scholarly journals Impact of Red Cell and Platelet Distribution Width in Patients of Medical Intensive Care Unit

2021 ◽  
Author(s):  
Ayush Dubey ◽  
Sunil Kumar ◽  
Sourya Acharya ◽  
Anil K. Wanjari ◽  
Shilpa Bawankule ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Platelet Distribution Width ◽  
Distribution Width ◽  
Icu Stay ◽  
The Impact ◽  
Apache Iv ◽  
Length Of Icu Stay

Abstract Introduction The red blood cell distribution width (RDW) is a measurement of variations in the size of red blood cells. As the width increases, the rate of mortality also increases, although the reason for it is still not known. On the other hand, platelet distribution width (PDW) is also useful in predicting morbidity and mortality in sepsis and other critically ill patients. In our study, we planned to study the impact of both RDW and PDW and evaluate their prognostic importance with outcome in patients admitted in medicine intensive care unit (MICU). Material and Method In these cross-sectional observational studies, 1,300 patients were included who were admitted in MICU. Critically ill patients were defined on the basis of qSOFA score greater than 2. PDW and RDW were obtained from Coulter report of complete blood count. Parameters included in Acute Physiology and Chronic Health Evaluation (APACHE) IV scores were taken and APACHE IV score was calculated. Correlation of RDW and PDW with outcomes such as length of ICU stay, use of mechanical ventilator, and discharge/death was done. Result The mean RDW (%) for the entire study population was 15.17 ± 3.01. The RDW (%) was significantly on the higher side in patients who succumbed to the disease as compared with the patients who were discharged. The correlation between the length of ICU stay (days) and RDW (%) was moderately positive and was significant (rho = 0.37, p ≤ 0.001). The correlation between the length of ICU stay (days) and PDW (%) was moderately positive and was significant (rho = 0.5, p ≤ 0.001). Conclusion RDW and PDW were found as significant indicators for period of stay in ICU, requirement for mechanical ventilation, and mortality rate in patients admitted to ICUs. As these are simple, easy to conduct, universally available tests, they can be regularly incorporated in patients admitted in ICUs.

scholarly journals Vascular access: the impact of ultrasonography

2016 ◽  
Vol 14 (4) ◽  
pp. 561-566 ◽  
Author(s):  
Carlos Eduardo Saldanha de Almeida ◽  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Vascular Access ◽  
Critically Ill Patients ◽  
Albert Einstein ◽  
Sao Paulo ◽  
Future Studies ◽  
The Impact ◽  
Puncture Technique

ABSTRACT Vascular punctures are often necessary in critically ill patients. They are secure, but not free of complications. Ultrasonography enhances safety of the procedure by decreasing puncture attempts, complications and costs. This study reviews important publications and the puncture technique using ultrasound, bringing part of the experience of the intensive care unit of the Hospital Israelita Albert Einstein, São Paulo (SP), Brazil, and discussing issues that should be considered in future studies.

scholarly journals The Association between Nutritional Status and In-Hospital Mortality of COVID-19 in Critically-Ill Patients in the ICU

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3302
Author(s):  
Michał Czapla ◽  
Raúl Juárez-Vela ◽  
Vicente Gea-Caballero ◽  
Stanisław Zieliński ◽  
Marzena Zielińska
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nutritional Status ◽  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Invasive Mechanical Ventilation ◽  
Nutritional Risk ◽  
Risk Of Death ◽  
The Impact

Background: Coronavirus disease 2019 (COVID-19) has become one of the leading causes of death worldwide. The impact of poor nutritional status on increased mortality and prolonged ICU (intensive care unit) stay in critically ill patients is well-documented. This study aims to assess how nutritional status and BMI (body mass index) affected in-hospital mortality in critically ill COVID-19 patients Methods: We conducted a retrospective study and analysed medical records of 286 COVID-19 patients admitted to the intensive care unit of the University Clinical Hospital in Wroclaw (Poland). Results: A total of 286 patients were analysed. In the sample group, 8% of patients who died had a BMI within the normal range, 46% were overweight, and 46% were obese. There was a statistically significantly higher death rate in men (73%) and those with BMIs between 25.0–29.9 (p = 0.011). Nonsurvivors had a statistically significantly higher HF (Heart Failure) rate (p = 0.037) and HT (hypertension) rate (p < 0.001). Furthermore, nonsurvivors were statistically significantly older (p < 0.001). The risk of death was higher in overweight patients (HR = 2.13; p = 0.038). Mortality was influenced by higher scores in parameters such as age (HR = 1.03; p = 0.001), NRS2002 (nutritional risk score, HR = 1.18; p = 0.019), PCT (procalcitonin, HR = 1.10; p < 0.001) and potassium level (HR = 1.40; p = 0.023). Conclusions: Being overweight in critically ill COVID-19 patients requiring invasive mechanical ventilation increases their risk of death significantly. Additional factors indicating a higher risk of death include the patient’s age, high PCT, potassium levels, and NRS ≥ 3 measured at the time of admission to the ICU.

