COMPARISON OF PULSE‐DOSE AND HIGH‐DOSE CORTICOSTEROIDS WITH NO CORTICOSTEROID TREATMENT FOR COVID‐19 PNEUMONIA IN THE INTENSIVE CARE UNIT

Objective: To evaluate whether pain management strategies within intensive care unit (ICU) settings contribute to chronic opioid use upon hospital discharge in opioid-naive patients requiring invasive mechanical ventilation. Design: A retrospective, observational study.Setting: An 18-bed mixed ICU at a community teaching hospital located in Brooklyn, New York.Participants: This study included mechanically ventilated patients requiring continuous opioid infusion from April 25, 2017 to May 16, 2019. Patients were excluded if they received chronic opioid therapy at home or expired during this hospital admission. Eligible patients were identified using an electronic health record data query.Main outcome measure(s): The proportion of ICU patients who continued to require opioids upon ICU and hospital discharge. Results: A total of 196 ICU patients were included in this study. Of these, 22 patients were transferred to a regular floor while receiving a fentanyl transdermal patch. However, the fentanyl patch treatment was continued only for three patients (2 percent) at hospital discharge.Conclusions: This retrospective study suggested that high-dose use of opioids in mechanically ventilated, opioid-naive ICU patients was not associated with continued opioid use upon hospital discharge.

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High-Dose Adrenaline in Adult In-Hospital Asystolic Cardiopulmonary Resuscitation: A Double-Blind Randomised Trial

Anaesthesia and Intensive Care ◽

10.1177/0310057x9302100210 ◽

1993 ◽

Vol 21 (2) ◽

pp. 192-196 ◽

Cited By ~ 38

Author(s):

J. Lipman ◽

W. Wilson ◽

S. Kobilski ◽

J. Scribante ◽

C. Lee ◽

...

Keyword(s):

Intensive Care Unit ◽

Cardiac Arrest ◽

Intensive Care ◽

Side Effects ◽

Cardiopulmonary Resuscitation ◽

Standard Dose ◽

Randomised Trial ◽

High Dose ◽

Double Blind ◽

To Receive

Forty intensive care unit patients requiring cardiopulmonary resuscitation were randomised to receive either the standard dose of adrenaline (1 mg every five minutes) or high-dose adrenaline (10 mg every five minutes). In the majority of patients, overwhelming sepsis was the major contributing factor leading to cardiac arrest. In this group of patients no difference could be detected in response to high-dose adrenaline compared with the standard dose. Although no side-effects were noted with this high dose of adrenaline, more investigation is required prior to its routine use in cardiopulmonary resuscitation.

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Periocular Necrotizing Fasciitis with Toxic Shock Syndrome

Case Reports in Ophthalmology ◽

10.1159/000488971 ◽

2018 ◽

Vol 9 (2) ◽

pp. 299-303

Author(s):

Tri Rejeki Herdiana ◽

Yasuhiro Takahashi ◽

Ma. Regina Paula Valencia ◽

Marian Grace Ana-Magadia ◽

Hirohiko Kakizaki

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Necrotizing Fasciitis ◽

Toxic Shock Syndrome ◽

Surgical Intervention ◽

High Dose ◽

Toxic Shock ◽

Intravenous Antibiotic ◽

High Level ◽

Prompt Diagnosis

Purpose: To report a case of periocular necrotizing fasciitis with toxic shock syndrome. Methods: This is a case report of a previously healthy 69-year-old woman with left preseptal eyelid infection that spread rapidly and deteriorated into necrosis of the eyelid with toxic shock syndrome. She was admitted to intensive care unit for hemodynamic stabilization. Results: Intravenous antibiotic and high-dose immunoglobulin were administered followed by surgical debridement. Rehabilitative eyelid reconstruction was performed after acute episode, resulting in patient satisfaction in relation to periocular function and appearance. Conclusion: We reported a case of periocular necrotizing fasciitis with toxic shock syndrome that necessitated early aggressive medical treatment and adequate surgical intervention to decrease morbidity and mortality. A high level of suspicion of periocular necrotizing fasciitis is necessary to make a prompt diagnosis.

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High-dose antipsychotic medication

Psychiatric Bulletin ◽

10.1192/pb.20.11.676 ◽

1996 ◽

Vol 20 (11) ◽

pp. 676-680 ◽

Cited By ~ 13

Author(s):

Peter L. Cornwall ◽

Fuad Hassanyeh ◽

Caprice Horn

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Clinical Practice ◽

Antipsychotic Medication ◽

Antipsychotic Drugs ◽

Maximum Dose ◽

High Dose ◽

National Formulary ◽

Physical Status ◽

High Dose Treatment

We audited the use of high-dose antipsychotic drugs in patients admitted to a special (intensive) care unit over two periods. Five out of 57 patients in the first sample and three out of 62 in the second were treated with a single antipsychotic drug above the British National Formulary maximum dose. The proportion of patients treated with antipsychotic drugs such that the total dose in chlorpromazine equivalents was greater than 1000 mg, fed. The audit showed improvements in clinical practice, particularly with respect to the onset of, indication for and outcome of high-dose treatment and in monitoring the patients' physical status.

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The Safe Use of High Dose Neuroleptics in a Psychiatric Intensive Care Unit

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048678609158885 ◽

1986 ◽

Vol 20 (3) ◽

pp. 370-375 ◽

Cited By ~ 10

Author(s):

Robert D. Goldney ◽

Neil D. Spence ◽

Julia A. Bowes

Keyword(s):

Intensive Care Unit ◽

Cardiac Arrest ◽

Intensive Care ◽

Sudden Death ◽

High Dose ◽

High Doses

A review of the use of high dose neuroleptics in the management of acute psychoses in a psychiatric intensive care unit confirms the previously reported safety of such regimes. The risk of extreme unwanted effects, such as cardiac arrest and sudden death, was considerably less than the risk of suicide as an inpatient. Although high doses of neuroleptics appear to be relatively safe, there is no advantage, in terms of the length of admission required in the intensive care unit, in using a dose of neuroleptic above the equivalent of 60-80 mg of haloperidol in any one 24-hour period.

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