scholarly journals The Value of Admission Serum IL-8 Monitoring and the Correlation with IL-8 (-251A/T) Polymorphism in Critically Ill Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ayman Abd Al-Maksoud Yousef ◽  
Ghada Abdulmomen Suliman ◽  
Maaly Mohamed Mabrouk
Keyword(s):  
Genetic Polymorphism ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mutant Allele ◽  
Mean Value ◽  
Sepsis Group ◽  
Positive Correlation ◽  
Complicated Process ◽  
Major Variation ◽  
The Mean

Background. The clinical management of sepsis is a highly complicated process. Disruption of the immune system explains in part the major variation in sepsis outcome. IL-8 is a proinflammatory cytokine, genetic polymorphism of this cytokine could explain the outcome of sepsis. The present study was conducted to determine the value of serum IL-8 monitoring and its (-251A/T) genetic polymorphism in critically ill patients. Patients and Methods. 180 critically ill patients were allocated into two groups, 90 septic patients (sepsis group) and 90 nonseptic patients (SIRS group). Admission serum IL-8 and its (-251A/T) mutant allele were detected. Results. The admission mean value of serum IL-8 was significantly elevated in sepsis group. In both groups, the mean value of serum IL-8 in nonsurvived patients and patients with IL-8 (-251A/T) mutant allele was significantly higher. A positive correlation of survival and IL-8 (-251A/T) mutant allele was detected in both groups. The serum IL-8 distinguished wild from IL-8 (-251A/T) mutant allele at a cut-off value of 600 pg/mL. Conclusion. The admission mean value of serum IL-8 was significantly elevated in septic, nonsurvived, and patients with IL-8 (-251A/T) mutant alleles. A positive correlation of survival and IL-8 (-251A/T) mutant allele patients was detected.

scholarly journals Factors influencing antibiotic treatment cost and outcome in critically ill patients: A “real-life” study

2014 ◽  
Vol 71 (12) ◽  
pp. 1102-1108 ◽  
Author(s):  
Aneta Peric ◽  
Maja Surbatovic ◽  
Sandra Vezmar-Kovacevic ◽  
Mirjana Antunovic ◽  
Milic Veljovic ◽  
...  
Keyword(s):  
Critically Ill ◽  
Antibiotic Treatment ◽  
Antimicrobial Therapy ◽  
Critically Ill Patients ◽  
Treatment Cost ◽  
Intensive Therapy ◽  
Sepsis Group ◽  
Factors Influencing ◽  
The Mean ◽  
The Cost

Background/Aim. Critically ill patients are at very high risk of developing severe infections in intensive care units (ICUs). Procalcitonin (PCT) levels are eleveted in the circulation in patients with bacterial sepsis and PCT might be useful in guiding antibiotic treatment. The aim of this study was to estimate factors influencing patients survival and treatment cost in ICU with special emphasis on the impact of PCT serum levels use in guiding antimicrobial therapy. Methods. The study was conducted from August 2010 to May 2012 in the Intensive Therapy Unit, Clinic of Anesthesiology and Intensive Therapy, Military Medical Academy (MMA), Belgrade, Serbia. All adult critically ill patients with sepsis and/or trauma admitted in the ICU were included in the study. This study included only the cost of antimicrobial therapy in the ICU and the cost for PCT analysis. We used prices valid in the MMA for the year 2012. PCT in serum was measured by homogeneous immunoassay on a Brahms Kryptor analyzer. Results. A total of 102 patients were enrolled. The mean patients age was 55 ? 19 years and 61.8% of patients were male. The mean length of stay (LOS) in the ICU was 12 ? 21 days. There was a statistically significant difference (p < 0.001) between the sepsis and trauma group regarding outcome (higher mortality rate was in the sepsis group, particularly in the patients with peritonitis who were mostly women). The patients younger than 70 years had better chance of survival. LOS, the use of carbapenems and PCT-measurement influenced the cost of therapy in the ICU. Conclusions. The obtained results show that age, the diagnosis and gender were the main predictors of survival of critically ill patients in the ICU. The cost of ICU stay was dependent on LOS, use of carbapenems and PCT measurement although the influence of these three factors on the outcome in the patients did not reach a statistical significance.

