scholarly journals The Meaning of Critical Illness for People Suffering From COVID-19: When a Frightening Unreality Becomes Reality

2021 ◽  
pp. 104973232110500
Author(s):  
Åsa Engström ◽  
Päivi Juuso ◽  
Maria Andersson ◽  
Anna Nordin ◽  
Ulrica Strömbäck
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Data Collection ◽  
Critically Ill ◽  
Study Data ◽  
Narrative Approach ◽  
Northern Sweden ◽  
Qualitative Design ◽  
Individual Interviews

The aim of this study was to elucidate the meaning of critical illness for people with COVID-19. This study used a qualitative design. Thirteen people who were critically ill with COVID-19 during 2020 and admitted to a COVID-19 intensive care unit in northern Sweden participated in the study. Data collection was conducted as individual interviews with a narrative approach, and data were analyzed with phenomenological hermeneutic interpretation. The participants did not think they would get critically ill with this unexpected illness. They experienced terrible nightmares where their relatives had been killed, and they missed their relatives both in their dreams and in reality, as they had not been allowed to be with them due to the virus. Gratefulness was described for surviving. Participants described thoughts of not being able to imagine going through this again. They felt fear and loneliness, as a terrifying unreality had become a reality.

Myopathy and Neuropathy Acquired in the Intensive Care Unit

2019 ◽  
pp. 677-684
Author(s):  
Priya S. Dhawan ◽  
Jennifer A. Tracy
Keyword(s):  
Skeletal Muscle ◽  
Intensive Care Unit ◽  
At Risk ◽  
Intensive Care ◽  
Peripheral Neuropathy ◽  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Illness Polyneuropathy ◽  
Muscle Disorder

Acquired weakness in critically ill patients is common, affecting between one-third to one-half of patients in the intensive care unit (ICU). Exposure to simultaneous stressors such as metabolic derangements, fluid and electrolyte shifts, infection, catabolic stress, and medications put patients in the ICU at risk for damage to both nerve and skeletal muscle with substantial and often lasting morbidity. Critical illness polyneuropathy is a length-dependent, axonal peripheral neuropathy occurring in patients in the ICU and unrelated to the primary illness. Critical illness myopathy is an ICU-associated muscle disorder occurring independently of denervation and uniquely identified by electrophysiologic and histologic characteristics.

The need to know: experiences of critically ill patients

2000 ◽  
Vol 9 (3) ◽  
pp. 192-198 ◽  
Author(s):  
JE Hupcey ◽  
HE Zimmerman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Nursing Staff ◽  
Critically Ill Patients ◽  
Second Phase ◽  
The Past ◽  
Intensive Care Unit Nurses ◽  
Vivid Memories

BACKGROUND: Critically ill patients vary in their memories of their experience in the intensive care unit. Some have little recall and need to learn about their critical illness. Others have more vivid memories of their experiences, some of which were extremely unpleasant. Patients' not knowing what was happening may have exacerbated the unpleasant experiences. OBJECTIVES: To elicit the experience of knowing for critically ill patients and to explore the differences in perceptions between patients who were intubated and those who were not intubated during the illness. METHODS: Grounded theory was used to explore the meaning of knowing and not knowing and the process by which knowing occurs. Unstructured interviews were done with 14 patients. RESULTS: Knowing had 2 phases: the need to know (1) during and (2) after the critical illness. The first phase had 3 facets: needing information, needing to be oriented, and having confusing perceptions. The second phase had 2 facets: needing information about what had happened and piecing together events. Many experiences with knowing during and after a critical illness were similar for both intubated and nonintubated patients. The main difference was the intensity of the experience in some categories. CONCLUSIONS: Critically ill patients have a strong need to know throughout and after their time in the intensive care unit. Nurses must address this need for constant reorientation to the past and present in these patients. In addition, adequate nursing staff must be available for these patients.

scholarly journals Childrens participation in the PICU from the nurses' perspective

2018 ◽  
Vol 9 (4) ◽  
pp. 65 ◽  
Author(s):  
Elisabeth Wimo ◽  
Ann-Mari Fagerdahl ◽  
Janet Mattsson
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Data Collection ◽  
Critically Ill ◽  
Pediatric Intensive Care Unit ◽  
Nursing Care ◽  
Pediatric Intensive Care ◽  
Qualitative Approach ◽  
Interpretive Phenomenology ◽  
Care Intervention

Children who are critically ill are vulnerable and the nurse has a responsibility to meet the child's needs in a pediatric intensive care unit (PICU). The aim was to explore the vulnerable child's participation and how it can be understood through the nurses’ perspective in the nursing care intervention. The study design was an exploratory inductive qualitative approach. Data collection was done through observations and interviews. The data from the observations were analyzed through interpretive phenomenology. The affective elements were viewed as essential for uncover how children participate in the PICU. Three themes emerged through the analysis: Mediated participation, Bodily participation and Participation by proxy. They all highlight different aspect of the vulnerable child's way of participating in the nursing care given, through nurses’ awareness and situated salience. The concept participation should be redefined and broadened; as participation can present itself through the child’s body in diverse ways.

