The effect of alcohol policy on intensive care unit admission patterns in Central Australia: A before–after cross-sectional study

2021 ◽  
Vol 49 (1) ◽  
pp. 35-43
Author(s):  
Carly Wright ◽  
Greg R McAnulty ◽  
Paul J Secombe
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Alcohol Misuse ◽  
Cross Sectional Study ◽  
Primary Diagnosis ◽  
Alcohol Policy ◽  
Sectional Study ◽  
Harm Minimisation ◽  
Cross Sectional

Alcohol misuse is a disproportionately large contributor to morbidity and mortality in the Northern Territory. A number of alcohol harm minimisation policies have been implemented in recent years. The effect of these on intensive care unit (ICU) admissions has not been fully explored. A retrospective before–after cross-sectional study was conducted at the Alice Springs Hospital ICU between 1 October 2017 and 30 September 2019. The primary outcome was the proportion of admissions in which alcohol misuse was a contributing factor in the 12 months before (pre-reforms phase) versus the 12 months following (post-reforms phase) implementation of alcohol legislation reforms. Secondary outcomes were measures of critical care resource use (length of stay, need for and duration of mechanical ventilation). After exclusions, 1323 ICU admissions were analysed. There was a reduction in the proportion of admissions associated with alcohol misuse between the pre-reforms and post-reforms phases (18.8% versus 11.7%, P < 0.01). This was true for both acute (10.6% versus 3.6%, P < 0.01) and chronic misuse (13.3% versus 9.6%, P = 0.03). Rates of mechanical ventilation were unchanged during the post-reforms phase (18.3% versus 14.7%). Admissions with a primary diagnosis of trauma were lower (10.5% versus 4.7%, P < 0.01). This study demonstrated a reduction in ICU admissions associated with alcohol misuse following the implementation of new alcohol harm minimisation policies. This apparent reduction in alcohol-related harm is suggestive of the effectiveness of the Northern Territory’s integrated alcohol harm reduction framework.

Nosocomial Sepsis and its Risk Factors: A Cross-Sectional Study in a Neonatal Intensive Care Unit

2019 ◽  
Vol 2 (1) ◽  
pp. 52-59
Author(s):  
Sunil Kumar Yadav ◽  
SP Yadav ◽  
P Kanodia ◽  
N K Bhatta ◽  
R R Singh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nosocomial Sepsis

Introduction: Nosocomial sepsis is a common and serious infection of neonates who are admitted in intensive care unit. They lead to significant morbidity and mortality in both developed and resource limited countries. The neonatal intensive care unit (NICU) is a suitable environment for disseminating the infections and, hence, needs preventive intervention. The study was carried out to determine the risk factors for nosocomial sepsis in neonatal intensive care unit. Material and Methods: This was a cross-sectional study conducted in a seven bedded teaching and referral hospital NICU. All neonates in NICU who did not have any sign of infection at admission and remained hospitalized for at least 48 hours were observed. Nosocomial sepsis was diagnosed according to the CDC criteria. Risk factors for nosocomial sepsis were analyzed with Chi-square test and Logistic regression model. P-value of <0.05 was considered significant. Results: Low birth weight (both preterm and IUGR) and mechanical ventilation were found to be related with nosocomial sepsis. Conclusions: Low birth weight and mechanical ventilation were the most important risk factors fornosocomial sepsis.

scholarly journals Utilization of mechanical ventilators in low resource Faculty: a cross sectional study

2020 ◽  
Author(s):  
Tigist Bacha ◽  
Netsanet Tsegaye ◽  
Wagari Tuli
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Mortality Rate ◽  
Severity Score ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multi Organ Dysfunction Syndrome