scholarly journals The laboratory findings and different COVID-19 severities: a systematic review and meta-analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Erfan Kazemi ◽  
Reihane Soldoozi Nejat ◽  
Fatemeh Ashkan ◽  
Hossein Sheibani
Keyword(s):  
Systematic Review ◽  
Platelet Count ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Lymphocyte Count ◽  
Leukocyte Count ◽  
Mean Value ◽  
The Other ◽  
Invasive Ventilation ◽  
Laboratory Findings

Abstract Background Abnormal laboratory findings are common in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this systematic review was to investigate the effect of the level of some laboratory factors (C-reactive protein (CRP), creatinine, leukocyte count, hemoglobin, and platelet count) on the severity and outcome of coronavirus disease 2019 (COVID-19). Methods We searched PubMed, Web of Science, Scopus, and Google Scholar. We collected the articles published before May 26, 2020. We gathered the laboratory factors in groups of patients with COVID-19, and studied the relation between level of these factors with severity and outcome of the disease. Results Mean CRP level, creatinine, hemoglobin, and the leukocytes count in the critically ill patients were significantly higher than those of the other groups (non-critical patients); mean CRP = 54.81 mg/l, mean creatinine = 86.82 μmol/l, mean hemoglobin = 144.05 g/l, and mean leukocyte count = 7.41 × 109. The lymphocyte count was higher in patients with mild/moderate disease (mean: 1.32 × 109) and in the invasive ventilation group (mean value of 0.72 × 109), but it was considerably lower than those of the other two groups. The results showed that the platelet count was higher in critically ill patients (mean value of 205.96 × 109). However, the amount was lower in the invasive ventilation group compared with the other groups (mean level = 185.67 × 109). Conclusion With increasing disease severity, the leukocyte count and the level of CRP increase significantly and the lymphocyte count decreases. There seems to be a significant relation between platelet level, hemoglobin, and creatinine level with severity of the disease. However, more studies are required to confirm this.

scholarly journals Procalcitonin Clearance for Early Prediction of Survival in Critically Ill Patients with Severe Sepsis

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mohd Basri Mat Nor ◽  
Azrina Md Ralib
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Prospective Observational Study ◽  
Small Sample Size ◽  
Small Sample ◽  
Sepsis Group ◽  
Single Centre ◽  
Dynamic Changes ◽  
Prediction Of Survival ◽  
Single Centre Study

Introduction. Serum procalcitonin (PCT) diagnosed sepsis in critically ill patients; however, its prediction for survival is not well established. We evaluated the prognostic value of dynamic changes of PCT in sepsis patients.Methods. A prospective observational study was conducted in adult ICU. Patients with systemic inflammatory response syndrome (SIRS) were recruited. Daily PCT were measured for 3 days. 48 h PCT clearance (PCTc-48) was defined as percentage of baseline PCT minus 48 h PCT over baseline PCT.Results. 95 SIRS patients were enrolled (67 sepsis and 28 noninfectious SIRS). 40% patients in the sepsis group died in hospital. Day 1-PCT was associated with diagnosis of sepsis (AUC 0.65 (95% CI, 0.55 to 0.76)) but was not predictive of mortality. In sepsis patients, PCTc-48 was associated with prediction of survival (AUC 0.69 (95% CI, 0.53 to 0.84)). Patients with PCTc-48 > 30% were independently associated with survival (HR 2.90 (95% CI 1.22 to 6.90)).Conclusions. PCTc-48 is associated with prediction of survival in critically ill patients with sepsis. This could assist clinicians in risk stratification; however, the small sample size, and a single-centre study, may limit the generalisability of the finding. This would benefit from replication in future multicentre study.

