scholarly journals The interrelations of radiologic findings and mechanical ventilation in community acquired pneumonia patients admitted to the intensive care unit: a multicentre retrospective study

2014 ◽  
Vol 13 (1) ◽  
pp. 5 ◽  
Author(s):  
Hakan Erdem ◽  
Zeliha Kocak-Tufan ◽  
Omer Yilmaz ◽  
Zuhal Karakurt ◽  
Aykut Cilli ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Retrospective Study ◽  
Community Acquired Pneumonia ◽  
Radiologic Findings ◽  
Multicentre Retrospective Study

scholarly journals Etiology and Impact of Coinfections in Children Hospitalized With Community-Acquired Pneumonia

2017 ◽  
Vol 218 (2) ◽  
pp. 179-188 ◽  
Author(s):  
Vikki G Nolan ◽  
Sandra R Arnold ◽  
Anna M Bramley ◽  
Krow Ampofo ◽  
Derek J Williams ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Unit Admission ◽  
Bacterial Infections ◽  
Clinical Characteristics ◽  
Community Acquired Pneumonia ◽  
Virus Infections ◽  
Oxygen Supplementation

Abstract Background Recognition that coinfections are common in children with community-acquired pneumonia (CAP) is increasing, but gaps remain in our understanding of their frequency and importance. Methods We analyzed data from 2219 children hospitalized with CAP and compared demographic and clinical characteristics and outcomes between groups with viruses alone, bacteria alone, or coinfections. We also assessed the frequency of selected pairings of codetected pathogens and their clinical characteristics. Results A total of 576 children (26%) had a coinfection. Children with only virus detected were younger, more likely to be black, and more likely to have comorbidities such as asthma, compared with children infected with typical bacteria alone. Children with virus-bacterium coinfections had a higher frequency of leukocytosis, consolidation on chest radiography, parapneumonic effusions, intensive care unit admission, and need for mechanical ventilation and an increased length of stay, compared with children infected with viruses alone. Virus-virus coinfections were generally comparable to single-virus infections, with the exception of the need for oxygen supplementation, which was higher during the first 24 hours of hospitalization in some virus-virus pairings. Conclusions Coinfections occurred in 26% of children hospitalized for CAP. Children with typical bacterial infections, alone or complicated by a viral infection, have worse outcomes than children infected with a virus alone.

scholarly journals Prognostic factors of adult tuberculous meningitis in intensive care unit: a single-center retrospective study in East China

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Baobao Feng ◽  
Xiao Fei ◽  
Ying Sun ◽  
Xingguo Zhang ◽  
Deya Shang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Retrospective Study ◽  
Tuberculous Meningitis ◽  
Adult Patients ◽  
Apache Ii ◽  
Cox Regression Analysis ◽  
Factors Associated

Abstract Background Tuberculous meningitis (TBM) is the most lethal form of tuberculosis worldwide. Data on critically ill TBM patients in the intensive care unit (ICU) of China are lacking. We tried to identify prognostic factors of adult TBM patients admitted to ICU in China. Methods We conducted a retrospective study on adult TBM in ICU between January 2008 and April 2018. Factors associated with unfavorable outcomes at 28 days were identified by logistic regression. Factors associated with 1-year mortality were studied by Cox proportional hazards modeling. Results Eighty adult patients diagnosed with TBM (age 38.5 (18–79) years, 45 (56 %) males) were included in the study. An unfavorable outcome was observed in 39 (49 %) patients and were independently associated with Acute Physiology and Chronic Health Evaluation (APACHE) II > 23 (adjusted odds ratio (aOR) 5.57, 95 % confidence interval (CI) 1.55–19.97), Sequential Organ Failure Assessment (SOFA) > 8 (aOR 9.74, 95 % CI 1.46–64.88), and mechanical ventilation (aOR 18.33, 95 % CI 3.15–106.80). Multivariate Cox regression analysis identified two factors associated with 1-year mortality: APACHE II > 23 (adjusted hazard ratio (aHR) 4.83; 95 % CI 2.21–10.55), and mechanical ventilation (aHR 9.71; 95 % CI 2.31–40.87). Conclusions For the most severe adult TBM patients of Medical Research Council (MRC) stage III, common clinical factors aren’t effective enough to predict outcomes. Our study demonstrates that the widely used APACHE II and SOFA scores on admission can be used to predict short-term outcomes, while APACHE II could also be used to predict long-term outcomes of adult patients with TBM in ICU.

scholarly journals Clinical Characteristics and Outcome of Critically Ill SARS-CoV-2 Patients Admitted to Intensive Care Unit of a Tertiary Care Hospital in North India: A Retrospective Study

2021 ◽  
Author(s):  
Reetu Verma ◽  
Rajeev Kumar Nishad ◽  
Rohit Patawa ◽  
Alok Kumar
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Retrospective Study ◽  
Critically Ill ◽  
Clinical Characteristics ◽  
Invasive Mechanical Ventilation ◽  
Age Groups ◽  
World Health ◽  
Comorbid Conditions

