Long-term functional outcome and performance status after intensive care unit re-admission: a prospective survey

• Background Long-term effects on patients’ families after a prolonged stay in a surgical intensive care unit are unclear. We hypothesized that illnesses requiring more than 7 days’ stay in the surgical intensive care unit would have significant, long-lasting effects on patients’ families that would be related to patients’ functional outcome. • Methods All patients who stayed in the general surgery intensive care unit 7 days or more between July 1, 1996, and June 30, 1997, were enrolled. A total of 128 patients met the entry criteria, and families of surviving patients were interviewed at baseline and 1, 3, 6, and 12 months later. Maximum dysfunction/impact was compared with patients’ functional outcome. • Results Significant disturbances in the families’ lives occurred throughout the 12 months of this study. Almost 60% of responding families provided a moderate or large amount of caregiving between 1 and 9 months after a prolonged illness, 44.9% had to quit work after 1 month, and more than 36.7% of families had lost savings after 1 year. Some families moved to a less expensive home, delayed educational plans, or delayed medical care for another family member. • Conclusions An acute surgical illness that results in a prolonged stay in an intensive care unit has a substantial effect on patients’ families that is maximal between 1 and 3 months and parallels the patient’s functional outcome. Systems that provide support to both patients and their families should be emphasized in the hospital and after discharge.

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Survival after cardiac surgery and long-term intensive care unit stay

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0032-1332330 ◽

2013 ◽

Vol 61 (S 01) ◽

Author(s):

C Schimmer ◽

K Hamouda ◽

M Özkur ◽

SP Sommer ◽

I Aleksic ◽

...

Keyword(s):

Intensive Care Unit ◽

Cardiac Surgery ◽

Intensive Care ◽

Intensive Care Unit Stay

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Sportliche Leistung von Pferden, die als Fohlen intensivmedizinischer Behandlung bedurften

Tierärztliche Praxis Ausgabe G Großtiere / Nutztiere ◽

10.1055/a-1037-3832 ◽

2019 ◽

Vol 47 (06) ◽

pp. 399-399

Author(s):

Lukas Demattio

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Sich Eine ◽

Factors Associated ◽

Intensivmedizinische Behandlung ◽

Sportliche Leistung

Studies AC, Chidlow H, Ere SG et al. Factors associated with long-term athletic outcome in Thoroughbred neonates admitted to an intensive care unit. Equine Vet J 2019; 51: 716–719 Für viele Pferdezüchter stellt sich immer wieder die Frage, wie viel Geld in ein Fohlen investiert werden soll, wenn dieses tierärztlicher Behandlung bedarf. Lohnt sich eine intensivmedizinische Behandlung für ein Fohlen, das für eine sportliche Nutzung vorgesehen ist? Diese Frage versuchten die Autoren in der Studie zu beantworten.

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Completeness of the operating room to intensive care unit handover: a matter of time?

BMC Anesthesiology ◽

10.1186/s12871-021-01247-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fabian Dusse ◽

Johanna Pütz ◽

Andreas Böhmer ◽

Mark Schieren ◽

Robin Joppich ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Information Transfer ◽

Time Pressure ◽

Intraoperative Complications ◽

Patient Characteristics ◽

Information Loss ◽

Ensure Patient Safety ◽

Underlying Diseases

Abstract Background Handovers of post-anesthesia patients to the intensive care unit (ICU) are often unstructured and performed under time pressure. Hence, they bear a high risk of poor communication, loss of information and potential patient harm. The aim of this study was to investigate the completeness of information transfer and the quantity of information loss during post anesthesia handovers of critical care patients. Methods Using a self-developed checklist, including 55 peri-operative items, patient handovers from the operation room or post anesthesia care unit to the ICU staff were observed and documented in real time. Observations were analyzed for the amount of correct and completely transferred patient data in relation to the written documentation within the anesthesia record and the patient’s chart. Results During a ten-week study period, 97 handovers were included. The mean duration of a handover was 146 seconds, interruptions occurred in 34% of all cases. While some items were transferred frequently (basic patient characteristics [72%], surgical procedure [83%], intraoperative complications [93.8%]) others were commonly missed (underlying diseases [23%], long-term medication [6%]). The completeness of information transfer is associated with the handover’s duration [B coefficient (95% CI): 0.118 (0.084-0.152), p<0.001] and increases significantly in handovers exceeding a duration of 2 minutes (24% ± 11.7 vs. 40% ± 18.04, p<0.001). Conclusions Handover completeness is affected by time pressure, interruptions, and inappropriate surroundings, which increase the risk of information loss. To improve completeness and ensure patient safety, an adequate time span for handover, and the implementation of communication tools are required.

