Anemia and Blood Transfusion

2019 ◽  
pp. 319-324
Author(s):  
Joy D. Hughes ◽  
Mariela Rivera ◽  
Myung S. Park
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Blood Transfusion ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Signs ◽  
Mortality Rates ◽  
Hemoglobin Level ◽  
High Morbidity ◽  
Active Hemorrhage

Critically ill patients commonly present with anemia, defined as a hemoglobin level less than 13.0 g/dL in men and less than 11.6 g/dL in women or as clinical signs of bleeding, including tachycardia and low urine output with active hemorrhage. Anemia is common, occurring in up to a third of critically ill patients, and is associated with high morbidity and mortality rates, particularly in patients with central nervous system injuries and disease. The causes of anemia can vary from chronic conditions such as kidney disease or malnutrition to acute conditions such as bleeding or consumptive coagulopathy.

scholarly journals Utilization patterns of central nervous system drugs: A cross-sectional study among the critically ill patients

2011 ◽  
Vol 02 (02) ◽  
pp. 119-123 ◽  
Author(s):  
Lisha Jenny John ◽  
Padmini Devi ◽  
Jenny John ◽  
Mohamed Arifulla ◽  
Shoba Guido
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Multiorgan Failure ◽  
Drug Prescription ◽  
Demographic Data ◽  
Cross Sectional ◽  
Case Record ◽  
Central Nervous System Drugs

ABSTRACT Introduction: Critically ill patients often receive central nervous system drugs due to primary disorder or complications secondary to multiorgan failure. The aim of the study was to evaluate the current utilization pattern of central nervous system drugs among patients in the medical intensive care unit. Materials and Methods: A prospective observational study carried out over a period of 1 year. The relevant data on drug prescription of each patient was collected from the inpatient case record. Drugs were classified into different groups based on WHO–ATC classification. The demographic data, clinical data, and utilization of different classes of drugs as well as individual drugs were analyzed. Results: A total of 325 consecutive patients were included for the analysis; 211 (65%) patients were males; 146 patients (45%) were above 55 years of age. Encephalopathy [63(19.38%)] and stroke [62(19%)] were the common central nervous system diagnoses. In a total of 1237 drugs, 68% of the drugs were prescribed by trade name. Midazolam (N05CD08) 142 (43.69%), morphine (N02AA01) 201 (61.84%), and atracurium (M03AC04) 82 (25.23%) were the most commonly used sedative, analgesic, and neuromuscular blocker, respectively. Phenytoin (N03AB02) 151 (46.46%) had maximum representation among antiepileptic agents. Conclusions: Utilization of drugs from multiple central nervous system drug classes was noticed. Rational use of drugs can be encouraged by prescription by brand name.

scholarly journals Combined Intravenous and Intraventricular Administration of Colistin Methanesulfonate in Critically Ill Patients with Central Nervous System Infection

2013 ◽  
Vol 57 (4) ◽  
pp. 1938-1940 ◽  
Author(s):  
Mairi Ziaka ◽  
Sophia L. Markantonis ◽  
Marizoza Fousteri ◽  
Paris Zygoulis ◽  
Dimitris Panidis ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Cerebrospinal Fluid ◽  
Nervous System ◽  
Critically Ill ◽  
Intravenous Administration ◽  
Critically Ill Patients ◽  
External Ventricular Drain ◽  
Central Nervous System Infection ◽  
Intraventricular Administration ◽  
Colistin Methanesulfonate

ABSTRACTColistin pharmacokinetics were prospectively studied after intravenous administration of colistin methanesulphonate in critically ill patients without central nervous system infection (controls,n= 5) and in patients with external ventricular drain-associated ventriculitis after intravenous administration (EVDViv,n= 3) or combined intravenous/intraventricular administration (EVDVcomb,n= 4). Cerebrospinal fluid (CSF)/serum colistin concentration ratios were higher in EVDViv than in control patients (11% versus 7%,P≤ 0.05) and in EVDVcomb compared to all other patients (P< 0.0001). CSF colistin concentrations above the MIC of 0.5 μg/ml were achieved only in EVDVcomb patients.

scholarly journals Pharmacology and Pharmacokinetics of Sedative Agents

2008 ◽  
Vol 9 (3) ◽  
pp. 253-254
Author(s):  
Mark Borthwick
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Care Units ◽  
The Central Nervous System ◽  
Sedative Agents

Our understanding of the pharmacology and pharmacokinetics of agents acting on the central nervous system has made considerable advances. This article describes the actions of the drugs most commonly used in critical care units for sedation of critically ill patients.

scholarly journals Continuous Electroencephalographic Monitoring in Critically Ill Patients With Central Nervous System Infections

