Comparison of enteral vs intravenous potassium supplementation in hypokalemia in post–cardiac surgery pediatric cardiac intensive care patients prospective open-label randomized control trial

Background Ventilator-associated pneumonia is associated with significant morbidity, mortality and healthcare costs. Most of the cost data that are available relate to general intensive care patients in privately remunerated institutions. This study assessed the cost of managing ventilator-associated pneumonia in a cardiac intensive care unit in the National Health Service in the United Kingdom. Methods Propensity-matched study of prospectively collected data from the cardiac surgical database between April 2011 and December 2014 in all patients undergoing cardiac surgery (n = 3416). Patients who were diagnosed as developing ventilator-associated pneumonia, as per the surveillance definition for ventilator-associated pneumonia (n = 338), were propensity score matched with those who did not (n = 338). Costs of treating post-op cardiac surgery patients in intensive care and cost difference if ventilator-associated pneumonia occurred based on Healthcare Resource Group categories were assessed. Secondary outcomes included differences in morbidity, mortality and cardiac intensive care unit and in-hospital length of stay. Results There were no significant differences in the pre-operative characteristics or procedures between the groups. Ventilator-associated pneumonia developed in 10% of post-cardiac surgery patients. Post-operatively, the ventilator-associated pneumonia group required longer ventilation (p < 0.01), more respiratory support, longer cardiac intensive care unit (8 vs 3, p < 0.001) and in-hospital stay (16 vs 9) days. The overall cost for post-operative recovery after cardiac surgery for ventilator-associated pneumonia patients was £15,124 compared to £6295 for non-ventilator-associated pneumonia (p < 0.01). The additional cost of treating patients with ventilator-associated pneumonia was £8829. Conclusion Ventilator-associated pneumonia was associated with significant morbidity to the patients, generating significant costs. This cost was nearer to the lower end for the cost for general intensive care unit patients in privately reimbursed systems.

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An observational study of cardiac intensive care patients receiving nasal high flow therapy

Australian Critical Care ◽

10.1016/j.aucc.2009.12.014 ◽

2010 ◽

Vol 23 (1) ◽

pp. 35

Author(s):

R. Parke ◽

S. McGuinness

Keyword(s):

Intensive Care ◽

Observational Study ◽

High Flow ◽

Intensive Care Patients ◽

Cardiac Intensive Care ◽

Nasal High Flow Therapy

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A NEW LOGISTIC MODEL FOR OUTCOME PREDICTION IN CARDIAC INTENSIVE CARE PATIENTS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(11)61227-8 ◽

2011 ◽

Vol 57 (14) ◽

pp. E1227

Author(s):

Khosro Hekmat ◽

Akmal M. Badreldin ◽

Markus Ferrari ◽

Torsten Doenst ◽

Edward M. Bender ◽

...

Keyword(s):

Intensive Care ◽

Logistic Model ◽

Outcome Prediction ◽

Intensive Care Patients ◽

Cardiac Intensive Care

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Effect of Sleep Disorder on Delirium in Post-Cardiac Surgery Patients

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2020.62 ◽

2020 ◽

Vol 47 (5) ◽

pp. 627-633 ◽

Cited By ~ 2

Author(s):

Hongbai Wang ◽

Liang Zhang ◽

Qipeng Luo ◽

Yinan Li ◽

Fuxia Yan

Keyword(s):