scholarly journals Albumin–Globulin Ratio Is an Independent Determinant of 28-Day Mortality in Patients with Critical Illness

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Bin Liu ◽  
Kun Xiao ◽  
Peng Yan ◽  
Tianyu Sun ◽  
Jiang Wang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cox Regression ◽  
Independent Predictor ◽  
Laboratory Data ◽  
Cox Regression Analysis ◽  
Increased Risk

Background. Critical illness in the intensive care unit (ICU) has been a global health priority. Systemic nutritional status has turned out to be related to the prognosis of critically ill patients. The albumin-globulin ratio (AGR) has been reported to be a novel prognostic factor of many diseases. This study is aimed at investigating whether the AGR could predict the mortality risk in critically ill patients. Methods. We enrolled 582 adult patients admitted to the respiratory intensive care unit (RICU). We collected the clinical and laboratory data. X-tile software was used to determine the optimal cut-off values for the AGR. Patients were divided into three groups according to the AGR (low AGR group with AGR < 0.8 , medium AGR group with AGR ranging from 0.8 to 1.1, and high AGR group with AGR > 1.1 ). Kaplan-Meier analysis was used for survival analysis. A Cox proportional hazard model was applied to the univariate and multivariate analyses for the potential predictors associated with survival. Results. Our present study showed that the AGR was related to the 28-day survival of critically ill patients in the RICU. The rate of pneumonia in the low AGR group was significantly higher than that in the other groups. Patients with a lower AGR present an increased risk of 28-day mortality compared to patients with a higher AGR. Cox regression analysis showed that the AGR might be an independent predictor of prognosis to 28-day survival in critically ill patients in the RICU. Medium and high AGR values remained independently associated with better 28-day survival than low AGR values (HR: 0.484 (0.263-0.892) ( p = 0.02 ); HR: 0.332 (0.166-0.665) ( p = 0.002 )). Conclusion. The AGR might be an independent predictor of prognosis in critically ill patients.

scholarly journals 1147 Sleep Correlates With Improved Functional Outcome In The Intensive Care Unit

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A437-A437
Author(s):  
L C Markun ◽  
A Sampat ◽  
R Dutta ◽  
G A Palchik ◽  
M Chow ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Injury ◽  
Critical Illness ◽  
Functional Outcome ◽  
Critically Ill ◽  
Acute Brain Injury ◽  
Subdural Hemorrhage ◽  
Neurological Patients ◽  
Chi Square Analysis

Abstract Introduction Disruption of sleep may have significant implications in acute brain injury, functional recovery, and critical illness. Few data exist characterizing sleep architecture in patients admitted to an intensive care unit (ICU). We aim to describe sleep and clinical characteristics in patients with acute brain injury and critical illness. Methods Retrospective analysis was performed in ICU patients who underwent continuous electroencephalographic (EEG) monitoring from 2018-2019. Sleep was scored based on AASM-defined EEG criteria. Clinical variables, EEG characteristics, and modified Ranking Scale (mRS) were collected. Good outcome was defined as mRS&lt;3. Differences were assessed using chi-square analysis and t-test. Results 205 patients were reviewed with a mean age of 57 years (range 18-91) and a majority (57%) were male. Patients carried a primary neurologic/neurosurgical (61%) or medical/surgical (39%) diagnosis. Status epilepticus, subdural hemorrhage, traumatic brain injury, encephalopathy and cardiac arrest accounted for the majority of diagnoses encountered. Only 58 patients (28%) achieved N1 sleep; of these 76.4% achieved N2, 2.8% N3, and none achieved REM. Of those achieving any sleep, 43% had good outcomes versus only 23% in those who did not (t=-7.45, p&lt;0.001). Neurological patients were more likely to attain sleep compared to those with other primary diagnoses (χ 2 (1)=7.08, p=0.008). Centrally acting anesthetics did not account for sleep differences between neurologic and non-neurologic patients (χ² (1)=2.01, p=0.16). However, those with primary brain injury reached sleep more often in the absence of anesthetic use (χ 2 (1)=4.82, p=0.03). The overall mortality was 32% in this cohort. Conclusion Most critically ill patients do not achieve electrophysiologic sleep. Of those who do, N1/N2 stages are seen most often. Neurological patients were more likely to sleep, and achieving any sleep was associated with improved functional outcome. Further studies are needed to determine whether sleep augmentation in the critically ill impacts functional outcome. Support N/A.

scholarly journals The Type II Iodothyronine Deiodinase Is Up-Regulated in Skeletal Muscle during Prolonged Critical Illness

2007 ◽  
Vol 92 (8) ◽  
pp. 3330-3333 ◽  
Author(s):  
Liese Mebis ◽  
Lies Langouche ◽  
Theo J. Visser ◽  
Greet Van den Berghe
Keyword(s):  
Skeletal Muscle ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Surgical Intensive Care Unit ◽  
Type Ii ◽  
Low T3 Syndrome ◽  
Low T3

