PS235 The Role of Transesophageal Cardiography in Risk Stratification and Mortality Reduction of Critically ill Patients With Complicated Infective Endocarditis: A 12 – Year Single Centre Retrospective Study

Introduction. Serum procalcitonin (PCT) diagnosed sepsis in critically ill patients; however, its prediction for survival is not well established. We evaluated the prognostic value of dynamic changes of PCT in sepsis patients.Methods. A prospective observational study was conducted in adult ICU. Patients with systemic inflammatory response syndrome (SIRS) were recruited. Daily PCT were measured for 3 days. 48 h PCT clearance (PCTc-48) was defined as percentage of baseline PCT minus 48 h PCT over baseline PCT.Results. 95 SIRS patients were enrolled (67 sepsis and 28 noninfectious SIRS). 40% patients in the sepsis group died in hospital. Day 1-PCT was associated with diagnosis of sepsis (AUC 0.65 (95% CI, 0.55 to 0.76)) but was not predictive of mortality. In sepsis patients, PCTc-48 was associated with prediction of survival (AUC 0.69 (95% CI, 0.53 to 0.84)). Patients with PCTc-48 > 30% were independently associated with survival (HR 2.90 (95% CI 1.22 to 6.90)).Conclusions. PCTc-48 is associated with prediction of survival in critically ill patients with sepsis. This could assist clinicians in risk stratification; however, the small sample size, and a single-centre study, may limit the generalisability of the finding. This would benefit from replication in future multicentre study.

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Serum Procalcitonin Level and Mortality Risk in Critically ill Patients with Ventilator-Associated Pneumonia

Cellular Physiology and Biochemistry ◽

10.1159/000438557 ◽

2015 ◽

Vol 37 (5) ◽

pp. 1967-1972 ◽

Cited By ~ 5

Author(s):

Bo Li ◽

Xin Zhao ◽

Shumei Li

Keyword(s):

Critically Ill ◽

Mortality Risk ◽

Critically Ill Patients ◽

Cox Regression ◽

High Serum ◽

Ventilator Associated Pneumonia ◽

Prognostic Role ◽

Procalcitonin Level ◽

Increased Risk

Background/Aims: The prognostic role of serum procalcitonin level in critically ill patients with ventilator-associated pneumonia was unclear. The aim of our study was to investigate the relationship between serum procalcitonin level and mortality risk in critically ill patients with ventilator-associated pneumonia. Methods: Data of critically ill patients with ventilator-associated pneumonia were retrospectively collected. Demographics, comorbidities, and serum procalcitonin level were extracted from electronic medical records. The primary outcome was mortality within two months after diagnosis. Multivariable Cox regression analyses were performed to assess the prognostic role of serum procalcitonin level in those patients. Results: A total of 115 critically ill patients with ventilator-associated pneumonia were enrolled in our study. Serum procalcitonin level was not associated with age, gender, or other comorbidities. Univariate Cox regression model showed that high serum procalcitonin level was associated increased risk of morality within 2 months after diagnosis (OR = 2.32, 95% CI 1.25-4.31, P = 0.008). Multivariable Cox regression model showed that high serum procalcitonin level was independently associated increased risk of morality within 2 months after diagnosis (OR = 2.38, 95% CI 1.26-4.50, P = 0.008). Conclusion: High serum procalcitonin level is an independent prognostic biomarker of mortality risk in critically ill patients with ventilator-associated pneumonia, and it's a promising biomarker of prognosis in critically ill patients.

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Do Aspirin and Other Antiplatelet Drugs Reduce the Mortality in Critically Ill Patients?

Thrombosis ◽

10.1155/2012/720254 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 30

Author(s):

Wolfgang Lösche ◽

Janina Boettel ◽

Björn Kabisch ◽

Johannes Winning ◽

Ralf A. Claus ◽

...

Keyword(s):

Organ Failure ◽

Critically Ill ◽

Critically Ill Patients ◽

Therapeutic Option ◽

Bleeding Risk ◽

Antiplatelet Drugs ◽

Beneficial Effects ◽

Prospective Trials ◽

High Bleeding Risk

Platelet activation has been implicated in microvascular thrombosis and organ failure in critically ill patients. In the first part the present paper summarises important data on the role of platelets in systemic inflammation and sepsis as well as on the beneficial effects of antiplatelet drugs in animal models of sepsis. In the second part the data of retrospective and prospective observational clinical studies on the effect of aspirin and other antiplatelet drugs in critically ill patients are reviewed. All of these studies have shown that aspirin and other antiplatelet drugs may reduce organ failure and mortality in these patients, even in case of high bleeding risk. From the data reviewed here interventional prospective trials are needed to test whether aspirin and other antiplatelet drugs might offer a novel therapeutic option to prevent organ failure in critically ill patients.

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Effects of manually-assisted cough combined with postural drainage, saline instillation and airway suctioning in critically-ill patients during high-frequency oscillatory ventilation: a prospective observational single centre trial

Physiotherapy Theory and Practice ◽

10.3109/09593985.2013.876694 ◽

2014 ◽

Vol 30 (5) ◽

pp. 306-311 ◽

Cited By ~ 1

Author(s):

George Ntoumenopoulos ◽

Marc Berry ◽

Luigi Camporota

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

High Frequency ◽

High Frequency Oscillatory Ventilation ◽

Single Centre ◽

Oscillatory Ventilation ◽

Postural Drainage ◽

Saline Instillation ◽

High Frequency Oscillatory ◽

Airway Suctioning

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BEDSIDE LAPAROSCOPY AS DIAGNOSTIC TOOL REVIEW OF ABDOMINAL PATHOLOGIES IN CRITICALLY ILL PATIENTS: REVIEW

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v6i1.2360 ◽

2022 ◽

Vol 6 (1) ◽

Author(s):

Danilo Coco ◽

Silvana Leanza

Keyword(s):

Retrospective Study ◽

Diagnostic Accuracy ◽

Critically Ill ◽

Critically Ill Patients ◽

Laboratory Tests ◽

Diagnostic Laparoscopy ◽

Delayed Diagnosis ◽

Definite Diagnosis ◽

Imaging Results ◽

Increase Rate

Introduction: The diagnosis of abdominal pathologies in critically ill patients is often difficult because of inconclusive laboratory tests or imaging results, or the inability to safely transfer a patient to the radiology room. These causes give a delayed diagnosis of abdominal pathology in the intensive care unit (ICU) and increase rate of morbidity and mortality. The aim of this retrospective study is to evaluate the safety and diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Aim: The aim of this retrospective study is to evaluate the safety and diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Materials and Methods: A literature research was carried out including PubMed, Medline, Embase, Cochrane and Google Scholar databases to identify articles reporting on importance of diagnostic accuracy of bedside diagnostic laparoscopy in the identification of intra-abdominal pathology in critically ill patients. Conclusions: Bedside diagnostic laparoscopy represents a safe and accurate technique for diagnosing intraabdominal pathology in an ICU setting and should be taken into consideration when patient transfer to radiology or the operating room is considered unsafe or when routine radiological examinations are not conclusive enough to reach a definite diagnosis. Keywords: Bedside laparoscopy, critically ill patients, ultrasonography (US), computed tomography (CT) , emergency surgery

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