Abstract 15293: Noninvasive Echocardiographic Cardiac Power Output Predicts Mortality in Cardiac Intensive Care Unit Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Barry Burstein ◽  
Vidhu Anand ◽  
Bradley Ternus ◽  
Meir Tabi ◽  
Nandan S Anavekar ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Power Output ◽  
Critically Ill Patients ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Power ◽  
The Mean ◽  
Cardiac Intensive Care

Introduction: A low cardiac power output (CPO), measured invasively, identifies critically ill patients at increased risk of mortality. CPO can also be measured non-invasively with transthoracic echocardiography (TTE), although prognostic data in critically ill patients is not available. Hypothesis: Reduced CPO measured by TTE is associated with increased hospital mortality in cardiac intensive care unit (CICU) patients. Methods: Using a database of CICU patients admitted between 2007 and 2018, we identified patients with TTE within one day (before or after) of CICU admission who had data necessary for calculation of CPO. Multivariable logistic regression determined the relationship between CPO and adjusted hospital mortality. Results: We included 5,585 patients with a mean age of 68.3±14.8 years, including 36.7% females. Admission diagnoses included acute coronary syndrome (ACS) in 57%, heart failure (HF) in 50%, cardiac arrest (CA) in 12%, and cardiogenic shock (CS) in 13%. The mean left ventricular ejection fraction (LVEF) was 47±16%, and the mean CPO was 1.0±0.4 W. CPO was inversely associated with the risk of hospital mortality (Figure A), including among patients with ACS, HF, and CS (Figure B). On multivariable analysis, lower CPO was associated with higher hospital mortality (OR 0.96 per 0.1 W, 95% CI 0.0.93-0.99, p=0.03). Hospital mortality was highest in patients with low CPO coupled with reduced LVEF, increased vasopressor requirements, or higher admission lactate. Hospital mortality was higher among patients with a CPO <0.6 W (adjusted OR 1.57, 95% CI 1.13-2.19, p = 0.007), particularly in the presence of admission lactate level >4 mmol/L (50.9%). Conclusions: Echocardiographic CPO was inversely associated with hospital mortality in CICU patients, particularly among patients with increased lactate and vasopressor requirements. Routine measurement of CPO provides important information beyond LVEF and should be considered in CICU patients.

scholarly journals A novel procalcitonin-based score for detecting sepsis among critically ill patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245748
Author(s):  
Tung-Lin Tsui ◽  
Ya-Ting Huang ◽  
Wei-Chih Kan ◽  
Mao-Sheng Huang ◽  
Min-Yu Lai ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Validation Cohort ◽  
Multivariate Logistic Regression Analysis ◽  
Sepsis Group ◽  
C Reactive Protein ◽  
Multivariate Logistic Regression ◽  
Reactive Protein

Background Procalcitonin (PCT) has been widely investigated as an infection biomarker. The study aimed to prove that serum PCT, combining with other relevant variables, has an even better sepsis-detecting ability in critically ill patients. Methods We conducted a retrospective cohort study in a regional teaching hospital enrolling eligible patients admitted to intensive care units (ICU) between July 1, 2016, and December 31, 2016, and followed them until March 31, 2017. The primary outcome measurement was the occurrence of sepsis. We used multivariate logistic regression analysis to determine the independent factors for sepsis and constructed a novel PCT-based score containing these factors. The area under the receiver operating characteristics curve (AUROC) was applied to evaluate sepsis-detecting abilities. Finally, we validated the score using a validation cohort. Results A total of 258 critically ill patients (70.9±16.3 years; 55.4% man) were enrolled in the derivation cohort and further subgrouped into the sepsis group (n = 115) and the non-sepsis group (n = 143). By using the multivariate logistic regression analysis, we disclosed five independent factors for detecting sepsis, namely, “serum PCT level,” “albumin level” and “neutrophil-lymphocyte ratio” at ICU admission, along with “diabetes mellitus,” and “with vasopressor.” We subsequently constructed a PCT-based score containing the five weighted factors. The PCT-based score performed well in detecting sepsis with the cut-points of 8 points (AUROC 0.80; 95% confidence interval (CI) 0.74–0.85; sensitivity 0.70; specificity 0.76), which was better than PCT alone, C-reactive protein and infection probability score. The findings were confirmed using an independent validation cohort (n = 72, 69.2±16.7 years, 62.5% men) (cut-point: 8 points; AUROC, 0.79; 95% CI 0.69–0.90; sensitivity 0.64; specificity 0.87). Conclusions We proposed a novel PCT-based score that performs better in detecting sepsis than serum PCT levels alone, C-reactive protein, and infection probability score.