Abstract Context: Critical illness is associated with the low T3 syndrome. It remains unclear whether altered type II deiodinase activity (D2) in skeletal muscle contributes to this syndrome. Objective: Our objective was to study D2 expression and activity in skeletal muscle of acute and prolonged critically ill patients. Design and Setting: We conducted a clinical observational study in acute and prolonged critical illness with comparison with healthy controls at a university hospital surgical intensive care unit. Patients: Subjects included 63 prolonged critically ill patients who died in the intensive care unit, 21 acutely ill patients, and 38 controls matched for age, gender, and body mass index. Results: Elevated expression of the D2 gene and D2 activity in skeletal muscle of prolonged, but not acute, critically ill patients were observed in the face of low circulating thyroid hormone levels. Conclusions: Reduced D2 activity does not appear to play a role in the pathogenesis of the low T3 syndrome of critical illness.

scholarly journals Evaluating the Role of the Interleukin-23/17 Axis in Critically Ill COVID-19 Patients

2021 ◽  
Vol 11 (9) ◽  
pp. 891
Author(s):  
Edison Jahaj ◽  
Alice G. Vassiliou ◽  
Chrysi Keskinidou ◽  
Parisis Gallos ◽  
Charikleia S. Vrettou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Potential Role ◽  
Illness Severity ◽  
Icu Admission ◽  
Interleukin 23

Studies have hypothesized a potential role of the interleukin (IL)-23/17 axis in coronavirus disease 2019 (COVID-19). However, to date, levels of IL-23 and 17 have not been compared between critically ill COVID-19 patients and critically ill non-COVID-19 patients. IL-23 and 17 were measured on admission to the intensive care unit (ICU) in critically ill COVID-19 (N = 38) and critically ill non-COVID-19 (N = 34) patients with an equal critical illness severity. Critically ill non-COVID-19 patients did not have sepsis or septic shock on ICU admission. None of the enrolled patients had previously received corticosteroids. In our study, circulating IL-17 levels were higher in the COVID-19 patients. More specifically, critically ill COVID-19 patients had levels of 0.78 (0.05–1.8) pg/mL compared to 0.11 (0.05–0.9) pg/mL in the critically ill non-COVID-19 patients (p = 0.04). In contrast, IL-23 levels were comparable between groups. A group of patients hospitalized in the specialized COVID-19 clinic (N = 16) was also used to evaluate IL-17 and IL-23 levels with respect to COVID-19 severity. Non-critically ill COVID-19 patients had undetectable levels of both cytokines. Our results support the notion of inhibiting IL-17 in critical COVID-19 infection.

scholarly journals THE USE OF 2% CHLORHEXIDINE GLUCONATE (CHG) AS A DAILY BATHING TO REDUCE BACTEREMIA IN CHILDREN WITH CRITICAL ILLNESS AT PICU/NICU

2016 ◽  
Vol 2 (1) ◽  
pp. 1
Author(s):  
Nopi Nur Khasanah
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Nosocomial Infection ◽  
Critically Ill ◽  
Pediatric Intensive Care ◽  
Central Venous Catheters ◽  
Chlorhexidine Gluconate ◽  
Critically Ill Children ◽  
Central Venous

Background: Bacteremia frequently occurs because of nosocomial infection that actually could be preventable. In children who are hospitalized ussually have a higher risk to experience it. Especially in children with critical illness at Pediatric Intensive Care Unit (PICU) at which the state of children to get an indication of central venous catheters (CVC). Objective: To analyze the use of 2% Chlorhexidine Gluconate (CHG) as a daily bathing treatment to reduce bacteremia in critically ill children in the PICU/NICU. Discussion: The study of the use 2% CHG as a daily bathing treatment for critically ill patients admitted to the intensive care unit has been carried out. However, only performed in adult patients. Developing research conducted in children, this study recommends the use of 2% CHG as a daily bathing treatment can be used in selected patients in the NICU when there is an effort by other measures, but still failed to reduce the incidence of CLABSI. Conclusions: Implementation of recommendations will involve approval by the appropriate organizational structure in charge of monitoring the evolution of the practice. Need staff whom known the instructions on the use of CHG to develop procedures daily bathing with 2% CHG in intensive care and decrease the incidence of bacteremia,.Keywords: Chlorhexidine Gluconate, Daily Bathing, Bacteremia in children, PICU/NICU.

Intensive care unit-related generalized neuromuscular weakness due to critical illness polyneuropathy/myopathy in critically ill patients

2014 ◽  
Vol 29 (1) ◽  
pp. 112-121 ◽  
Author(s):  
Efstratios Apostolakis ◽  
Nikolaos A. Papakonstantinou ◽  
Nikolaos G. Baikoussis ◽  
George Papadopoulos
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Critical Illness Polyneuropathy
Sign in / Sign up

Export Citation Format

Share Document