scholarly journals Demographic and clinical profile with early outcome of critically ill COVID-19 patients admitted in an ICU of a tertiary care hospital in Dhaka, Bangladesh

2020 ◽  
pp. 51-55
Author(s):  
ASM Areef Ahsan ◽  
Rozina Sultana ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
Debasish Kumar Saha ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Rt Pcr ◽  
Demographic Profile ◽  
Icu Stay ◽  
Length Of Icu Stay

Background: First outbreak of corona virus disease (COVID-19) started in Wuhan, China at December 2019 and since then, it spread globally but information about critically ill patients with COVID-19 is still limited. So, it is important to know the demographic profile and overall outcome of COVID-19 patients. We aimed to describe the clinic-demographic characteristics and outcome of critically ill COVID-19 patients admitted in our intensive care unit. Methods: This prospective observational study was carried out in the intensive care unit of department of Critical Care Medicine of BIRDEM General Hospital, Dhaka, Bangladesh from 11th June to 31st October, 2020. Out of 382 suspected cases, 86 patients were found to be RT-PCR for COVID-19 positive and were included in this study. After admission in ICU, all patients were resuscitated according to ICU protocol. Length of ICU stay were recorded and patient outcomes were mentioned as survival (transferred or discharged) or death. Results: A total of 86 patients (male 53, female 33, mean age 63.6 ± 12.8 years) with RT-PCR for COVID-19 positive were enrolled in this study. Regarding COVID related symptoms, Ninety six percent(83) had respiratory distress, 93.02 % (n=80) had cough, 84.9% (n=73) had history of fever,11.6 % (n=10) had loose motion and 7% (n=6), had anosmia. Diabetes mellitus (DM) was the most common co morbidity (91.9%).For improvement of oxygenation of COVID patient, we treated 7% of patients (n=6) by nasal Cannula, 24.4% (n=21) by Face Mask, 20.9% (n=18) by Non Rebreather Mask, 22.1% (n= 19) by High Flow Nasal Cannula (HFNC) and 25.6% (n= 22) by Mechanical Ventilation. Mean length of ICU stay were 6.9 ± 3.6 days and range of icu stay were 1-20 days. Among 86 COVID patient, 51.16% (n=44) were transferred to the isolation ward or discharged at home and 48.8% (n=42) were died. Conclusion: This study showed the overall demographic and clinical features of critically ill COVID-19 patients, admitted in an icu of a tertiary care hospital. As it is a single centered study, we need more study with multi center approach to know the detail demographic profile and outcome of COVID-19 patients. Birdem Med J 2020; 10, COVID Supplement: 51-55

Intensive Care Unit prioritization: The impact of ICU bed availability on mortality in critically ill patients who requested ICU admission in court in a Brazilian cohort

2021 ◽  
Vol 66 ◽  
pp. 126-131
Author(s):  
Ana Cristina Santos ◽  
Simone Luzia Fidelis de Oliveira ◽  
Virgílio Luiz Marques Macedo ◽  
Paula Lauane Araujo ◽  
Francine Salapata Fraiberg ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Icu Admission ◽  
The Impact ◽  
Brazilian Cohort

scholarly journals Anemia and Blood Transfusions in Critically Ill Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
M. Kamran Athar ◽  
Nitin Puri ◽  
David R. Gerber
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Blood Cell ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Blood Transfusions ◽  
The Past ◽  
Growing Body ◽  
The Impact