Abstract Background Few studies are available from Africa on the use of mechanical ventilation (MV) in the pediatric intensive care unit (PICU). Knowledge of the outcome of patients on MV is critical for better use of resources and clinical decision making. We aimed to see the outcome and pattern of patients treated in a pediatric intensive care unit in a teresery hospital, which is the first study to evaluate an Ethiopian PICU. Methods A cross-sectional study with retrospective data collection was employed. Data were abstracted from the patients’ medical records by trained health professionals. SPSS version 21 software was used for data entry and analysis. The reports were depicted descriptively using measures of central tendency, dispersion, and displayed through tables and graphs. Results There were 536 patients admitted during the study period. 202 (41.2%) incidence of mechanical ventilation (MV) rate 63.6% of the participants were males and 130 (59.1%) died. The most common indication for the initiation of MV was respiratory problems 46 (20.9%). we identified 30.59/1000 ventilator days developed complications.Ventilator-associated pneumonia accounted for 18.6% of the complications with 20.9/1000 ventilator days. Survival of medical cases was better than the surgical cases (including trauma); [AOR = 0.13, 95% CI(0.04–0.413)] and those who have MV for more than 3 days are 79% more likely to die than those of less than 3 days ventilated; (p = 0.003). Those who have multi-organ dysfunction syndrome die more likely than the other group of patients; [AOR = 0.181, 95% CI (0.08, 0.412)] and the patient who had high PIM II severity score had higher mortality rate; [AOR = 35, 95% CI (1.7, 11)]. Conclusions In the current study, the mortality rate of mechanically ventilated pediatric patients was high. Severity score, multi-organ dysfunction syndrome, length of stay, and being a surgical patient increased the risk of mortality. Adequate education of PICU staff on the use of mechanical ventilator and prevention of complications as well as the use of severity score is necessary.

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

scholarly journals Inhaled Nitric Oxide in Patients with Severe COVID-19 Infection at Intensive Care Unit – A Cross Sectional Study

2021 ◽  
Vol 7 (4) ◽  
pp. 318-319
Author(s):  
Laura Herranz ◽  
Juliana Gurgel da Silveira ◽  
Luis Filipe Lannes Trocado ◽  
Anna Luiza Alvaraes ◽  
Juliana Fittipaldi
Keyword(s):  
Nitric Oxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Cross Sectional Study ◽  
Inhaled Nitric Oxide ◽  
Sectional Study ◽  
Cross Sectional

Increase in Pediatric Intensive Care Unit Hospitalizations Due to Toxic Ingestions during the COVID-19 Pandemic

2021 ◽  
Author(s):  
Jennifer L. van Helmond ◽  
Brittany Fitts ◽  
Jigar C. Chauhan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Home Environment ◽  
Clinical Characteristics ◽  
Pediatric Intensive Care ◽  
Cross Sectional Study ◽  
Mitigation Measures ◽  
Sectional Study ◽  
Cross Sectional

AbstractThe coronavirus disease 2019 (COVID-19) pandemic and related community mitigation measures had a significant psychosocial impact. We suspected that more patients were admitted to our pediatric intensive care unit (PICU) for toxic ingestions since the start of the pandemic. We therefore investigated if PICU admissions related to toxic ingestions were higher in 2020 as a result of COVID-19 compared with previous years. We completed a cross-sectional study at a tertiary children's hospital comparing admissions to our PICU between April 2020 and October 2020, during which COVID-19 and community mitigation measures were in place, to those during the same 7-month period in the previous 3 years. Total PICU admissions, admissions for all toxic ingestions (intentional ingestions and accidental ingestions), and demographic and clinical characteristics of patients were compared. Total PICU admissions in 2020 during COVID-19 pandemic months were lower compared with the same months in the preceding 3 years (−16%, p< 0.001), however, admissions for toxic ingestions were higher during COVID-19 (+64%, p< 0.001). When separated by type, intentional (+55%, p = 0.012) and accidental ingestions (+94%, p = 0.021) were higher during COVID-19. COVID-19 with community mitigation measures has led to an increase in PICU admissions for intentional and accidental ingestions, indicating an increase in severity of toxic ingestions in children associated with the pandemic. Mental health of adolescents, and safety of infants and toddlers in their home environment, should be targeted with specific interventions in the ongoing COVID-19 pandemic.

scholarly journals A multi-center cross-sectional study on blood purification among adult patients in intensive care unit in China

2019 ◽  
Vol 132 (10) ◽  
pp. 1208-1211 ◽  
Author(s):  
Yang Gao ◽  
Zhi-Dong Qi ◽  
Rui-Jin Liu ◽  
Hai-Tao Liu ◽  
Qiu-Yuan Han ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cross Sectional Study ◽  
Blood Purification ◽  
Adult Patients ◽  
Sectional Study ◽  
Cross Sectional
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