scholarly journals CORRELATION BETWEEN BODY MASS INDEX AND MICROALBUMINURIA IN ESSENTIAL HYPERTENSIVE ADULTS

2020 ◽  
pp. 54-56
Author(s):  
IRENGBAM SUSUPRIYA DEVI ◽  
GLADYS RAI ◽  
V. P. S PUNIA ◽  
MANOJ KUMAR NANDKEOLIAR
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Early Morning ◽  
Mean Value ◽  
Control Group ◽  
Inclusion Criteria ◽  
Hypertensive Patients ◽  
Positive Correlation ◽  
Arterial Blood ◽  
The Mean

Objective: This study aimed to find the correlation between body mass index (BMI) and microalbuminuria (MA) in essential hypertensive adults. Methods: This study included 35 essential hypertensive patients in the 18–65 years of age group, who satisfied the inclusion criteria. Arterial blood pressure was measured by a sphygmomanometer and the first voided early morning urine sample was collected for the estimation of microalbumin. Results: The mean age of the population studied was 49±11.08 in essential hypertensive patients and 46.89±11.10 in the control group. The mean value of BMI in the hypertensive group was found to be 27.59±5.45. In the present study, the mean value of microalbumin in essential hypertensive patients was 20.95±16.96. A significant positive correlation between BMI and MA was observed in the study with p<0.001. Conclusion: Our study shows a positive correlation between BMI and MA. Therefore, this study will help in the early detection of renal injury and prevents its progression to renal failure by lifestyle and diet modifications.

Pharmacokinetics of Benzylpenicillin (Penicillin G) during Prolonged Intermittent Renal Replacement Therapy

Chemotherapy ◽  
2019 ◽  
Vol 64 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Vesa Cheng ◽  
Matthew Rawlins ◽  
Tim Chang ◽  
Emma Fox ◽  
John Dyer ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Penicillin G ◽  
Blood Samples ◽  
Staphylococcus Aureus Bacteremia ◽  
The Mean ◽  
Intermittent Renal Replacement Therapy

Prolonged intermittent renal replacement therapy (PIRRT) is an increasingly adopted method of renal replacement in critically ill patients. Like continuous renal replacement therapy, PIRRT can alter the pharmacokinetics (PK) of many drugs. In this setting, dosing data for antibiotics like benzylpenicillin are lacking. In order to enable clinicians to prescribe benzylpenicillin safely and effectively, knowledge of the effects of PIRRT on the plasma PK of benzylpenicillin is required. Herein, we describe the PK of benzylpenicillin in 2 critically ill patients on PIRRT for the treatment of penicillin-susceptible Staphylococcus aureus bacteremia complicated by infective endocarditis. Blood samples were taken for each patient taken over dosing periods during PIRRT and off PIRRT. Two-compartment PK models described significant differences in the mean clearance of benzylpenicillin with and without PIRRT (6.61 vs. 3.04 L/h respectively). We would suggest a benzylpenicillin dose of 1,800 mg (3 million units) every 6-h during PIRRT therapy as sufficient to attain PK/pharmacodynamic target.

