scholarly journals Do heart and respiratory rate variability improve prediction of extubation outcomes in critically ill patients?

Critical Care ◽  
2014 ◽  
Vol 18 (2) ◽  
pp. R65 ◽  
Author(s):  
Andrew JE Seely ◽  
Andrea Bravi ◽  
Christophe Herry ◽  
Geoffrey Green ◽  
André Longtin ◽  
...  
Critical Care ◽  
2014 ◽  
Vol 18 (6) ◽  
Author(s):  
Andrew JE Seely ◽  
◽  
Andrea Bravi ◽  
Christophe Herry ◽  
Geoffrey Green ◽  
...  

1987 ◽  
Vol XXXI (4) ◽  
pp. 221
Author(s):  
B. KRIEGER ◽  
D. FEINERMAN ◽  
A. ZARON ◽  
F. BIZOUSKY

2020 ◽  
Vol 10 (6) ◽  
Author(s):  
Poupak Rahimzadeh ◽  
Hamid Reza Faiz ◽  
Reza Farahmandrad ◽  
Babak Hassanlouei ◽  
Azadeh Habibi ◽  
...  

Background: World Health Organization (WHO) declared that the outbreak of COVID-19 constituted a public health emergency of global concern. Objectives: Owing to limited data on critically ill patients admitted to ICU, we aimed to describe the clinical characteristics and prognosis of these patients based on ventilatory variables and clinical features. Methods: In this retrospective study, 45 critically ill patients with laboratory-confirmed COVID-19 who were admitted to Intensive Care Unit (ICU) wards of the hospital from April 8 to May 9, 2020, were enrolled. Medical files of the patients were reviewed, and demographic and clinical characteristics, laboratory data, lung CT scan findings, causes of intubation, and outcomes of the patients were all collected. Results: The median age of the patients was 67 years (range 22 to 91), 64% were men, and hypertension was the most common comorbidity. History of close contact with previously confirmed patients was positive in 62.2% of the patients. The mean time from symptom onset to hospital admission was 5.98 ± 2.93 days. The most common symptoms at the onset of illness were dyspnea (95.6%), and gastrointestinal symptoms (22.2%) were rare. The average length of the intubation was 4.84 ± 3.28 days. The distribution of intubation causes in the deceased patients was significantly more than the recovered patients (P = 0.031). The mean score of lung CT involvement in deaths (370.26 ± 207.50) was significantly higher than the recovered patients (235.71 ± 81.21) (P = 0.042). Length of the intubation had a statistically direct correlation with respiratory rate (P = 0.03). Conclusions: Most of the critically ill patients admitted to ICU were older men and had poor outcomes with a high mortality rate. Furthermore, the score of chest CT involvement and respiratory rate are important prognostic factors in determining the severity of the illness, requiring ventilatory support, and outcome.


2021 ◽  
Vol 17 (8) ◽  
pp. 73-80
Author(s):  
V.I. Trykhlib ◽  
N.R. Tsiurak ◽  
K.P. Beliaeva ◽  
T.I. Lysenko ◽  
A.O. Yeroshenko ◽  
...  

The article presents a review of the literature sources and results of a personal study. It was found that in our group, there were more persons aged 18–30 years among those who were in inpatient treatment, and among those who were treated in the ICU, the patients were aged 60 years or over. On average, patients who were treated in the ICU were admitted on the 6th day of illness. Most patients complained of dry or unproductive cough, moderate general weakness. Relatively more often moderate general weakness was registered in patients with a moderate course, and moderate and pronounced was typical for patients with a severe course (p < 0.05). Dyspnea was predominantly found in severely ill patients (in one-third of patients during exercise, in 17.7 % patients at rest). In patients with a non-serious course, a small number of patients had dyspnea on exertion (4.3 to 12.1 %). On admission, the average temperature was within normal or subfebrile, which predominated in patients with a moderate course (p < 0.05). With a mild course, half of the patients had a temperature within the normal range. Febrile fever was more often registered in the moderate and severe course. Pyretic body temperature was most typical for a severe course (p < 0.05). It is noteworthy that even in those patients who were treated in the intensive care unit, at admission a quarter of the patients had a normal temperature, and 41.2 % — subfebrile. On ave-rage, the duration of fever before admission in critically ill patients was 5 days, and in those who died — 2 days. Dry cough was significantly more common in severe patients (p < 0.05). In the mild course, only one-fifth of patients complained of dry or unproductive cough. In the moderate course, the dry or unproductive cough was symptomatic for one-third of patients. There was no significant difference in the frequency of complaints of sore throat (p > 0.05). On average, a respiratory rate on admission in critically ill patients did not differ between those who survived and those who died, while those who died more often presented with a respiratory rate of 30/min or more, tachycardia, and more reduced saturation values.


Author(s):  
Thomas A Carmo ◽  
Isabella B Ferreira ◽  
Rodrigo C Menezes ◽  
Gabriel P Telles ◽  
Matheus L Otero ◽  
...  

Abstract Background Severity stratification scores developed in intensive care units (ICUs) are used in interventional studies to identify the most critically ill. Studies that evaluate accuracy of these scores in ICU patients admitted with pneumonia are lacking. This study aims to determine performance of severity scores as predictors of mortality in critically ill patients admitted with pneumonia. Methods Prospective cohort study in a general ICU in Brazil. ICU severity scores (Simplified Acute Physiology Score 3 [SAPS 3] and Sepsis-Related Organ Failure Assessment [qSOFA]), prognostic scores of pneumonia (CURB-65 [confusion, urea, respiratory rate, blood pressure, age] and CRB-65 [confusion, respiratory rate, blood pressure, age]), and clinical and epidemiological variables in the first 6 hours of hospitalization were analyzed. Results Two hundred patients were included between 2015 and 2018, with a median age of 81 years (interquartile range, 67–90 years) and female predominance (52%), primarily admitted from the emergency department (65%) with community-acquired pneumonia (CAP, 80.5%). SAPS 3, CURB-65, CRB-65,and qSOFA all exhibited poor performance in predicting mortality. Multivariate regression identified variables independently associated with mortality that were used to develop a novel pneumonia-specific ICU severity score (Pneumonia Shock score) that outperformed SAPS 3, CURB-65, and CRB-65. The Shock score was validated in an external multicenter cohort of critically ill patients admitted with CAP. Conclusions We created a parsimonious score that accurately identifies patients with pneumonia at highest risk of ICU death. These findings are critical to accurately stratify patients with severe pneumonia in therapeutic trials that aim to reduce mortality.


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