Reliability and utility of the Acute Care Index of Function in intensive care patients: An observational study

Heart & Lung ◽  
2016 ◽  
Vol 45 (1) ◽  
pp. 10-14 ◽  
Author(s):  
Bernie Bissett ◽  
Margot Green ◽  
Vince Marzano ◽  
Susannah Byrne ◽  
I. Anne Leditschke ◽  
...  
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Acute Care ◽  
Intensive Care Patients ◽  
Care Index

scholarly journals The feasibility and reliability of actigraphy to monitor sleep in intensive care patients: an observational study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
L. J. Delaney ◽  
E. Litton ◽  
K. L. Melehan ◽  
H.-C. C. Huang ◽  
V. Lopez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Moderate Level ◽  
Sleep Monitoring ◽  
Clinical Trial Registration ◽  
Wake Time ◽  
Intensive Care Patients

Abstract Background Sleep amongst intensive care patients is reduced and highly fragmented which may adversely impact on recovery. The current challenge for Intensive Care clinicians is identifying feasible and accurate assessments of sleep that can be widely implemented. The objective of this study was to investigate the feasibility and reliability of a minimally invasive sleep monitoring technique compared to the gold standard, polysomnography, for sleep monitoring. Methods Prospective observational study employing a within subject design in adult patients admitted to an Intensive Care Unit. Sleep monitoring was undertaken amongst minimally sedated patients via concurrent polysomnography and actigraphy monitoring over a 24-h duration to assess agreement between the two methods; total sleep time and wake time. Results We recruited 80 patients who were mechanically ventilated (24%) and non-ventilated (76%) within the intensive care unit. Sleep was found to be highly fragmented, composed of numerous sleep bouts and characterized by abnormal sleep architecture. Actigraphy was found to have a moderate level of overall agreement in identifying sleep and wake states with polysomnography (69.4%; K = 0.386, p < 0.05) in an epoch by epoch analysis, with a moderate level of sensitivity (65.5%) and specificity (76.1%). Monitoring accuracy via actigraphy was improved amongst non-ventilated patients (specificity 83.7%; sensitivity 56.7%). Actigraphy was found to have a moderate correlation with polysomnography reported total sleep time (r = 0.359, p < 0.05) and wakefulness (r = 0.371, p < 0.05). Bland–Altman plots indicated that sleep was underestimated by actigraphy, with wakeful states overestimated. Conclusions Actigraphy was easy and safe to use, provided moderate level of agreement with polysomnography in distinguishing between sleep and wakeful states, and may be a reasonable alternative to measure sleep in intensive care patients. Clinical Trial Registration number ACTRN12615000945527 (Registered 9/9/2015).

scholarly journals A Prospective Observational Study of the Change in Systemic Ionised Calcium following 4% Citrate Locking of Venous Haemodialysis Catheters in Intensive Care Patients

2018 ◽  
Vol 46 (4) ◽  
pp. 381-385
Author(s):  
S. Shewdin ◽  
Y. C. Bong ◽  
S. Okano ◽  
M. D. Chatfield ◽  
J. Walsham
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Clinical Signs ◽  
Dialysis Catheter ◽  
Citrate Solution ◽  
Arterial Blood Gas ◽  
Intensive Care Patients ◽  
Arterial Blood ◽  
Ionised Calcium