2008 ◽  
Vol 65 (12) ◽  
Author(s):  
Emmanuel Carrera ◽  
Jan Claassen ◽  
Mauro Oddo ◽  
Ronald G. Emerson ◽  
Stephan A. Mayer ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Central Nervous System Infections

scholarly journals Neonatal Ureaplasma parvum meningitis complicated with subdural hematoma: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Canyang Zhan ◽  
Lihua Chen ◽  
Lingling Hu
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Subdural Hematoma ◽  
Central Nervous System Infection ◽  
Neonatal Meningitis ◽  
High Morbidity ◽  
Ureaplasma Parvum ◽  
Protein Levels ◽  
Csf Analysis ◽  
Empirical Antibiotics

Abstract Background Neonatal meningitis is a severe infectious disease of the central nervous system with high morbidity and mortality. Ureaplasma parvum is extremely rare in neonatal central nervous system infection. Case presentation We herein report a case of U. parvum meningitis in a full-term neonate who presented with fever and seizure complicated with subdural hematoma. After hematoma evacuation, the seizure disappeared, though the fever remained. Cerebrospinal fluid (CSF) analysis showed inflammation with CSF pleocytosis (1135–1319 leukocytes/μl, mainly lymphocytes), elevated CSF protein levels (1.36–2.259 g/l) and decreased CSF glucose (0.45–1.21 mmol/l). However, no bacterial or viral pathogens in either CSF or blood were detected by routine culture or serology. Additionally, PCR for enteroviruses and herpes simplex virus was negative. Furthermore, the CSF findings did not improve with empirical antibiotics, and the baby experienced repeated fever. Thus, we performed metagenomic next-generation sequencing (mNGS) to identify the etiology of the infection. U. parvum was identified by mNGS in CSF samples and confirmed by culture incubation on mycoplasma identification medium. The patient’s condition improved after treatment with erythromycin for approximately 5 weeks. Conclusions Considering the difficulty of etiological diagnosis in neonatal U. parvum meningitis, mNGS might offer a new strategy for diagnosing neurological infections.

IMPACT OF BLOOD TRANSFUSION ON NOSOCOMIAL INFECTIONS IN CRITICALLY ILL PATIENTS

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 443A
Author(s):  
Jean-Sebastien Rachoin ◽  
Ralph Daher ◽  
Christa Schorr ◽  
Barry Milcarek ◽  
Joseph Parrillo ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Nosocomial Infections

Urinary biomarkers predict progression and adverse outcomes ofacute kidney injury in critical illness

2021 ◽  
Author(s):  
Stephen Duff ◽  
Ruairi Irwin ◽  
Jean Maxime Cote ◽  
Lynn Redahan ◽  
Blaithin A McMahon ◽  
...  
Keyword(s):  
Critically Ill ◽  
Cystatin C ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Urinary Biomarkers ◽  
High Morbidity ◽  
Diagnostic Analysis ◽  
Prognostic Analysis ◽  
Stage 1

Abstract Background Acute Kidney Injury (AKI) is common in hospitalized patients and is associated with high morbidity and mortality. The Dublin Acute Biomarker Group Evaluation (DAMAGE) Study is a prospective cohort study of critically ill patients (n = 717). We hypothesised that novel urinary biomarkers would predict progression of AKI and associated outcomes. Methods The primary (diagnostic) analysis assessed the ability of biomarkers levels at the time of early Stage 1 or2 AKI to predict progression to higher AKI Stage, RRT or Death within 7 days of ICU admission. In the secondary (prognostic) analysis, we investigated the association between biomarker levels and RRT or Death within 30 days. Results In total, 186 patients had an AKI within 7 days of admission. In the primary (diagnostic) analysis, eight of the 14 biomarkers were independently associated with progression. The best predictors were Cystatin C (aOR 5.2; 95% CI, 1.3-23.6), IL-18 (aOR 5.1; 95% CI, 1.8-15.7), Albumin (aOR 4.9; 95% CI, 1.5-18.3) and NGAL (aOR 4.6; 95% CI, 1.4-17.9). ROC and Net Reclassification Index analyses similarly demonstrated improved prediction by these biomarkers. In the secondary (prognostic) analysis of Stage 1-3 AKI cases, IL-18, NGAL, Albumin, and MCP-1 were also independently associated with RRT or Death within 30 days. Conclusions Among 14 novel urinary biomarkers assessed, Cystatin C, IL-18, Albumin and NGAL were the best predictors of Stage 1-2 AKI progression. These biomarkers, after further validation, may have utility to inform diagnostic and prognostic assessment and guide management of AKI in critically ill patients.

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