Anemia is common in critically ill patients. As a consequence packed red blood cell (PRBC) transfusions are frequent in the critically ill. Over the past two decades a growing body of literature has emerged, linking PRBC transfusion to infections, immunosuppression, organ dysfunction, and a higher mortality rate. However, despite growing evidence that risk of PRBC transfusion outweighs its benefit, significant numbers of critically ill patients still receive PRBC transfusion during their intensive care unit (ICU) stay. In this paper, we summarize the current literature concerning the impact of anemia on outcomes in critically ill patients and the potential complications of PRBC transfusions.

scholarly journals Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis

2021 ◽  
Vol 10 (19) ◽  
pp. 4412
Author(s):  
Markus Jäckel ◽  
Nico Aicher ◽  
Paul Marc Biever ◽  
Laura Heine ◽  
Xavier Bemtgen ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Propensity Score ◽  
Critically Ill ◽  
Primary Endpoint ◽  
Critically Ill Patients ◽  
Icu Stay ◽  
Nursing Delirium Screening Scale ◽  
Prolonged Icu Stay ◽  
Icu Delirium

Background: Delirium complicating the course of Intensive care unit (ICU) therapy is a known driver of morbidity and mortality. It has been speculated that infection with the neurotrophic SARS-CoV-2 might promote delirium. Methods: Retrospective registry analysis including all patients treated at least 48 h on a medical intensive care unit. The primary endpoint was development of delirium as diagnosed by Nursing Delirium screening scale ≥2. Results were confirmed by propensity score matching. Results: 542 patients were included. The primary endpoint was reached in 352/542 (64.9%) patients, without significant differences between COVID-19 patients and non-COVID-19 patients (51.4% and 65.9%, respectively, p = 0.07) and correlated with prolonged ICU stay in both groups. In a subgroup of patients with ICU stay >10 days delirium was significantly lower in COVID-19 patients (p ≤ 0.01). After adjustment for confounders, COVID-19 correlated independently with less ICU delirium (p ≤ 0.01). In the propensity score matched cohort, patients with COVID-19 had significantly lower delirium incidence compared to the matched control patients (p ≤ 0.01). Conclusion: Delirium is frequent in critically ill patients with and without COVID-19 treated at an intensive care unit. Data suggests that COVID-19 itself is not a driver of delirium per se.

scholarly journals 559. Outcomes of Convalescent Plasma Transfusion for SARS-CoV2 Patients in the Intensive Care Unit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S344-S345
Author(s):  
Rabeeya Khalid ◽  
Alvin G Thomas ◽  
Daisy Zhu ◽  
Iva Minga ◽  
Nirmit Desai ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Inflammatory Markers ◽  
Small Sample ◽  
Plasma Transfusion ◽  
Mechanically Ventilated ◽  
Case Series Study ◽  
The Impact

Abstract Background SARS-CoV2 is a grave illness and few therapeutic agents have yielded benefit or reduced mortality. Administration of convalescent plasma (CP) in viral illnesses in the past, including SARS, before day 14, has been associated with a shorter hospital course. In the present study, we are interested in determining the benefit of administering CP to critically ill patients in the intensive care unit, and the impact on mortality and other clinical markers. Methods 5 critically ill patients with confirmed SARS-CoV2 infection were observed in the uncontrolled case series study. Mechanically ventilated patients with severe ARDS (PaO2/FiO2 &lt; 100) were eligible to receive CP transfusion. We reviewed daily vital signs, inflammatory markers, PaO2/FiO2 ratio and SOFA scores before and after CP transfusions. SARS-CoV2 PCR viral load testing was completed on day 0 of transfusion and repeated on day 3 and 6. Complications during the hospitalization and 30-day mortality were assessed. Results All 5 patients were mechanically ventilated at the time of transfusion and between day 7 to 31 of their illness. Following plasma transfusion, body temperature and inflammatory markers remained elevated in four patients (figure 1). SOFA score and PaO2/FiO2 ratios continued to worsen in three and four patients respectively (figure 2). SARS-CoV2 PCR remained positive in 4 patients. 4 of the 5 patients had died at the end of the follow up period. One patient was successfully extubated on day 29 (table 1) and discharged after a long hospital course. Fever curve and trends of inflammatory markers Trends of SOFA socre and PaO2:FiO2 ratio Patient characteristics Conclusion In our patient cohort, the administration of CP did not improve laboratory markers or clinical outcomes. Some notable limitations of this study are the small sample size, and that the patients received CP late in their disease course. Further investigation is necessary to draw definitive conclusions about the utility of CP in the treatment of SARS-CoV2. Disclosures All Authors: No reported disclosures

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