CURB-65 and SMRT-CO in the prediction of early transfers to the intensive care unit among patients with community-acquired pneumonia initially admitted to a general ward

2011 ◽  
Vol 6 (9) ◽  
pp. 513-518 ◽  
Author(s):  
Moises A. Huaman ◽  
Alicia Diaz-Kuan ◽  
Sara Hegab ◽  
Indira Brar ◽  
Scott Kaatz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Community Acquired Pneumonia ◽  
General Ward

scholarly journals Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations

2021 ◽  
Author(s):  
Gianmarco Secco ◽  
◽  
Marzia Delorenzo ◽  
Francesco Salinaro ◽  
Caterina Zattera ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Structure And Function ◽  
General Ward ◽  
Prognostic Role ◽  
Interstitial Syndrome ◽  
Lung Structure ◽  
And Function ◽  
The Relationship

AbstractBedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.

scholarly journals Improvement in process of care and outcome in patients requiring intensive care unit admission for community acquired pneumonia

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Hugues Georges ◽  
Cécile Journaux ◽  
Patrick Devos ◽  
Serge Alfandari ◽  
Pierre Yves Delannoy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Community Acquired Pneumonia ◽  
Process Of Care

Radiographically Confirmed Community-Acquired Pneumonia in Pediatric Patients Prior to Pneumococcal Vaccination in Nepal

2017 ◽  
Vol 13 (01) ◽  
pp. 057-062
Author(s):  
Dhruba Shrestha ◽  
Ganendra Raya ◽  
Amar Prajapati ◽  
Suruchi Dhaubhadel ◽  
Sushmita Puri ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pleural Effusion ◽  
Intensive Care Unit Admission ◽  
Pneumococcal Vaccination ◽  
Community Acquired Pneumonia ◽  
Blood Cultures ◽  
Hospital Treatment ◽  
High Morbidity ◽  
Rural Nepal

Background The massive burden of pediatric pneumonia is associated with high morbidity and mortality, particularly in developing countries where immunization programs are absent or recently been implemented. The objective of this study was to describe the number of hospitalizations and outcomes of children aged 1 month to 10 years with community-acquired pneumonia (CAP) between January 1, 2014, and June 30, 2015, in semi-rural Nepal. Methods This retrospective study was undertaken prior to the implementation of the pneumococcal conjugate vaccination (PCV) program in Bhaktapur district of Nepal. Chart review of children with CAP, defined as the presence of symptoms, physical examination findings compatible with bacterial pneumonia together with lobar consolidation on chest X-ray (CXR), was performed. Data extracted included laboratory parameters and blood cultures on admission, antibiotic treatment, and length of hospital stay, as well as complications, such as death, intensive care unit admission, pleural effusion, and empyema. Outcomes assessed were clinical improvement accompanied by radiological improvement of consolidation. Results During the study period, 367 patients were admitted with pneumonia, of which, 74 (20%) had definite CXR evidence of lobar pneumonia. A total of 86.5% of the cases were children < 5 years of age. Admission blood cultures from all patients were negative. More than 80% of patients had white blood cell (WBC) counts >11,000/mm3 and ≥ 75% neutrophils. The highest number of cases presented between February and July. Forty-three of 45 patients responded to crystalline penicillin (CP), and 25/27 patients treated with cefotaxime also responded; the mean duration of treatment was 10 ± 2.3 days. There were no deaths. None of the patients developed empyema, sepsis, or pleural effusion or required intensive care unit admission. Conclusions CAP in pre-PCV semi-rural Nepal mostly affects male children < 5 years old and peaks between March and May. In-hospital treatment with CP or cefotaxime is effective.

Assessment of Respiratory Function In the Intensive Care Unit

1994 ◽  
Vol 21 (S1) ◽  
pp. S28-S34 ◽  
Author(s):  
Charles F. Bolton
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pulmonary Function ◽  
Phrenic Nerve ◽  
Respiratory Function ◽  
General Ward ◽  
Needle Electromyography ◽  
Clinical Observations ◽  
Demyelinating Neuropathies ◽  
Phrenic Nerves

AbstractDisorders of both the central and peripheral nervous systems are important causes of respiratory insufficiency. However, simple clinical observations and pulmonary function measurements may fail to identify the location and type of disorder. This can often be accomplished by the newly-developed technique of phrenic nerve conduction and needle electromyography of the diaphragm which delineate the various disturbances of central drive, axonal or demyelinating neuropathies of the phrenic nerves and certain myopathies. These studies have been preformed safely and with little discomfort on adults, children or infants, and in out-patient and general ward settings. We have found they are of particular value in the intensive care unit.

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