Introduction: World Health Organisation (WHO) declared the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outbreak a pandemic on 11 March 2020, due to the constantly increasing number of cases outside China. Previously, India had global record of highest single day spike of Corona Virus Disease-19 (COVID-19) cases, with 97,894 cases on 17thSeptember 2020. Aim: To find out the demographic and clinical characteristics of critically ill patients of SARS-CoV-2 and comparing the outcomes of patients admitted in COVID dedicated Intensive Care Unit (ICU) with and without co-morbidities and also in different age groups and sex. Material and Methods: This retrospective study from July 2020 to December 2020 was a single centre observational experience of management of COVID-19 patients at COVID dedicated ICU in Firozabad, India. The following data were recorded: age, sex, comorbidities and mode of oxygen delivery (invasive mechanical ventilation, non-invasive mechanical ventilation, high flow nasal canula). Chi-square test was used to compare the outcomes of patients admitted in COVID dedicated ICU with and without co-morbidities and also in different age groups and sex. Results: In this study, the data of 120 severely ill COVID-19 patients were reviewed. The mean age of patients were (58±15.29) years and male to female ratio was 3:1. At least one comorbid condition was reported in 53.3% of patients-most common being Hypertension (36.6%) followed by Diabetes mellitus 2 (20%), COPD (15%). Then Cardiovascular Diseases, Renal, Liver diseases and ailments followed. All patients admitted to COVID ICU had moderate to severe Acute Respiratory Distress Syndrome (ARDS). Older age (61 years and above, mortality 17%), male sex (16.7% deaths among 90 critically ill male COVID patients) and presence of comorbid conditions appear to have higher mortality in this study. However apart from comorbid conditions (p=0.001) none was statistically significant. The overall mortality in this study of 120 critically ill COVID patients was 14.16%. Conclusion: From this study, it can be suggested that survival of critically ill COVID patients can further be improved by better management of their comorbid conditions and avoiding complications of invasive ventilation. However, further multicentric studies with large sample size are needed to confirm these findings.

scholarly journals Use of recombinant human deoxyribonuclease in pediatric intensive care unit – a single-center experience

2022 ◽  
Vol 40 ◽  
Author(s):  
Daniel Meireles ◽  
Sofia Ribeiro Fernandes ◽  
Alzira Sarmento ◽  
Telma Barbosa ◽  
Manuel Ferreira Magalhães ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Invasive Mechanical Ventilation ◽  
Pediatric Intensive Care ◽  
Convulsive Status Epilepticus ◽  
Single Center Experience ◽  
Radiologic Findings ◽  
Clinical Complications

ABSTRACT Objective: Dornase alfa (rhDNase) reduces the viscosity of purulent sputum in the lungs. The use in patients with cystic fibrosis (CF) is proven. However, the evidence of its applicability to other conditions is limited. This study aims to present the authors’ experience with the use of rhDNase in non-CF patients admitted to the Pediatric Intensive Care Unit (PICU). At the study center, rhDNase was used during flexible bronchoscopies in 24 cases, of which 20 (83%) had atelectasis and seven (29%) were admitted to PICU. Four patients (57%) were on invasive mechanical ventilation (MV). Case description: Two cases of daily rhDNase administration at PICU are presented: patient A was an 8-year-old boy admitted with septic shock and acute respiratory distress syndrome (ARDS). The patient required mechanical ventilation with aggressive settings and experienced several clinical complications. On D50, he started rhDNase treatment with an improvement in FiO2, PaCO2 and PaO2/FiO2 ratio according to radiologic findings. He was extubated on D23 of treatment. Patient B was a 17-month-old girl admitted with a convulsive status epilepticus who experienced respiratory complications (infectious and barotrauma) with ARDS, requiring aggressive ventilation. She initiated rhDNase treatment on D60. During the treatment an improvement in FiO2, PaO2/FiO2 ratio and a tendency of PaCO2 decrease were found. She had radiological improvement. No complications were described. Comments: RhDNase may be a helpful and safe tool to use in PICU prolonged intubated patients with ventilator-induced lung injury. Further studies are needed to assess and propose valid indications.

scholarly journals Respiratory Modalities in Preventing Reintubation in a Pediatric Intensive Care Unit

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199153
Author(s):  
Ameer Al-Hadidi ◽  
Morta Lapkus ◽  
Patrick Karabon ◽  
Begum Akay ◽  
Paras Khandhar
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Noninvasive Positive Pressure Ventilation ◽  
Pediatric Intensive Care ◽  
Nasal Cannula ◽  
Respiratory Support ◽  
Positive Pressure ◽  
P Value

Post-extubation respiratory failure requiring reintubation in a Pediatric Intensive Care Unit (PICU) results in significant morbidity. Data in the pediatric population comparing various therapeutic respiratory modalities for avoiding reintubation is lacking. Our objective was to compare therapeutic respiratory modalities following extubation from mechanical ventilation. About 491 children admitted to a single-center PICU requiring mechanical ventilation from January 2010 through December 2017 were retrospectively reviewed. Therapeutic respiratory support assisted in avoiding reintubation in the majority of patients initially extubated to room air or nasal cannula with high-flow nasal cannula (80%) or noninvasive positive pressure ventilation (100%). Patients requiring therapeutic respiratory support had longer PICU LOS (10.92 vs 6.91 days, P-value = .0357) and hospital LOS (16.43 vs 10.20 days, P-value = .0250). Therapeutic respiratory support following extubation can assist in avoiding reintubation. Those who required therapeutic respiratory support experienced a significantly longer PICU and hospital LOS. Further prospective clinical trials are warranted.

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