scholarly journals Comparative study of two methods of weaning from mechanical ventilation in a cancer surgical intensive care unit

Critical Care ◽  
2007 ◽  
Vol 11 (Suppl 2) ◽  
pp. P172
Author(s):  
W Salem ◽  
N Fahmy
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Comparative Study ◽  
Surgical Intensive Care Unit ◽  
Weaning From Mechanical Ventilation ◽  
Surgical Intensive Care

scholarly journals Association of hidden fluid administration with development of fluid overload reveals opportunities for targeted fluid minimization

2020 ◽  
Vol 8 ◽  
pp. 205031212097946
Author(s):  
Trisha Branan ◽  
Susan E Smith ◽  
Andrea Sikora Newsome ◽  
Rebecca Phan ◽  
W Anthony Hawkins
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Fluid Overload ◽  
Binary Logistic Regression ◽  
Fluid Volume ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Poor Outcomes ◽  
The Impact

Background: Fluid overload is associated with poor outcomes, but mitigating its occurrence poses significant challenges. Objective: This study sought to assess the impact of hidden fluid volume on fluid overload. Methods: This study was a multi-center, retrospective evaluation of adults admitted to a medical or surgical intensive care unit for at least 72 h. Patients were divided into tertiles (low, moderate, and high) based on the hidden fluid volume received. Hidden fluids were defined as intravenous medications, line flushes, blood products, and enteral nutrition. The primary outcome was the incidence of fluid overload at intensive care unit (day 3). Secondary outcomes included mechanical-ventilation free days and association of hidden fluid volume with fluid overload, length of stay, and mortality. Results: A total of 219 (73 per tertile) were included, with hidden fluid volume comprising ⩽2500, 2501–4400, and >4400 mL in the low, moderate, and high tertiles, respectively. Incidence of fluid overload was significantly different across groups (low: 3%, moderate: 14%, high: 25%; p < 0.001). No difference existed in mechanical-ventilation free days or in-hospital mortality across tertiles. In binary logistic regression, hidden fluid volume received at 3 days was independently associated with fluid overload (odds ratio = 1.40, 95% confidence interval = 1.15–1.70). Conclusion: The volume of hidden fluid volume administered by intensive care unit day 3 independently predicted development of fluid overload.

scholarly journals Profile of Neurosurgical Patients in a Tertiary Level Intensive Care Unit in Nepal

2018 ◽  
Vol 16 (3) ◽  
pp. 336-339
Author(s):  
Subhash Prasad Acharya ◽  
Binita Bhattarai ◽  
Adheesh Bhattarai ◽  
Saurabh Pradhan ◽  
Mohan Raj Sharma
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Unit Mortality ◽  
Surgical Intensive Care Unit ◽  
Tertiary Level ◽  
Surgical Intensive Care ◽  
Mortality And Morbidity ◽  
Neurosurgical Patients ◽  
One Year

Background: Neurosurgery has developed as a separate specialty and neurosurgical patients are some of the most common admitted in the intensive care unit. The objective of the study was to study the profile of neurosurgical patients admitted in level III mixed, medical-surgical intensive care unit in a tertiary level teaching hospital in Nepal with the view to identify the causes of intensive care unit admission, types of neurosurgery performed, outcome of the patients, in terms of intensive care unit stay, mechanical ventilation days and mortality.Methods: A retrospective study was designed and all neurosurgical patients admitted to the intensive care unit of our center between 13 April 2017 and 13April 2018 (1st Baisakh 2074 to 30th Chaitra 2074) were enrolled in this study.Results: A total of 813 patients were admitted in ICU over a period of one year (2074 B.S.) of which 199 (24.48 %) were neurosurgical cases. Among these 170 (85.42%) cases were post-surgical, with 29 (14.58%) being pre-operative patients. One hundred forty nine patients (74.9%) were on mechanical ventilation. One hundred and thirty two (66.3%) patients improved and were transferred to a step down ward. Forty-three (22.5%) died in the intensive care unit, 14 (7.03%) left the hospital against medical advice and 9 (4.5%) patients expired after withdrawal of life support.Conclusions: Despite improved care over the recent years the mortality and morbidity of neurosurgical patients is high.Keywords: Intensive care unit; mortality; neurosurgery; outcome.

scholarly journals Risk Factors for Carbapenem Resistant Klebsiella pneumoniae Hospital Infection in the Intensive Care Unit

2018 ◽  
Vol 19 (3) ◽  
pp. 255-261
Author(s):  
Zorana M. Djordjevic ◽  
Marko M. Folic ◽  
Nevena Gajovic ◽  
Slobodan M. Jankovic
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Logistic Regression ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Surgical Intensive Care Unit ◽  
Multivariate Logistic Regression ◽  
Surgical Intensive Care ◽  
Carbapenem Resistant

Abstract Carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a major threat to patients in hospitals, increasing mortality, length of stay and costs. The aim of this study was to discover risk factors for the development of hospital infections (HIs) caused by CR-Kp. A prospective cohort study was conducted in the Medical-Surgical Intensive Care Unit of the Clinical Centre in Kragujevac, Kragujevac, Serbia, from January 1, 2011, to December 31, 2015. The “cases” were patients with HIs caused by CR-Kp, while the “controls” were patients infected with carbapenem-sensitive Klebsiella pneumoniae (CS-Kp). The significance of multiple putative risk factors for HIs caused by CR-Kp was tested using multivariate logistic regression. Although univariate analyses pointed to many risk factors, with a significant influence on the occurrence of hospital CR-Kp infections, the multivariate logistic regression identified five independent risk factors: use of mechanical ventilation (OR=6.090; 95% CI=1.030-36.020; p=0.046); length of antibiotic therapy before HIs (days) (OR=1.080; 95% CI=1.003-1.387; p=0.045); previous use of carbapenems (OR=7.005; 95% CI=1.054-46.572; p=0.044); previous use of ciprofloxacin (OR=20.628; 95% CI=2.292-185.687; p=0.007) and previous use of metronidazole (OR=40.320; 95% CI=2.347-692.795; p=0.011) HIs caused by CR-Kp are strongly associated with the use of mechanical ventilation and the duration of the previous use of certain antibiotics (carbapenems, ciprofloxacin and metronidazole).

scholarly journals Communicating While Receiving Mechanical Ventilation: Texting With a Smartphone

2016 ◽  
Vol 25 (2) ◽  
pp. e38-e39 ◽  
Author(s):  
Joseph Shiber ◽  
Ayesha Thomas ◽  
Ashley Northcutt
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Southeastern United States ◽  
Tertiary Care ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Care Level ◽  
Handheld Device ◽  
Level I

Two young adults with severe facial injuries were receiving care in the trauma/surgical intensive care unit at a tertiary care, level I trauma center in the southeastern United States. Both patients were able to communicate by texting on their cellphones to family members, friends, and caregivers in the intensive care unit. Patients who are awake and already have experience texting with a smartphone or other electronic handheld device may be able to communicate well while receiving mechanical ventilation.

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