scholarly journals Dexmedetomidine-Associated Hyperthermia: A Retrospective Cohort Study of Intensive Care Unit Admissions between 2009 and 2016

2017 ◽  
Vol 45 (6) ◽  
pp. 727-736 ◽  
Author(s):  
K. E. D. Grayson ◽  
A. E. Tobin ◽  
D. T. K. Lim ◽  
D. E. Reid ◽  
M. Ghani
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart ◽  
Increased Risk

Dexmedetomidine-associated hyperthermia has not been previously studied. Analysis is warranted to determine whether this potentially dangerous complication is more prevalent than previously realised. We aimed to examine the association between dexmedetomidine and temperature ≥39.5°C, including patient characteristics, temporality and potential risk factors. We conducted a retrospective cohort study of all intensive care unit (ICU) admissions between 1 July 2009 and 31 May 2016 in a tertiary ICU in Australia. Temperature data was available for 9,782 ICU admissions. Dexmedetomidine was given intravenously to 611 (6.3%) patients at a dose of 0 to 1.5 g/kg/hour. Temperatures ≥39.5°C were recorded in 341 (3.5%) patients. Overall hospital mortality was 10.8% for all admissions and 29.3% for patients with temperatures ≥39.5°C. Dexmedetomidine exposure was more frequent in patients with temperature recordings ≥39.5°C compared to those with temperatures <39.5°C, 11.94% versus 2.94% (odds ratio [OR] 4.49; 95% confidence intervals [CI] 3.37, 5.92; P <0.001). The association was stronger for patients post-open heart surgery (OHS) with temperatures ≥39.5°C (OR 12.9; 95% CI 5.01, 31.62; P <0.001). Multivariate analysis showed an independent association between dexmedetomidine and a temperature ≥39.5°C in two particular patient groups: OHS (OR 2.72; 95% CI 1.1, 6.9; P <0.001), and obesity (OR 3.44; 95% CI 1.5, 7.9; P <0.001). Dexmedetomidine exposure is associated with an increased risk of hyperthermia. Possible risk factors are open heart surgery and obesity.

scholarly journals Risk factors for acute kidney injury in a pediatric intensive care unit: a retrospective cohort study

Medwave ◽  
2017 ◽  
Vol 17 (03) ◽  
pp. e6940-e6940 ◽  
Author(s):  
Lina María Serna-Higuita ◽  
John Fredy Nieto-Ríos ◽  
Jorge Eduardo Contreras-Saldarriaga ◽  
Juan Felipe Escobar-Cataño ◽  
Luz Adriana Gómez-Ramírez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Pediatric Intensive Care

scholarly journals Risk Factors for Candidemia After Open Heart Surgery: Results From a Multicenter Case–Control Study

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Daniele Roberto Giacobbe ◽  
Antonio Salsano ◽  
Filippo Del Puente ◽  
Ambra Miette ◽  
Antonio Vena ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Heart Surgery ◽  
Case Control Study ◽  
Open Heart Surgery ◽  
Case Control ◽  
Open Heart ◽  
Previous Therapy ◽  
Control Study

Abstract Background Candida species are among the most frequent causative agents of health care–associated bloodstream infections, with mortality &gt;40% in critically ill patients. Specific populations of critically ill patients may present peculiar risk factors related to their reason for intensive care unit admission. The primary objective of the present study was to assess the predictors of candidemia after open heart surgery. Methods This retrospective, matched case–control study was conducted in 8 Italian hospitals from 2009 to 2016. The primary study objective was to assess factors associated with the development of candidemia after open heart surgery. Results Overall, 222 patients (74 cases and 148 controls) were included in the study. Candidemia developed at a median time (interquartile range) of 23 (14–36) days after surgery. In multivariable analysis, independent predictors of candidemia were New York Heart Association class III or IV (odds ratio [OR], 23.81; 95% CI, 5.73–98.95; P &lt; .001), previous therapy with carbapenems (OR, 8.87; 95% CI, 2.57–30.67; P = .001), and previous therapy with fluoroquinolones (OR, 5.73; 95% CI, 1.61–20.41; P = .007). Crude 30-day mortality of candidemia was 53% (39/74). Septic shock was independently associated with mortality in the multivariable model (OR, 5.64; 95% CI, 1.91–16.63; P = .002). No association between prolonged cardiopulmonary bypass time and candidemia was observed in this study. Conclusions Previous broad-spectrum antibiotic therapy and high NYHA class were independent predictors of candidemia in cardiac surgery patients with prolonged postoperative intensive care unit stay.

Readmission to the Intensive Care Unit: Incidence, Risk Factors, Resource Use, and Outcomes. A Retrospective Cohort Study

2017 ◽  
Vol 14 (8) ◽  
pp. 1312-1319 ◽  
Author(s):  
Carolina R. Ponzoni ◽  
Thiago D. Corrêa ◽  
Roberto R. Filho ◽  
Ary Serpa Neto ◽  
Murillo S. C. Assunção ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Resource Use ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Incidence Risk

scholarly journals Risk Factors for Prolonged Intensive Care Unit Stay After Open Heart Surgery in Adults

2018 ◽  
Vol 46 (4) ◽  
pp. 283-291 ◽  
Author(s):  
Muzaffer Tunc ◽  
◽  
Cengiz Sahutoglu ◽  
Nursen Karaca ◽  
Seden Kocabas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Stay ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Open Heart

scholarly journals Thromboembolic Rates Are Similar Between Intensive Care Unit and Nonintensive Care Unit Hospitalized Patients With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Retrospective Cohort Study

2021 ◽  
Vol 27 ◽  
pp. 107602962110533
Author(s):  
Heidi Worth ◽  
Kasey Helmlinger ◽  
Renju Raj ◽  
Eric Heidel ◽  
Ronald Lands
Keyword(s):  
Intensive Care Unit ◽  
Cohort Study ◽  
Intensive Care ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Thromboembolic Event ◽  
Hospitalized Patients ◽  
Thromboembolic Events ◽  
Icu Patients ◽  
Increased Risk

High rates of thromboembolic events have been described in intensive care unit (ICU) patients. Data regarding thromboembolic events in all hospitalized patients has been less frequently reported, raising concerns that thromboembolic events in non-ICU may be underrecognized. In addition, optimal anticoagulation type and dose is still unsettled at this time. This is a retrospective cohort study of 159 hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia during a 9-month period to determine an association between the frequency of thromboembolic rates and hospitalized patients with COVID-19. Secondary outcomes sought to investigate association of thromboembolic events with relation to place of admission, risk factors, anticoagulation, mortality, hospital length of stay, and discharge disposition. Among the cohort of 159 hospitalized patients who met criteria, 16 (10%) were diagnosed with a thromboembolic event. There were a total of 18 thromboembolic events with 12 venous and 6 arterial. Admission to the ICU was not associated with a higher frequency of thromboembolic events compared with non-ICU patients (37.5% vs 62.5%), p = .71. Patients with a thromboembolic event had a significantly higher mortality compared with those with no thromboembolic event (37.5% vs 13.3%), p = .012. Patients hospitalized with COVID-19 have increased rates of thromboembolic events, both venous and arterial, which contribute to a significant increase in mortality. However, the frequency of thromboembolism in patients admitted to the ICU was similar to events in non-ICU patients. We hope to increase awareness of the increased risk of hypercoagulability in all hospitalized patients with COVID-19 including non-ICU patients.

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