/L was not significantly associated with in-hospital mortality (OR 0.990, 95% CI 0.966–1.014). In the logistic regression model with plasma osmolality as a tri-categorical variable, only high osmolality was significantly associated with in-hospital mortality (OR 1.90, 95% CI 1.38–2.64), whereas low osmolality was not associated with in-hospital mortality (OR 1.28, 95% CI 0.84–1.94). The interactions between plasma osmolality and age or complications were not significant.Conclusion: High osmolality, rather than low osmolality, can predict a poor prognosis in children in PICUs.

scholarly journals Nanopore sequencing provides rapid and reliable insight into microbial profiles of Intensive Care Units

2021 ◽  
Author(s):  
Guilherme Marcelino Viana de Siqueira ◽  
Felipe Marcelo Pereira-dos-Santos ◽  
Rafael Silva-Rocha ◽  
Maria-Eugenia Guazzaroni
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Nanopore Sequencing ◽  
Accurate Identification ◽  
Complex Samples ◽  
Healthcare Settings ◽  
Long Read ◽  
Single Use ◽  
Sequencing Platforms ◽  
Insight Into

Fast and accurate identification of pathogens is an essential task in healthcare settings. Next generation sequencing platforms such as Illumina have greatly expanded the capacity with which different organisms can be detected in hospital samples, and third-generation nanopore-driven sequencing devices such as Oxford Nanopore's minION have recently emerged as ideal sequencing platforms for routine healthcare surveillance due to their long-read capacity and high portability. Despite its great potential, protocols and analysis pipelines for nanopore sequencing are still being extensively validated. In this work, we assess the ability of nanopore sequencing to provide reliable community profiles based on 16S rRNA sequencing in comparison to traditional Illumina platforms using samples collected from Intensive Care Units from a hospital in Brazil. While our results point that lower throughputs may be a shortcoming of the method in more complex samples, we show that the use of single-use Flongle flowcells in nanopore sequencing runs can provide insightful information on the community composition in healthcare settings.

Physician Attitudes in Romania toward Withholding and Withdrawal of Intensive Care for Infants with Very Poor Prognosis

2013 ◽  
Vol 31 (06) ◽  
pp. 477-482
Author(s):  
Anca Bivoleanu ◽  
Maria Stamatin ◽  
Silvia-Maria Stoicescu ◽  
Edward Bell
Keyword(s):  
Intensive Care ◽  
Poor Prognosis ◽  
Physician Attitudes

scholarly journals COVID-19 in patients with heart failure: the new and the old epidemic

2020 ◽  
Vol 97 (1145) ◽  
pp. 175-179
Author(s):  
Nicolò Sisti ◽  
Serafina Valente ◽  
Giulia Elena Mandoli ◽  
Ciro Santoro ◽  
Carlotta Sciaccaluga ◽  
...  
Keyword(s):  
Heart Failure ◽  
Intensive Care ◽  
Cardiovascular Diseases ◽  
Chronic Heart Failure ◽  
Poor Prognosis ◽  
Myocardial Injury ◽  
Careful Monitoring ◽  
Clinical Challenge ◽  
Patients With Heart Failure ◽  
Acute Decompensation

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread in nearly 200 countries in less than 4 months since its first identification; accordingly, the coronavirus disease 2019 (COVID 2019) has affirmed itself as a clinical challenge. The prevalence of pre-existing cardiovascular diseases in patients with COVID19 is high and this dreadful combination dictates poor prognosis along with the higher risk of intensive care mortality. In the setting of chronic heart failure, SARS-CoV-2 can be responsible for myocardial injury and acute decompensation through various mechanisms. Given the clinical and epidemiological complexity of COVID-19, patiens with heart failure may require particular care since the viral infection has been identified, considering an adequate re-evaluation of medical therapy and a careful monitoring during ventilation.

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