Intensive Care Unit psychosis, the therapeutic nurse–patient relationship and the influence of the intensive care setting: analyses of interrelating factors

This article is part of a series exploring how the COVID-19 pandemic affected,and continues to affect, a psychiatric intensive care unit (PICU) in London, UK. The series so far has focused primarily on the systems, processes and practical challenges of managing acutely disturbed patients in the npatient setting with the added complexity of COVID-19 infection. This article outlines the psychological impact on staff and patients on a PICU during this time.

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Rumination—A New Complication of Neonatal Intensive Care

PEDIATRICS ◽

10.1542/peds.66.4.551 ◽

1980 ◽

Vol 66 (4) ◽

pp. 551-555

Author(s):

Thomas G. Sheagren ◽

Henry H. Mangurten ◽

Frantz Brea ◽

Susan Lutostanski

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Treatment Program ◽

Successful Treatment ◽

Neonatal Intensive Care ◽

Care Setting ◽

Intensive Care Setting ◽

Rumination Syndrome ◽

Newborn Intensive Care Unit ◽

Newborn Intensive Care

The infant rumination syndrome has not been previously reported in a neonatal intensive care setting. We recently managed three infants in our newborn intensive care unit who developed rumination following chronic courses in the unit. The events leading to this condition in each infant are described, as well as the successful treatment program that was instituted. With recognition of factors predisposing to this disorder, the problem may be avoided, providing these infants with the best chance for optimal development despite the need for prolonged intensive care.

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Euglycemic ketoacidosis as a cause of a metabolic acidosis in the Intensive Care Unit

Acute Medicine Journal ◽

10.52964/amja.0578 ◽

2012 ◽

Vol 11 (4) ◽

pp. 219-221

Author(s):

Robert John ◽

◽

Hemang Yadav ◽

Martin John ◽

◽

...

Keyword(s):

Myocardial Infarction ◽

Type 2 Diabetes ◽

Intensive Care Unit ◽

Intensive Care ◽

Ketone Body ◽

Insulin Infusion ◽

Care Setting ◽

Intensive Care Setting

Euglycaemic ketoacidosis is a rare endocrine emergency, which can have disastrous consequences if left undiagnosed. We present the case of a 57 year old man with type 2 diabetes who developed ketoacidosis (DKA) following a myocardial infarction, despite being normoglycaemic, following discontinuation of his insulin infusion in an intensive care setting. The case highlights the importance of capillary ketone body testing in this scenario as well as the dangers of an over reliance on blood glucose values in the diagnosis of ketoacidosis. The notion that DKA can occur in both type 1 and type 2 diabetes is reaffirmed and the value of adequate insulin therapy in euglycaemic ketoacidosis is emphasized.

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Infections in the Intensive Care Unit

10.1093/med/9780199918027.003.0015 ◽

2017 ◽

Author(s):

Samina Afreen ◽

Hector R. Wong ◽

Marian G. Michaels

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Nosocomial Infections ◽

Care Setting ◽

Blood Products ◽

Intensive Care Setting ◽

Increased Risk ◽

Immune Deficiencies ◽

Frequent Problem ◽

Infectious Condition

Infections are a frequent problem for children cared for in the intensive care setting. The child can have a primary infectious condition that is severe enough to require hospitalization in the intensive care unit (ICU). Alternatively once in the ICU setting children are at risk for nosocomial infections due to a need for catheters that breech the cutaneous barriers, mechanical ventilation and exposures to blood products. Finally, many children sick enough to be in an intensive care setting have underlying immune deficiencies which put that at increased risk. This chapter reviews some of the major underlying infections that lead to intensive care stays as well as the major nosocomial infections which can plague our patients.

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The challenge of prognostic markers in acute pancreatitis: internist’s point of view

Journal of Genetic Engineering and Biotechnology ◽

10.1186/s43141-021-00178-3 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Ombretta Para ◽

Lorenzo Caruso ◽

Maria Teresa Savo ◽

Elisa Antonielli ◽

Eleonora Blasi ◽

...

Keyword(s):

Internal Medicine ◽

Intensive Care Unit ◽

Acute Pancreatitis ◽

Intensive Care ◽

Hospital Mortality ◽

Sofa Score ◽

Care Setting ◽

Adverse Outcome ◽

Intensive Care Setting ◽

Internal Medicine Ward

AbstractAcute pancreatitis, the most frequent hospitalization reason in internal medicine ward among gastrointestinal diseases, is burdened by high mortality rate. The disease manifests mainly in a mild form, but about 20-30% patients have a severe progress that requires intensive care. Patients presenting with acute pancreatitis should be clinically evaluated for organ failure signs and symptoms. Stratifying patients in the first days from symptoms onset is essential to determine therapy and care setting. The aim of our study is to evaluate prognostic factors for acute pancreatitis patients, hospitalized in internal medicine wards, and moreover, understanding the role of various prognostic scores validated in intensive care setting in predicting in-hospital mortality and/or admission to intensive care unit. We conducted a retrospective study enrolling all patients with diagnosis of acute pancreatitis admitted took an internal medicine ward between January 2013 and May 2019. Adverse outcome was considered in-hospital mortality and/or admission to intensive care unit. In total, 146 patients (137 with positive outcome and 9 with adverse outcome) were enrolled. The median age was (67.89 ± 16.44), with a slight prevalence of male (55.1%) compared to female (44.9%). C protein reactive (p = 0.02), creatinine (p = 0.01), sodium (p = 0.05), and troponin I (p = 0.013) after 48 h were significantly increased in patients with adverse outcome. In our study, progression in SOFA score independently increases the probability of adverse outcome in patients hospitalized with acute pancreatitis. SOFA score > 5 is highly predictive of in-hospital mortality (O.R. 32.00; C.I. 6.73-152.5; p = 0.001) compared to other scores. The use of an easy tool, validated in intensive care setting such as SOFA score, might help to better stratify the risk of in-hospital mortality and/or clinical worsening in patients hospitalized with acute pancreatitis in internal medicine ward.

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Pacemaker and ICDs: troubleshooting

The ESC Textbook of Intensive and Acute Cardiovascular Care ◽

10.1093/med/9780198849346.003.0056 ◽

2021 ◽

pp. 755-764

Author(s):

Neasa Starr ◽

Haran Burri

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Care Setting ◽

Intensive Care Setting ◽

Cardiac Device ◽

Basic Premise ◽

Cardiac Devices ◽

Effective Care

As patients with implanted cardiac devices are commonly encountered in the intensive care unit (ICU), in this chapter we aim to outline the basic premise of how pacemaker and defibrillators function. In order to provide safe and effective care for cardiac device patients in an intensive care setting or who have to undergo surgery, we will discuss management of these patients in these specific contexts.

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