Determination of total and unbound propofol in patients during intensive care sedation by ultrafiltration and LC–MS/MS

2016 ◽  
Vol 126 ◽  
pp. 148-155 ◽  
Author(s):  
Andreas Eisenried ◽  
Andreas Wehrfritz ◽  
Harald Ihmsen ◽  
Jürgen Schüttler ◽  
Christian Jeleazcov
Keyword(s):  
Intensive Care ◽  
Intensive Care Sedation

scholarly journals Early determination of case fatality rate of COVID-19 pandemic during the ongoing Yemeni armed conflict

2021 ◽  
pp. 1-15
Author(s):  
Abdulla Salem Bin Ghouth ◽  
Ali Ahmed Al-Waleedi ◽  
Marhami Fahriani ◽  
Firzan Nainu ◽  
Harapan Harapan
Keyword(s):  
Young Adults ◽  
Intensive Care ◽  
Armed Conflict ◽  
Case Fatality Rate ◽  
Preventive Measures ◽  
Case Fatality ◽  
Fatality Rate ◽  
Mechanical Ventilators ◽  
Poor Outcomes

Abstract Objectives: To determine the case-fatality rate (CFR) of coronavirus disease 2019 (COVID-19) and its associated determinants in order to understand the true magnitude of the problem during ongoing conflict in Yemen. Methods: The CFR among confirmed COVID-19 cases in Yemen was calculated. The data was retrieved from national COVID-19 surveillance between April 10, when the first COVID-19 case reported, and May 31, 2020. Results: A total of 419 confirmed COVID-19 cases were reported. There were 14.1% and 5.7% of cases who required intensive care and mechanical ventilators, respectively. Out of total cases, 95 deaths were reported, giving CFR of 22.6% which is much higher compared to other countries. CFR was significantly higher among elderly compared to young adults and varied between governorates. Mortality was associated with preexisting hypertension (OR: 2.30; 95%CI: 1.58, 3.54) and diabetes (OR: 1.68; 95%CI: 1.08, 2.61). Conclusions: Elderly and those with comorbidities, in particular hypertension and diabetes, have higher risk for poor outcomes and therefore should receive more attention in the clinical setting. Preventive measures should also be prioritized to protect those groups in order to reduce the severe cases and deaths-associated COVID-19 in armed-conflict.

scholarly journals AnaConDa™ and Mirus™ for intensive care sedation, 24 h desflurane versus isoflurane in one patient

SpringerPlus ◽  
2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Hagen Bomberg ◽  
Heinrich V. Groesdonk ◽  
Martin Bellgardt ◽  
Thomas Volk ◽  
Andreas Meiser
Keyword(s):  
Intensive Care ◽  
Intensive Care Sedation

Are the Naranjo Criteria Reliable and Valid for Determination of Adverse Drug Reactions in the Intensive Care Unit?

2005 ◽  
Vol 39 (11) ◽  
pp. 1823-1827 ◽  
Author(s):  
Sandra L Kane-Gill ◽  
Levent Kirisci ◽  
Dev S Pathak
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adverse Drug Reactions ◽  
Reliability And Validity ◽  
Kappa Statistic ◽  
Weighted Kappa ◽  
Drug Reactions ◽  
Rater Reliability ◽  
Cronbach Alpha

BACKGROUND The Naranjo criteria are frequently used for determination of causality for suspected adverse drug reactions (ADRs); however, the psychometric properties have not been studied in the critically ill. OBJECTIVE To evaluate the reliability and validity of the Naranjo criteria for ADR determination in the intensive care unit (ICU). METHODS All patients admitted to a surgical ICU during a 3-month period were enrolled. Four raters independently reviewed 142 suspected ADRs using the Naranjo criteria (review 1). Raters evaluated the 142 suspected ADRs 3–4 weeks later, again using the Naranjo criteria (review 2). Inter-rater reliability was tested using the kappa statistic. The weighted kappa statistic was calculated between reviews 1 and 2 for the intra-rater reliability of each rater. Cronbach alpha was computed to assess the inter-item consistency correlation. The Naranjo criteria were compared with expert opinion for criterion validity for each rater and reported as a Spearman rank (rs) coefficient. RESULTS The kappa statistic ranged from 0.14 to 0.33, reflecting poor inter-rater agreement. The weighted kappa within raters was 0.5402–0.9371. The Cronbach alpha ranged from 0.443 to 0.660, which is considered moderate to good. The rs coefficient range was 0.385–0.545; all rs coefficients were statistically significant (p < 0.05). CONCLUSIONS Inter-rater reliability is marginal; however, within-rater evaluation appears to be consistent. The inter-item correlation is expected to be higher since all questions pertain to ADRs. Overall, the Naranjo criteria need modification for use in the ICU to improve reliability, validity, and clinical usefulness.

