High vancomycin dosage regimens required by intensive care unit patients cotreated with drugs to improve haemodynamics following cardiac surgical procedures

Introduction: Nosocomial COVID-19 increases morbidity and mortality in patients undergoing surgical procedures. This study assesses the consenting process in patients admitted for surgical procedures with regard to risks of contracting nosocomial COVID-19 infection during the three lockdown periods in the United Kingdom. Methods: Retrospective review of consecutive surgical patients admitted to our tertiary referral centre for surgical procedures during the lockdown periods in the United Kingdom. Data from our hospital’s electronic theatre database cross-referenced with the online surgical operative, admission and discharge records were reviewed by three independent reviewers. Discussion: A total of 180 patients (104 males and 76 females) were studied. No patients tested positive perioperatively for COVID-19. The first lockdown had a significantly larger proportion of consultants consenting (P < 0.001). Surgeons consented patients for risk of COVID-19 infection in 34.4% of cases, COVID-19-related illness in 33.9%, inpatient Intensive Care Unit (ITU) admission secondary to COVID-19 infection and risk of death due to COVID-19 in 0.0% and risk of death secondary to inpatient COVID infection in 1.1%. Conclusion: As surgical activity continues and COVID-19 persists, surgeons should be vigilant and ensure proper documentation for consent regarding COVID-19-related complications in line with the Royal College of Surgeons of England guidelines.

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Management and Outcomes of Laryngeal Injuries in the Pediatric Population

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348941112001204 ◽

2011 ◽

Vol 120 (12) ◽

pp. 787-795 ◽

Cited By ~ 15

Author(s):

Douglas Sidell ◽

Abie H. Mendelsohn ◽

Nina L. Shapiro ◽

Maie St. John

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Surgical Procedures ◽

Data Bank ◽

Fracture Repair ◽

Laryngeal Trauma ◽

Discharge Disposition ◽

National Trauma ◽

Organ Systems ◽

National Trauma Data Bank

Objectives: Pediatric laryngeal trauma is an uncommon event. The purpose of this study was to identify outcomes following surgical procedures for pediatric laryngeal trauma, and to provide an in-depth review of the literature. Methods: The National Trauma Data Bank was utilized to identify pediatric laryngeal trauma incidents with admission years 2002 through 2006. Patient demographics, injury type, surgical procedures, hospital and intensive care unit durations, ventilator duration, and discharge disposition were abstracted. Results: There were 69 laryngeal trauma incidents identified, with a median patient age of 12.8 years and an overall mortality rate of 8.7%. Laryngeal injury was frequently blunt-force in nature (82.8%) and often occurred in conjunction with trauma to multiple organ systems (76.8%). Tracheotomy (16 procedures), laryngeal suturing (13 procedures), and laryngeal fracture repair (10 procedures) were the most frequent procedures identified. Laryngeal fracture repair was noted to increase the overall hospital duration (p = 0.040). The communication scores were affected only by tracheotomy (p = 0.013). Surgical intervention did not significantly affect the frequency of home discharge. Conclusions: Pediatric laryngeal trauma is an uncommon event that can be evaluated with the National Trauma Data Bank. Although patients who undergo laryngeal fracture repair appear to have an increased duration of hospitalization, patients who undergo tracheotomy or laryngeal suturing do not have increased durations of ventilator dependence, stay in an intensive care unit, or hospitalization.

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Dexmedetomidine Related Polyuria and Hypernatremia in Intensive Care Unit.

Pakistan Journal of Kidney Diseases ◽

10.53778/pjkd502142 ◽

2021 ◽

Vol 5 (02) ◽

Author(s):

Mubashar Dilawar ◽

Muhammad Mohsin Riaz ◽

Omer Sabir ◽

Muhammad Bilal Basit

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Diabetes Insipidus ◽

Surgical Procedures ◽

Arginine Vasopressin ◽

Vasopressin Release ◽

Sedation And Analgesia

Dexmedetomidine is commonly used sedative nowadays. It’s being used as an anesthetic for surgical procedures and frequently being used in ICU Settings for sedation, and analgesia. Dexmedetomidine is a highly selective, alpha-2 agonist that also blocks arginine-vasopressin release. Dexmedetomidine is suspected to cause diabetes insipidus leading to polyuria and hypernatremia. We report a case of Diabetes Insipidus associated with use of dexmedetomidine.

