scholarly journals Incidence and Risk Factors for Delirium among Mechanically Ventilated Patients in an African Intensive Care Setting: An Observational Multicenter Study

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Arthur Kwizera ◽  
Jane Nakibuuka ◽  
Lameck Ssemogerere ◽  
Charles Sendikadiwa ◽  
Daniel Obua ◽  
...  
Keyword(s):  
Mental Illness ◽  
Intensive Care ◽  
Endotracheal Tube ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Respiratory Acidosis ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
History Of ◽  
Ventilated Patients

Aim. Delirium is common among mechanically ventilated patients in the intensive care unit (ICU). There are little data regarding delirium among mechanically ventilated patients in Africa. We sought to determine the burden of delirium and associated factors in Uganda.Methods. We conducted a multicenter prospective study among mechanically ventilated patients in Uganda. Eligible patients were screened daily for delirium using the confusional assessment method (CAM-ICU). Comparisons were made usingt-test, chi-squares, and Fisher’s exact test. Predictors were assessed using logistic regression. The level of statistical significance was set atP<0.05.Results. Of 160 patients, 81 (51%) had delirium. Median time to onset of delirium was 3.7 days. At bivariate analysis, history of mental illness, sedation, multiorgan dysfunction, neurosurgery, tachypnea, low mean arterial pressure, oliguria, fevers, metabolic acidosis, respiratory acidosis, anaemia, physical restraints, marital status, and endotracheal tube use were significant predictors. At multivariable analysis, having a history of mental illness, sedation, respiratory acidosis, higher PEEP, endotracheal tubes, and anaemia predicted delirium.Conclusion. The prevalence of delirium in a young African population is lower than expected considering the high mortality. A history of mental illness, anaemia, sedation, endotracheal tube use, and respiratory acidosis were factors associated with delirium.

scholarly journals Prevalence and predictors of an out-of-range cuff pressure of endotracheal tube in mechanically ventilated patients in a teaching hospital in Iran

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Hamidreza Hemmati ◽  
Shahrzad Izadi ◽  
Setareh Soltani ◽  
Fatemeh Aghamohammadlou ◽  
Majid Mirmohammadkhani
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Endotracheal Tube ◽  
Teaching Hospital ◽  
High Pressures ◽  
Cuff Pressure ◽  
Normal Range ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ventilated Patients

Background: The study aimed to investigate the out-of-range cuff pressure of endotracheal tube in mechanically ventilated patients. Methodology: This cross-sectional study was performed in Semnan, Iran in 2019. The cuff pressure was measured in patients aged over 18 years who were intubated for at least 24 hours. Out-of-range pressure was defined as a pressure of < 20 cmH2O or > 30 cmH2O. A multiple logistic regression model was used for analysis. Results: Of 222 cases, 67 (30.2%) had cuff pressure in the normal range and 155 (69.8%) were not in the normal range; 41 (18.5%) and 114 (51.4%) had low and high pressures. The two groups were not significantly different in terms of age and gender. Longer mechanical ventilation (p = 0.004) and hospitalization place (p = 0.001) were the two factors that had a relationship with the out-of-range pressure. The probability of out-of-range pressure was significantly higher in the cardiac (p = 0.001, OR = 6.91) and internal medicine (p = 0.008, OR = 4.61), compared to the emergency intensive care unit. Conclusion: The authorities should take into consideration some important factors, such as the lack of instructions in hospital units, lack of proficiency for correct measurement, deficient required facilities, and not using the facilities for regular monitoring. Keywords: Mechanical Ventilation, Endotracheal Intubation, Airway Management, Pressure. Citation: Hemmati H, Izadi S, Soltani S, Aghamohammadlou F, Mirmohammadkhani M. Prevalence and predictors of an out-of-range cuff pressure of endotracheal tube in mechanically ventilated patients in a teaching hospital in Iran. Anaesth. pain intensive care 2020;24(5): Received: 20 June 2020, Reviewed: 24, 28 June 2020, Accepted: 1 July 2020

scholarly journals The ethical concerns of seeking consent from critically ill, mechanically ventilated patients for research – A matter of possessing capacity or surrogate insight

2018 ◽  
Vol 13 (3) ◽  
pp. 107-111 ◽  
Author(s):  
Avelino C Verceles ◽  
Waqas Bhatti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Informed Consent ◽  
Critically Ill ◽  
Ethical Issues ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ethical Concerns ◽  
Multiple Factors ◽  
Ventilated Patients

Conducting clinical research on subjects admitted to intensive care units is challenging, as they frequently lack the capacity to provide informed consent due to multiple factors including intensive care unit acquired delirium, coma, the need for sedation, or underlying critical illness. However, the presence of one or more of these characteristics does not automatically designate a potential subject as lacking capacity to provide their own informed consent. We review the ethical issues involved in obtaining informed consent for medical research from mechanically ventilated, critically ill patients, in addition to the concerns that may arise when a legally authorized representative is asked to provide informed consent on behalf of these patients.

Sign in / Sign up

Export Citation Format

Share Document