Intensive care referral

2007 ◽  
pp. 293-296
Keyword(s):  
Mechanical Ventilation ◽  
Critical Care ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Organ Failure ◽  
Intensive Care Medicine ◽  
General Term ◽  
Multiple Organ ◽  
Mechanical Support ◽  
Organ Systems

Intensive care medicine 294 Mechanical ventilation 295 Intensive care medicine is the branch of medicine that deals with acute organ failure requiring invasive supportive therapies. It involves patient care in many settings, and the more general term ‘critical care’ is often preferred. Very often several organs are failing at the same time. Drugs and mechanical support are now available for multiple organ systems, the oldest of which is mechanical ventilation for respiratory failure....

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

Decisions Made By Critical Care Nurses During Mechanical Ventilation and Weaning in an Australian Intensive Care Unit

2007 ◽  
Vol 16 (5) ◽  
pp. 434-443 ◽  
Author(s):  
Louise Rose ◽  
Sioban Nelson ◽  
Linda Johnston ◽  
Jeffrey J. Presneill
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Intensive Care ◽  
Interdisciplinary Collaboration ◽  
Multiple Organ ◽  
Critical Care Nurses ◽  
Royal Melbourne Hospital ◽  
Adult Intensive Care Unit ◽  
Fraction Of Inspired Oxygen

Background Responsibilities of critical care nurses for management of mechanical ventilation may differ among countries. Organizational interventions, including weaning protocols, may have a variable impact in settings that differ in nursing autonomy and interdisciplinary collaboration. Objective To characterize the role of Australian critical care nurses in the management of mechanical ventilation. Methods A 3-month, prospective cohort study was performed. All clinical decisions related to mechanical ventilation in a 24-bed, combined medical-surgical adult intensive care unit at the Royal Melbourne Hospital, a university-affiliated teaching hospital in Melbourne, Victoria, Australia, were determined. Results Of 474 patients admitted during the 81-day study period, 319 (67%) received mechanical ventilation. Death occurred in 12.5% (40/319) of patients. Median durations of mechanical ventilation and intensive care stay were 0.9 and 1.9 days, respectively. A total of 3986 ventilation and weaning decisions (defined as any adjustment to ventilator settings, including mode change; rate or pressure support adjustment; and titration of tidal volume, positive end-expiratory pressure, or fraction of inspired oxygen) were made. Of these, 2538 decisions (64%) were made by nurses alone, 693 (17%) by medical staff, and 755 (19%) by nurses and staff in collaboration. Decisions made exclusively by nurses were less common for patients with predominantly respiratory disease or multiple organ dysfunction than for other patients. Conclusions In this unit, critical care nurses have high levels of responsibility for, and autonomy in, the management of mechanical ventilation and weaning. Revalidation of protocols for ventilation practices in other clinical contexts may be needed.

Multiple Organ Dysfunction Syndrome

2015 ◽  
Author(s):  
Vishal Bansal ◽  
Jay Doucet
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Organ Failure ◽  
Organ Dysfunction ◽  
Multiple Organ Dysfunction Syndrome ◽  
Multiple Organ ◽  
Multiple Organ Dysfunction ◽  
Organ Systems ◽  
Ultimate Outcome

The concept of and approach to multiple organ dysfunction syndrome (MODS), also known as progressive systems failure, multiple organ failure, and multiple system organ failure, have evolved over the last decade. Characterized by progressive but potentially reversible tissue damage and dysfunction of two or more organ systems that arise after a significant physiologic insult and its subsequent management, MODS evolves in the wake of a profound disruption of systemic homeostasis. Pre-existing illness, nutritional status, hospital course, and genetic variation all lead to the development of organ dysfunction in patients exposed to these risk factors. The ultimate outcome from MODS is influenced not only by a patient’s genetic and biological predisposition but also by specific management principles practiced by intensivists. This review details the clinical definitions, quantification, prevention, evaluation, support, and outcomes of organ dysfunction. A figure shows the increasing severity of organ dysfunction correlated with increasing intensive care unit mortality, and an algorithm details the approach to MODS. Tables list risk factors and prognosis for MODS, the multiple organ dysfunction (MOD) score, the sequential organ failure assessment (SOFA) score, intensive care unit interventions that reduce mortality or attenuate organ dysfunction along with unproven or disproven ICU interventions, and the temporal evolution of MODS. This review contains 1 figure, 7 tables, and 159 references.