In vivo Elimination of Clonidine by Continuous Venovenous Hemofiltration in Critically Ill Patients

2020 ◽  
Vol 49 (5) ◽  
pp. 622-626
Author(s):  
Huub L.A. van den Oever ◽  
Marieke Zeeman ◽  
Polina Nassikovker ◽  
Carmen Bles ◽  
Fred A.L. van Steveninck ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Continuous Venovenous Hemofiltration ◽  
Kidney Dysfunction ◽  
Sieving Coefficient ◽  
The Mean ◽  
Ventilated Patients

Background: Clonidine is an α2-agonist that is commonly used for sedation in the intensive care unit. When patients are on continuous venovenous hemofiltration (CVVH) in the presence of kidney dysfunction, the sieving coefficient of clonidine is required to estimate how much drug is removed by CVVH. In the present study, we measured the sieving coefficient of clonidine in critically ill, ventilated patients receiving CVVH. Methods: A total of 20 samples of plasma and ultrafiltrate of 3 patients on CVVH, using a standard 1.5 m2 polyacrylonitrile AN69 membrane, during continuous clonidine infusion were collected. After correction for the effect of predilution, we calculated the sieving coefficient for clonidine. Results: The mean sieving coefficient of clonidine was 0.52 (SD 0.097). Conclusion: Using a polyacrylonitrile AN69 membrane in a CVVH machine, the in vivo sieving coefficient of clonidine was 0.52.

scholarly journals Comparison between nurses' and families' opinion about priorities of immediate patient's family needs

2018 ◽  
Vol 9 (1) ◽  
pp. 113
Author(s):  
Intessar Mohamed Ahmad
Keyword(s):  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Time Frame ◽  
Medical Institute ◽  
Family Needs ◽  
The Family ◽  
The Mean ◽  
Individual Needs ◽  
Strongly Agree

Background and objective: Acute critical illness represents a crisis not just for the individual patient however conjointly for the members of the family. Moreover, the admission of the patient represents a sudden crisis allowing no time for its preparation. The responsibilities of critical care nurses extend beyond the patients in the intensive care unit (ICU) to incorporate the members of the family of these patients. Nurses are a primary resource for members of family of ICU patients and they are in a perfect position to assist patients’ members of the family in an applicable approach. For this reason, recognition of these needs by nursing personnel is very important for applying of holistic nursing care. The aims of this study were 1) Ranking the immediate needs of members of family of critically ill patients and nurses. 2) Comparing between nurses, and families, opinion regarding priorities of immediate patient's family needs using Critical Care Family Needs Inventory (CCFNI).Methods: This descriptive study was conducted at the general ICUs of Damanhour Medical Institute which has 15 beds, Damanhour chest hospital which has 7 beds and Itay Elbaroad General Hospital which has 11 beds. The three units have a total of 100 nurses. A questionnaire was used for data collection. It consisted of part one which comprised patient's condition whose families were studied participants, biosocial knowledge related to the members of family and part two which included CCFNI tool. The adapted CCFNI was translated into colloquial Arabic. Participant members of family were individually interviewed by the researcher. Members of family were required to answer each statement with strongly agree, agree, neutral, do not agree and strongly do not agree. The interview took approximately 45 to 60 minutes to be completed, and all interviews took place within the 72 hours' time frame of each patient's admission to the critical care unit. The nurses were approached and given the questionnaires to be filled in by themselves during handover, tea or lunch break.Results: Generally, families ranked their knowledge, proximity and comfort needs higher in importance than the nurses. Also, the knowledge and assurance needs were ranked above the needs for support, comfort, and proximity by our participating nurses and members of family. Moreover, the mean scores of knowledge, proximity, support and comfort needs for members of family were significantly higher than these for nurses. Out of 35 needs of the members of family in the CCFNI, there were no significant differences between the mean scores of the nurses and those of the members of family in 10 individual needs. Results show that the nurses were correct in 10 out of 35 members of family’ individual needs. The remaining mean scores from 25 individual needs showed significant differences between the nurses and actual family needs. Results show that did not meet all the specific family needs during the care of the critically ill patients. Results show that members of family scored significantly higher than nurses on 20 statements while, the nurses scored significantly higher than members of family on only 5 of the statements.Conclusions: Families considered that knowledge then assurance was the most important needs. While nurses considered that assurance then knowledge were the most important needs which indicate that nurses underestimated the needs of the family and family need may be inaccurately evaluated by heath care team and almost unmet. Furthermore, Members of family in this study considered the needs that bring comfort and support as less in priority needs.

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