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The Impact of Implementing a “Pain, Agitation, and Delirium Bundle” in a Pediatric Intensive Care Unit: Improved Delirium Diagnosis

Journal of Pediatric Intensive Care ◽

10.1055/s-0041-1723037 ◽

2021 ◽

Author(s):

Lise D. Cloedt ◽

Kenza Benbouzid ◽

Annie Lavoie ◽

Marie-Élaine Metras ◽

Marie-Christine Lavoie ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Post Intervention ◽

Number Of Patients ◽

Implementation Period ◽

Short And Long Term ◽

The Impact

AbstractDelirium is associated with significant negative outcomes, yet it remains underdiagnosed in children. We describe the impact of implementing a pain, agitation, and delirium (PAD) bundle on the rate of delirium detection in a pediatric intensive care unit (PICU). This represents a single-center, pre-/post-intervention retrospective and prospective cohort study. The study was conducted at a PICU in a quaternary university-affiliated pediatric hospital. All patients consecutively admitted to the PICU in October and November 2017 and 2018. Purpose of the study was describe the impact of the implementation of a PAD bundle. The rate of delirium detection and the utilization of sedative and analgesics in the pre- and post-implementation phases were measured. A total of 176 and 138 patients were admitted during the pre- and post-implementation phases, respectively. Of them, 7 (4%) and 44 (31.9%) were diagnosed with delirium (p < 0.001). Delirium was diagnosed in the first 48 hours of PICU admission and lasted for a median of 2 days (interquartile range [IQR]: 2–4). Delirium diagnosis was higher in patients receiving invasive ventilation (p < 0.001). Compliance with the PAD bundle scoring was 79% for the delirium scale. Score results were discussed during medical rounds for 68% of the patients in the post-implementation period. The number of patients who received opioids and benzodiazepines and the cumulative doses were not statistically different between the two cohorts. More patients received dexmedetomidine and the cumulative daily dose was higher in the post-implementation period (p < 0.001). The implementation of a PAD bundle in a PICU was associated with an increased recognition of delirium diagnosis. Further studies are needed to evaluate the impact of this increased diagnostic rate on short- and long-term outcomes.

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A critical decision point: Short‐ and long‐term outcomes of older surgical patients admitted to a Queensland intensive care unit

Australasian Journal on Ageing ◽

10.1111/ajag.12997 ◽

2021 ◽

Author(s):

Alice T. Zhang ◽

Samuel X. Tan ◽

Praga S. Pillay ◽

David Stewart

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Surgical Patients ◽

Decision Point ◽

Long Term Outcomes ◽

Short And Long Term

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Management of long-term hypothyroidism: a potential marker of quality of medicines reconciliation in the intensive care unit

International Journal of Pharmacy Practice ◽

10.1111/j.2042-7174.2012.00205.x ◽

2012 ◽

Vol 20 (5) ◽

pp. 303-306 ◽

Cited By ~ 10

Author(s):

Nicholas A. Barrett ◽

Andrew Jones ◽

Craig Whiteley ◽

Sarah Yassin ◽

Cathrine A. McKenzie

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Potential Marker ◽

Medicines Reconciliation

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Outcomes of Chronic Hemodialysis Patients in the Intensive Care Unit

Critical Care Research and Practice ◽

10.1155/2013/715807 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7

Author(s):

Melanie Chan ◽

Marlies Ostermann

Keyword(s):

Intensive Care Unit ◽

Renal Function ◽

Intensive Care ◽

Kidney Injury ◽

Chronic Hemodialysis ◽

Current Evidence ◽

Icu Outcome ◽

Stage Renal Disease ◽

End Stage

Patients with end-stage renal disease (ESRD) experience higher rates of hospitalisation, cardiovascular events, and all-cause mortality and are more likely to require admission to the intensive care unit (ICU) than patients with normal renal function. Sepsis and cardiovascular diseases are the most common reasons for ICU admission. ICU mortality rates in patients requiring chronic hemodialysis are significantly higher than for patients without ESRD; however, dialysis patients have a better ICU outcome than those with acute kidney injury (AKI) requiring renal replacement therapy suggesting that factors other than loss of renal function contribute to their prognosis. Current evidence suggests, the longer-term outcomes after discharge from ICU may be favourable and that long-term dependence on dialysis should not prejudice against prompt referral or admission to ICU.

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