Psychological long-term effects of a no-sedation protocol in critically ill patients

AbstractDecreased glomerular filtration rate (GFR) is linked to poor survival. The predictive value of creatinine estimated GFR (eGFR) and cystatin C eGFR in critically ill patients may differ substantially, but has been less studied. This study compares long-term mortality risk prediction by eGFR using a creatinine equation (CKD-EPI), a cystatin C equation (CAPA) and a combined creatinine/cystatin C equation (CKD-EPI), in 22,488 patients treated in intensive care at three University Hospitals in Sweden, between 2004 and 2015. Patients were analysed for both creatinine and cystatin C on the same blood sample tube at admission, using accredited laboratory methods. During follow-up (median 5.1 years) 8401 (37%) patients died. Reduced eGFR was significantly associated with death by all eGFR-equations in Cox regression models. However, patients reclassified to a lower GFR-category by using the cystatin C-based equation, as compared to the creatinine-based equation, had significantly higher mortality risk compared to the referent patients not reclassified. The cystatin C equation increased C-statistics for death prediction (p < 0.001 vs. creatinine, p = 0.013 vs. combined equation). In conclusion, this data favours the sole cystatin C equation rather than the creatinine or combined equations when estimating GFR for risk prediction purposes in critically ill patients.

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ICU admissions: Consequences after discharge

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738020932613 ◽

2020 ◽

Vol 13 (9) ◽

pp. 550-556

Author(s):

Minal Karavadra ◽

Ricky Bell

Keyword(s):

Intensive Care ◽

Cognitive Decline ◽

Intensive Care Units ◽

Critically Ill ◽

Critically Ill Patients ◽

Psychiatric Disturbance ◽

Intensive Care Department ◽

Previous Level ◽

The Uk

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

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What are the effects of alpha-2 agonists for long-term sedation during mechanical ventilation in critically ill patients?

Cochrane Clinical Answers ◽

10.1002/cca.750 ◽

2015 ◽

Keyword(s):

Mechanical Ventilation ◽

Critically Ill ◽

Critically Ill Patients

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Protein C levels can be forecasted by global haemostatic tests in critically ill patients and predict long-term survival

Thrombosis Research ◽

10.1016/j.thromres.2004.09.020 ◽

2005 ◽

Vol 116 (1) ◽

pp. 15-24 ◽

Cited By ~ 7

Author(s):

Gunnar Nilsson ◽

Jan Astermark ◽

Stefan Lethagen ◽

Einar Vernersson ◽

Erik Berntorp

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Protein C ◽

Term Survival ◽

Long Term Survival

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Association between frailty and short- and long-term outcomes among critically ill patients: a multicentre prospective cohort study

Canadian Medical Association Journal ◽

10.1503/cmaj.130639 ◽

2013 ◽

Vol 186 (2) ◽

pp. E95-E102 ◽

Cited By ~ 226

Author(s):

S. M. Bagshaw ◽

H. T. Stelfox ◽

R. C. McDermid ◽

D. B. Rolfson ◽

R. T. Tsuyuki ◽

...

Keyword(s):

Cohort Study ◽

Critically Ill ◽

Prospective Cohort Study ◽

Critically Ill Patients ◽

Prospective Cohort ◽

Long Term Outcomes ◽

Short And Long Term

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Colonization with Extensively Drug-Resistant Acinetobacter Baumannii and Prognosis in Critically Ill Patients: An Observational Cohort Study

10.21203/rs.3.rs-225795/v1 ◽

2021 ◽

Author(s):

Yue Zheng ◽

Nana Xu ◽

Jiaojiao Pang ◽

Hui Han ◽

Hongna Yang ◽

...

Keyword(s):

Regression Model ◽

Acinetobacter Baumannii ◽

Critically Ill ◽

Critically Ill Patients ◽

Drug Resistant ◽

Short Term ◽

Term Survival ◽

Extensively Drug Resistant ◽

Kaplan Meier

Abstract Background: Acinetobacter baumannii is one of the most often isolated opportunistic pathogens in intensive care units (ICUs). Extensively drug-resistant A. baumannii (XDR-AB) strains lack susceptibility to almost all antibiotics and pose a heavy burden on healthcare institutions. In this study, we evaluated the impact of XDR-AB colonization on both the short-term and long-term survival of critically ill patients.Methods: We prospectively enrolled patients from two adult ICUs in Qilu Hospital of Shandong University from April 2018 through December 2018. Using nasopharyngeal and perirectal swabs, we evaluated the presence of XDR-AB colonization. Participants were followed up for six months. Primary endpoints were 28-day and six-month mortality after ICU admission. For survival analysis, we used the Kaplan-Meier curve. We identified risk factors associated with 28-day and six-month mortality using the logistic regression model and Cox proportional-hazards survival regression model, respectively. Results: Out of 431 patients, 77 were colonized with XDR-AB. Based on the Kaplan-Meier curve results, the survival before 28 days did not differ by colonization status; however, a significant lower survival rate was obtained at six months in colonized patients. Univariate and multivariate results confirmed that XDR-AB colonization was not associated with 28-day mortality, but was an independent risk factor of lower survival days at six months, resulting in a 1.97 times higher risk of death at six months.Conclusions: XDR-AB colonization has no effect on short-term mortality but is associated with lower long-term survival in critically ill patients.

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