Traditionally heparin has been the anticoagulant of choice for venous dialysis catheter locking. There is systemic leakage of heparin catheter locking solutions at the time of injection. Alternative agents, such as citrate, are increasingly being used. We are not aware of any data in the critical care literature on the effect of citrate locking of venous dialysis catheters on systemic ionised calcium (iCa2+). To assess the effect of 4% citrate locking of venous dialysis catheters on systemic iCa2+ in intensive care patients we performed a prospective observational study of 50 paired samples in 26 intensive care patients receiving 4% citrate dialysis catheter locking in an adult tertiary intensive care unit between May 2016 and December 2016. Arterial blood gas (ABG) analysis was performed prior to venous dialysis catheter locking and a baseline iCa2+ result obtained. The catheter was locked with 4% citrate solution. A further ABG was sampled between 30 and 120 seconds later and the iCa2+ results were compared. Patients were observed for clinical signs of hypocalcaemia. On average, there was little difference between the pre- and post-catheter locking iCa2+ (median pre-locking iCa2+ 1.19 mmol/l, mean change of +0.004 mmol/l, 95% confidence interval [CI] −0.004 to 0.013, P=0.34). There was no evidence this difference differed by length of catheter (P=0.26) or site of catheter (P=0.85) insertion, but there was some evidence that this differed by receipt of citrate dialysis circuit anticoagulation (P=0.013). Patients who received citrate dialysis circuit anticoagulation had an increase in catheter locking iCa2+ by 0.017 mmol/l (95% CI 0.005 to 0.028). Locking of venous dialysis catheters with 4% citrate solution has no clinically significant effect on systemic iCa2+ in intensive care patients with indwelling venous dialysis catheters.

Outcomes of Intensive Care Patients Older Than 90 Years: An 11‐Year National Observational Study

2020 ◽  
Vol 68 (8) ◽  
pp. 1842-1846
Author(s):  
Lenneke E. M. Haas ◽  
Ferishta Bakhshi‐Raiez ◽  
Diederik Dijk ◽  
Dylan W. Lange ◽  
Nicolette F. Keizer
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Intensive Care Patients

scholarly journals The feasibility and reliability of actigraphy to monitor sleep in intensive care patients: An observational study

2020 ◽  
Author(s):  
L.J. Delaney ◽  
E. Litton ◽  
K.L Melehan ◽  
H-C.C Huang ◽  
V Lopez ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Total Sleep Time ◽  
Sleep Time ◽  
Moderate Level ◽  
Sleep Monitoring ◽  
Clinical Trial Registration ◽  
Wake Time ◽  
Intensive Care Patients

Abstract Background: Sleep amongst intensive care patients is reduced and highly fragmented which may adversely impact on recovery. The current challenge for Intensive Care clinicians is identifying feasible and accurate assessments of sleep that can be widely implemented. The objective of this study was to investigate the feasibility and reliability of a minimally invasive sleep monitoring technique compared to the gold standard, polysomnography, for sleep monitoring. Methods: Prospective observational study employing a within subject design in adult patients admitted to an Intensive Care Unit. Sleep monitoring was undertaken amongst minimally sedated patients via concurrent polysomnography and actigraphy monitoring over a 24-hour duration to assess agreement between the two methods; total sleep time and wake time. Results: We recruited 80 patients who were mechanically ventilated (24%) and non-ventilated (76%) within the intensive care unit. Sleep was found to be highly fragmented, composed of numerous sleep bouts and characterized by abnormal sleep architecture. Actigraphy was found to have a moderate level of overall agreement in identifying sleep and wake states with polysomnography (69.4%; K = 0.386, p < 0.05) in an epoch by epoch analysis, with a moderate level of sensitivity (65.5%) and specificity (76.1%). Monitoring accuracy via actigraphy was improved amongst non-ventilated patients (specificity 83.7%; sensitivity 56.7%). Actigraphy was found to have a moderate correlation with polysomnography reported total sleep time (r = 0.359, p < 0.05) and wakefulness (r = 0.371 p < 0.05). Bland-Altman plots indicated that sleep was underestimated by actigraphy, with wakeful states overestimated. Conclusions: Actigraphy was easy and safe to use, provided moderate level of agreement with polysomnography in distinguishing between sleep and wakeful states, and may be a reasonable alternative to measure sleep in intensive care patients. Clinical Trial Registration number: ACTRN12615000945527 (Registered 9/9/2015)

Sign in / Sign up

Export Citation Format

Share Document