Intensive Care Unit ◽

Logistic Regression ◽

Regression Analysis ◽

Cardiac Surgery ◽

Intensive Care ◽

Sleep Quality ◽

Sleep Disorder ◽

Logistic Regression Analysis ◽

Univariate Analysis ◽

Post Cardiac Surgery

ABSTRACT:Background:Post-cardiac surgery patients exhibit a higher incidence of postoperative delirium (PD) compared to non-cardiac surgery patients. Patients with various cardiac diseases suffer from preoperative sleep disorder (SPD) induced by anxiety, depression, breathing disorder, or other factors.Objective:To examine the effect of sleep disorder on delirium in post-cardiac surgery patients.Methods:We prospectively selected 186 patients undergoing selective cardiac valve surgery. Preoperative sleep quality and cognitive function of all eligible participants were assessed through the Pittsburgh Sleep Quality Index (PSQI) and the Montreal Cognitive Assessment, respectively. The Confusion Assessment Method for Intensive Care Unit was used to assess PD from the first to seventh day postoperatively. Patients were divided into two groups according to the PD diagnosis: (1) No PD group and (2) the PD group.Results:Of 186 eligible patients, 29 (15.6%) were diagnosed with PD. A univariate analysis showed that gender (p = 0.040), age (p = 0.009), SPD (p = 0.008), intraoperative infusion volume (p = 0.034), postoperative intubation time (p = 0.001), and intensive care unit stay time (p = 0.009) were associated with PD. A multivariate logistic regression analysis demonstrated that age (odds ratio (OR): 1.106; p = 0.001) and SPD (OR: 3.223; p = 0.047) were independently associated with PD. A receiver operating characteristic curve demonstrated that preoperative PSQI was predictive of PD (area under curve: 0.706; 95% confidence interval: 0.595–0.816). A binomial logistic regression analysis showed that there was a significant association between preoperative 6 and 21 PSQI scores and PD incidence (p = 0.009).Conclusions:Preoperative SPD was significantly associated with PD and a main predictor of PD.

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Effect of pentoxifylline on histological activity and fibrosis of nonalcoholic steatohepatitis patients: A one year randomized control trial

Journal of Translational Internal Medicine ◽

10.1515/jtim-2017-0021 ◽

2017 ◽

Vol 5 (3) ◽

pp. 155-163 ◽

Cited By ~ 8

Author(s):

Shahinul Alam ◽

SKM Nazmul Hasan ◽

Golam Mustafa ◽

Mahabubul Alam ◽

Mohammad Kamal ◽

...

Keyword(s):

Fatty Liver ◽

Nonalcoholic Steatohepatitis ◽

Randomized Control Trial ◽

Lifestyle Modification ◽

Control Group ◽

Open Label ◽

Histological Activity ◽

Randomized Control ◽

One Year ◽

Lobular Inflammation

AbstractBackground and ObjectivesTo observe the effect of Pentoxifylline for 1 year on hepatic histological activity and fibrosis of nonalcoholic steatohepatitis (NASH).Materials and MethodsA single center, open label Randomized Control Trial. Patients were included if they had ultrasonographic evidence of fatty liver and nonalcoholic fatty liver disease activity score (NAS) ≥ 5 on liver histology. A total of 35 patients were selected; 25 of PL (Experimental) group and 10 of L (Control) group. PL group received 400 mg pentoxifylline thrice daily along with lifestyle modification and there was only lifestyle modification for the L group. After one year, NAS and fibrosis was compared in both groups.ResultsIn PL group, NAS improved 2.10 ± 1.07; whereas in L group, NAS was 0.90 ± 0.99 (P = 0.006). As per the protocol analysis, NAS ≥ 2 improved in 15/20 (75%) in PL group and in 3/10 (30%) in L group (P = 0.018). In PL group, the individual component of NAS, steatosis improved from 2.30 ± 0.66 to 0.95 ± 0.76 (P = 0.000), lobular inflammation from 1.65 ± 0.59 to 1.05 ± 0.51 (P = 0.002) and hepatocyte ballooning from 1.50 ± 0.51 to 1.30 ± 0.57 (P = 0.258). In L group, steatosis improved from 2.30 ± 0.68 to 1.40 ± 1.08 (P = 0.01), lobular inflammation and hepatocyte ballooning did not improve. The fibrosis score did not improve in any group. In PL group, NAS improved significantly (P = 0.027; OR=22.76, CI=1.43-362.40) independent of weight reduction.ConclusionPentoxifylline for 1 year improves the hepatic histological activity but not fibrosis of NASH patients.

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