scholarly journals KORELASI ANTARA KADAR PROKALSITONIN DAN MYELOPEROXIDASE INDEX PADA PASIEN SEPSIS

2019 ◽  
Vol 25 (3) ◽  
pp. 358
Author(s):  
Sri Rejeki Wulandari ◽  
Betty Agustina Tambunan ◽  
Paulus Budiono Notopuro ◽  
Hardiono Hardiono
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Organ Failure ◽  
Intensive Care Medicine ◽  
Critical Care Medicine ◽  
Cross Sectional

Sepsis masih menjadi masalah utama di dunia. Europan Society of Intensive Care Medicine (ESICM) dan Society of Critical Care Medicine (SCCM) mengikutsertakan quick Sequential Organ Failure Asssessment  (qSOFA) untuk mendiagnosis sepsis. Diperlukan pemeriksaan laboratorium akurat dan cepat selain kultur. Prokalsitonin sebagai penanda spesifik infeksi bakteri. Myeloperoxidase index (MPXI) parameter baru untuk membantu diagnosis sepsis. Penelitian ini bertujuan menganalisis korelasi kadar prokalsitonin dengan MPXI pada pasien sepsis.  Jenis penelitian cross sectional observasional. Pengambilan sampel Desember 2017  – Februari 2018. Subjek penelitian terdiri dari 71 pasien sepsis yang dirawat di Ruang Resusitasi, Ruang Observasi Intensif, dan ruang Intensive Care Unit (ICU) RSUD Dr. Soetomo Surabaya berdasarkan kriteria qSOFA dan SIRS. Pemeriksaan prokalsitonin dengan metode CLIA (ADVIA Centaur XP), MPXI dengan  metode  flowcytometry (ADVIA 2120i) dan kultur menggunakan alat PhoenixTM 100. Kadar prokalsitonin 0,01 ng/mL – 265,16 ng/mL (rerata 16,13 ± 40,91 ng/mL). Nilai MPXI -25,5 – 4,6 (rerata -7,939 ± 4,903). Tidak terdapat korelasi antara kadar prokalsitonin dengan MPXI ( p = 0,604 dan r = - 0,063). Tidak terdapat  korelasi kadar prokalsitonin dengan MPXI pada hasil  kultur positif (p = 0,675, r = 0,072) dan negatif (p = 0,401, r = - 0,147). Kadar prokalsitonin tidak berkolerasi dengan MPXI pada pasien sepsis

scholarly journals Pediatric Sequential Organ Failure Assessment Score: Modifikasi Sistem Skor Pada Sepsis Anak

2020 ◽  
Vol 70 (2) ◽  
pp. 32-37
Author(s):  
Rismala Dewi
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Intensive Care Medicine ◽  
Pediatric Intensive Care Unit ◽  
European Society ◽  
Pediatric Intensive Care ◽  
Failure Assessment

