scholarly journals 483: FUNCTIONAL DECLINE FOLLOWING ICU ADMISSION OF THE CRITICALLY ILL CHILD

2021 ◽  
Vol 50 (1) ◽  
pp. 232-232
Author(s):  
Debra Rosenbaum ◽  
Anne Stormorken ◽  
Steven Shein
Keyword(s):  
Critically Ill ◽  
Functional Decline ◽  
Icu Admission ◽  
Critically Ill Child

Care of the critically ill child in Irish hospitals

2015 ◽  
Author(s):  
Dr G Maloney ◽  
◽  
Dr M J White ◽  
Dr K Bailey ◽  
Dr A Bergin ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Child

scholarly journals Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Eleni Papoutsi ◽  
Vassilis G. Giannakoulis ◽  
Eleni Xourgia ◽  
Christina Routsi ◽  
Anastasia Kotanidou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mechanical Ventilation ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Meta Analysis ◽  
Mortality And Morbidity ◽  
Icu Admission ◽  
All Cause Mortality ◽  
Detectable Difference

Abstract Background Although several international guidelines recommend early over late intubation of patients with severe coronavirus disease 2019 (COVID-19), this issue is still controversial. We aimed to investigate the effect (if any) of timing of intubation on clinical outcomes of critically ill patients with COVID-19 by carrying out a systematic review and meta-analysis. Methods PubMed and Scopus were systematically searched, while references and preprint servers were explored, for relevant articles up to December 26, 2020, to identify studies which reported on mortality and/or morbidity of patients with COVID-19 undergoing early versus late intubation. “Early” was defined as intubation within 24 h from intensive care unit (ICU) admission, while “late” as intubation at any time after 24 h of ICU admission. All-cause mortality and duration of mechanical ventilation (MV) were the primary outcomes of the meta-analysis. Pooled risk ratio (RR), pooled mean difference (MD) and 95% confidence intervals (CI) were calculated using a random effects model. The meta-analysis was registered with PROSPERO (CRD42020222147). Results A total of 12 studies, involving 8944 critically ill patients with COVID-19, were included. There was no statistically detectable difference on all-cause mortality between patients undergoing early versus late intubation (3981 deaths; 45.4% versus 39.1%; RR 1.07, 95% CI 0.99–1.15, p = 0.08). This was also the case for duration of MV (1892 patients; MD − 0.58 days, 95% CI − 3.06 to 1.89 days, p = 0.65). In a sensitivity analysis using an alternate definition of early/late intubation, intubation without versus with a prior trial of high-flow nasal cannula or noninvasive mechanical ventilation was still not associated with a statistically detectable difference on all-cause mortality (1128 deaths; 48.9% versus 42.5%; RR 1.11, 95% CI 0.99–1.25, p = 0.08). Conclusions The synthesized evidence suggests that timing of intubation may have no effect on mortality and morbidity of critically ill patients with COVID-19. These results might justify a wait-and-see approach, which may lead to fewer intubations. Relevant guidelines may therefore need to be updated.

scholarly journals Prognostic impact of elevated lactate levels on mortality in critically ill patients with and without preadmission metformin treatment: a Danish registry-based cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Rene A. Posma ◽  
Trine Frøslev ◽  
Bente Jespersen ◽  
Iwan C. C. van der Horst ◽  
Daan J. Touw ◽  
...  
Keyword(s):  
Cohort Study ◽  
Mortality Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cox Regression ◽  
Lower Mortality ◽  
Prognostic Impact ◽  
Icu Admission ◽  
Lactate Levels ◽  
Restricted Cubic Splines

Abstract Background Lactate is a robust prognostic marker for the outcome of critically ill patients. Several small studies reported that metformin users have higher lactate levels at ICU admission without a concomitant increase in mortality. However, this has not been investigated in a larger cohort. We aimed to determine whether the association between lactate levels around ICU admission and mortality is different in metformin users compared to metformin nonusers. Methods This cohort study included patients admitted to ICUs in northern Denmark between January 2010 and August 2017 with any circulating lactate measured around ICU admission, which was defined as 12 h before until 6 h after admission. The association between the mean of the lactate levels measured during this period and 30-day mortality was determined for metformin users and nonusers by modelling restricted cubic splines obtained from a Cox regression model. Results Of 37,293 included patients, 3183 (9%) used metformin. The median (interquartile range) lactate level was 1.8 (1.2–3.2) in metformin users and 1.6 (1.0–2.7) mmol/L in metformin nonusers. Lactate levels were strongly associated with mortality for both metformin users and nonusers. However, the association of lactate with mortality was different for metformin users, with a lower mortality rate in metformin users than in nonusers when admitted with similar lactate levels. This was observed over the whole range of lactate levels, and consequently, the relation of lactate with mortality was shifted rightwards for metformin users. Conclusion In this large observational cohort of critically ill patients, early lactate levels were strongly associated with mortality. Irrespective of the degree of hyperlactataemia, similar lactate levels were associated with a lower mortality rate in metformin users compared with metformin nonusers. Therefore, lactate levels around ICU admission should be interpreted according to metformin use.

The critically ill child

1993 ◽  
Vol 21 (Supplement) ◽  
pp. S306 ◽  
Author(s):  
David G. Nichols ◽  
Mark C. Rogers
Keyword(s):  
Critically Ill ◽  
Critically Ill Child

Diagnostic Open Lung Biopsy in the Critically Ill Child

PEDIATRICS ◽  
1973 ◽  
Vol 52 (4) ◽  
pp. 605-608
Author(s):  
Stacy A. Roback ◽  
William H. Weintraub ◽  
Mark Nesbit ◽  
Panayiotis K. Spanos ◽  
Barbara Burke ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Critically Ill ◽  
Lung Tissue ◽  
Lung Biopsy ◽  
Open Lung Biopsy ◽  
University Of Minnesota ◽  
Biopsy Technique ◽  
Open Lung ◽  
Critically Ill Child ◽  
The University

Forty-six open biopsies in 40 acutely ill children with rapidly decreasing pulmonary reserve were performed at the University of Minnesota Hospitals between January 1, 1970, and January 1, 1972. Tissue obtained was adequate in all patients and no serious complications ensued. Information obtained resulted in the change in treatment in 30 patients. This procedure is recommended over closed biopsy when the magnitude of the patient's illness and degree of pulmonary function do not allow acceptance of the risks known to occur with a closed biopsy technique and when histologic examination of lung tissue is required.

THE CRITICALLY ILL CHILD: DIAGNOSIS AND MANAGEMENT OF HEAD INJURY

PEDIATRICS ◽  
1971 ◽  
Vol 48 (3) ◽  
pp. 400-400
Author(s):  
Darryl C. DeVivo ◽  
Philip R. Dodge
Keyword(s):  
Head Injury ◽  
Critically Ill ◽  
Diagnosis And Management ◽  
Child Diagnosis ◽  
Critically Ill Child

In the article, "The Critically Ill Child: Diagnosis and Management of Head Injury," by D. C. DeVivo and P. R. Dodge (Pediatrics, 48: 129, 1971), the word evaluation (pp. 135, left column, line 22) should be changed to elevation.

Sign in / Sign up

Export Citation Format

Share Document