A method for measurement of oxygen uptake in neonates

1979 ◽  
Vol 46 (6) ◽  
pp. 1200-1204 ◽  
Author(s):  
D. B. Raemer ◽  
D. R. Westenskow ◽  
D. K. Gehmlich ◽  
C. P. Richardson ◽  
W. S. Jordan
Keyword(s):  
Intensive Care ◽  
Oxygen Uptake ◽  
Positive Airway Pressure ◽  
Animal Experiments ◽  
Newborn Infants ◽  
Positive End Expiratory Pressure ◽  
Newborn Intensive Care Unit ◽  
Frequent Use ◽  
Newborn Intensive Care

The frequent use of continuous positive airway pressure and positive end-expiratory pressure in newborn infants with pulmonary disease has prevented the use of conventional methods for measuring oxygen uptake (VO2) in intensive-care units. A feed-back replenishment technique for the determination of the oxygen uptake of these newborn infants has been developed. An instrument utilizing this method has been designed and built permitting continuous VO2 monitoring without interfering in the routine ventilatory therapy of the critically ill infant. Theoretical, bench, and animal experiments using room air as an inspired gas indicate instrument accuracies as a percentage of full scale of 2.4, 2.8, and 7.3, respectively. Preliminary trials on infants demonstrate that the instrument functions satisfactorily in the newborn intensive-care unit.

Death and dying

2019 ◽  
pp. 579-589
Author(s):  
Carl Waldmann ◽  
Andrew Rhodes ◽  
Neil Soni ◽  
Jonathan Handy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Donation ◽  
Death And Dying ◽  
Best Interests ◽  
Life Care ◽  
Determination Of Death ◽  
Brainstem Death ◽  
Donation After Brain Death

This chapter discusses death and dying, and includes discussion on confirming death using neurological criteria (brainstem death), withdrawing and withholding treatment, organ donation after brain death (DBD), and organ donation after circulatory determination of death (DCD). Death is common in the intensive care unit (ICU) and it is important to identify patients whose condition meets the criteria for brainstem death testing as well as patients where continued treatment is not considered to be in their overall best interests. Confirming death using neurological criteria allows the relatives to be presented with the certainty of a diagnosis of death whether organ donation is possible or not. Decisions to withraw treatment are common in the ICU and are associated with approximately 50% of all deaths in the ICU. The decision is made by the multidisciplinary team in consultation with the patient’s relatives and taking into account the patient’s values and preferences. In both situations the possibility of organ donation should be considered and explored, and, when it is a possibility, it should be routinely offered to the relatives as an end-of-life care option.

Determination of plasma bicarbonate of neonates in intensive care.

1988 ◽  
Vol 34 (7) ◽  
pp. 1483-1485 ◽  
Author(s):  
P Masters ◽  
M E Blackburn ◽  
M J Henderson ◽  
J F Barrett ◽  
P R Dear
Keyword(s):  
Intensive Care ◽  
Clinical Significance ◽  
Systematic Bias ◽  
Blood Gas ◽  
Laboratory Measurements ◽  
Blood Samples ◽  
Plasma Bicarbonate ◽  
A Value ◽  
Hasselbalch Equation

Abstract Most modern blood-gas analyzers are programmed to use the Henderson-Hasselbalch equation to calculate a value for plasma bicarbonate. It has been suggested, however, that among acutely ill patients, including newborns, these calculated values may be at variance with measured total CO2. To assess the clinical significance of such errors, we compared calculated bicarbonate with measured total CO2 in 79 blood samples from 40 babies in intensive care. The calculated bicarbonate values consistently exceeded the measured values by about 1.5 mmol/L. Of the errors, 94% were within the range -10% to +20%. When the systematic bias was removed, calculated and measured bicarbonate values agreed within +/- 3.30 mmol/L in 95% of cases. Because calculated values can be obtained much more quickly and frequently than laboratory measurements, we believe that these limits are clinically acceptable.

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