Pendahuluan: Society of Critical Care Medicine (SCCM) dan European Society of Intensive Care Medicine (ESICM) mengeluarkan definisi sepsis terbaru (Sepsis-3) yaitu disfungsi organ yang mengancam jiwa akibat disregulasi respon imun pejamu terhadap infeksi. Skor Sequential Organ Failure Assessment (SOFA) telah dipilih dan divalidasi sebagai sistem penilaian untuk mengukur disfungsi organ dikarenakan skor SOFA pada pasien dewasa dengan kecurigaan infeksi, sebanding atau bahkan lebih unggul daripada sistem penilaian lainnya dalam membedakan mortalitas rumah sakit. Untuk mengadaptasi definisi Sepsis-3, skor SOFA diadaptasi dan divalidasi untuk pasien anak-anak yang mengidap sakit kritis (pSOFA) dengan menggunakan kriteria yang telah disesuaikan berdasarkan usia. Hasil penelitian menunjukan perkiraan mortalitas pada pSOFA saat waktu kedatangan, hari 2, 4, 7 dan 14 setelah masuk Pediatric Intensive Care Unit (PICU) lebih baik dibandingkan skor disfungsi organ lainnya. Evaluasi serial dari skor pSOFA pada hari pertama setelah masuk PICU juga sangat baik dalam memprediksi prognosis dari pasien pediatri onkologi yang memakai ventilator selama 3 hari, anak-anak dengan sepsis di PICU dan berguna untuk memprediksi mortalitas 30 hari pada populasi PICU, namun kurang berhasil dalam memprediksi lamanya pasien untuk dirawat di PICU.

scholarly journals РЕТРОСПЕКТИВНЫЙ АНАЛИЗ ПРИЧИН ЛЕТАЛЬНОСТИ У БОЛЬНЫХ С ТЯЖЕЛЫМ ТЕЧЕНИЕМ COVID-19

2021 ◽  
pp. 62-68
Author(s):  
S. SEREDA ◽  
S. DUBROV ◽  
M. DENYSIUK ◽  
O KOTLIAR ◽  
S. CHERNIAIEV ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Causes Of Death ◽  
Multiple Organ ◽  
Common Causes ◽  
The Mean

In Ukraine, more than 3.5 million cases of COVID-19 have been registered during the pandemic, and the death toll is almost 90,000. Ukraine is a leader in Europe in the growth of new cases of COVID-19 and mortality from this disease. The search for effective treatment regimens and new approaches to the management of patients with coronavirus disease in order to reduce the severity of coronavirus disease, reduce mortality, the number of complications and improve the rehabilitation period is very important nowadays. The aim of the work. To determine the main causes of mortality in patients with severe COVID-19 by analyzing the frequency and structure of complications in deceased patients. Materials and methods. The study conducted a retrospective analysis of 122 medical charts of deceased patients with COVID-19 who were hospitalized in a communal non-profit enterprise “Kyiv city clinical hospital №17” for the period from September 2020 to November 2021. Results and discussion. The overall mortality among patients with COVID-19 was 9.3%, in the intensive care unit (ICU) – 48.4%. The most common causes of death in patients with COVID-19 were: respiratory failure (RF) – 100% of cases, pulmonary embolism (PE) and acute heart failure (AHF) - about 60%. The average length of stay of patients in inpatient treatment was 11.67 ± 8.05 days, and in the intensive care unit – 7.94 ± 6.24 days. The mean age of patients hospitalized in the ICU was 63.5 ± 12.9 years and the mean age of patients who died was 71.2 ± 10.29 years. Prognostically significant criteria for lethal consequences were the presence of comorbidity: cardiovascular diseases- 92.3%, endocrine system diseases – 28.4%, nervous system diseases – 23.07%, kidney diseases – 9.6%, cancer – 9,6%, autoimmune conditions – 7.69%, varicose veins – 5.7%, respiratory system diseases – 5.7%. In patients with fatal outcome lymphopenia (84.6%) was observed in patients on admission to the ICU. Vasopressor and inotropic support was performed in 50 % of patients with COVID-19. In 25 % of those who died during long-term treatment and long-term respiratory support, there was the development of multiple organ failure, which in most cases was the point of no return. Conclusions. The most common causes of death were: respiratory failure, thrombosis, acute cardiovascular failure, sepsis and multiple organ failure. The main nature of the complications is common, but the cohort may be affected by different factors and the percentage of complications may differ in other hospitals.

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