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Rotational Thromboelastometry Helps to Reduce Blood Product Consumption in Critically Ill Patients during Small Surgical Procedures at the Intensive Care Unit - a Retrospective Clinical Analysis and Literature Search

Transfusion Medicine and Hemotherapy ◽

10.1159/000486453 ◽

2018 ◽

Vol 45 (6) ◽

pp. 385-387

Author(s):

Tomas Vymazal ◽

Marta Astraverkhava ◽

Miroslav Durila

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Critically Ill ◽

Surgical Procedures ◽

Critically Ill Patients ◽

Literature Search ◽

Blood Product ◽

Clinical Analysis ◽

Rotational Thromboelastometry ◽

Product Consumption

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Evaluating biapenem dosage regimens in intensive care unit patients with Pseudomonas aeruginosa infections: a pharmacokinetic/pharmacodynamic analysis using Monte Carlo simulation

International Journal of Antimicrobial Agents ◽

10.1016/j.ijantimicag.2017.07.005 ◽

2018 ◽

Vol 51 (3) ◽

pp. 484-487 ◽

Cited By ~ 2

Author(s):

Yongfu Hang ◽

Yafang Chen ◽

Ling Xue ◽

Shusen Sun ◽

Long Liu ◽

...

Keyword(s):

Intensive Care Unit ◽

Pseudomonas Aeruginosa ◽

Monte Carlo Simulation ◽

Monte Carlo ◽

Intensive Care ◽

Dosage Regimens ◽

Pharmacodynamic Analysis

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Validity of Unplanned Admission to an Intensive Care Unit as a Measure of Patient Safety in Surgical Patients

Anesthesiology ◽

10.1097/00000542-200512000-00004 ◽

2005 ◽

Vol 103 (6) ◽

pp. 1121-1129 ◽

Cited By ~ 51

Author(s):

Guy Haller ◽

Paul S. Myles ◽

Rory Wolfe ◽

Anthony M. Weeks ◽

Johannes Stoelwinder ◽

...

Keyword(s):

Intensive Care Unit ◽

Patient Safety ◽

Intensive Care ◽

Length Of Stay ◽

Surgical Procedures ◽

Strong Support ◽

Interquartile Range ◽

Hospital Length Of Stay ◽

Surgical Patients ◽

Unplanned Admission

Background An unplanned admission to the intensive care unit within 24 h of a procedure (UIA) is a recommended clinical indicator in surgical patients. Often regarded as a surrogate marker of adverse events, it has potential as a direct measure of patient safety. Its true validity for such use is currently unknown. Methods The authors validated UIA as an indicator of safety in surgical patients in a prospective cohort study of 44,130 patients admitted to their hospital. They assessed the association of UIA with intraoperative incidents and near misses, increased hospital length of stay, and 30-day mortality as three constructs of patient safety. Results The authors identified 201 patients with a UIA; 104 (52.2%) had at least one incident or near miss. After adjusting for confounders, these incidents were significantly associated with UIA in all categories of surgical procedures analyzed; odds ratios were 12.21 (95% confidence interval [CI], 6.33-23.58), 4.06 (95% CI, 2.74-6.03), and 2.13 (95% CI, 1.02-4.42), respectively. The 30-day mortality for patients with UIA was 10.9%, compared with 1.1% in non-UIA patients. After risk adjustment, UIA was associated with excess mortality in several types of surgical procedures (odds ratio, 3.89; 95% CI, 2.14-7.04). The median length of stay was increased if UIA occurred: 16 days (interquartile range, 10-31) versus 2 days (interquartile range, 0.5-9) (P < 0.001). For patients with a UIA, the likelihood of discharge from hospital was significantly decreased in most surgical categories analyzed, with adjusted hazard ratios of 0.41 (95% CI, 0.23-0.77) to 0.58 (95% CI, 0.37-0.93). Conclusions These findings provide strong support for the construct validity of UIA as a measure of patient safety.

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