scholarly journals Trends in Intravenous Magnesium Use and Outcomes for Status Asthmaticus in Children’s Hospitals from 2010 to 2017

2020 ◽  
Vol 15 (7) ◽  
pp. 403-406
Author(s):  
Vineeta Mittal ◽  
Matt Hall ◽  
James Antoon ◽  
Jessica Gold ◽  
Chen Kenyon ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Unit Admission ◽  
Status Asthmaticus ◽  
Geometric Mean ◽  
Health Information System ◽  
Admission Rate ◽  
Children's Hospitals ◽  
Children’S Hospitals

Intravenous (IV) magnesium is used as an adjunct therapy in management of status asthmaticus with a goal of reducing intubation rate. A recent review suggests that IV magnesium use in status asthmaticus reduces admission rates. This is contrary to the observation of practicing emergency room physicians. The goal of this study was to assess trends in IV magnesium use for status asthmaticus in US children’s hospitals over 8 years through a retrospective analysis of children younger than 18 years using the Pediatric Health Information System database. Outcomes were IV magnesium use, inpatient and intensive care unit admission rate, geometric mean length of stay, and 7-day all-cause readmission rate. IV magnesium use for asthma hospitalization more than doubled over 8 years (17% vs. 36%; P < .001). Yearly trends were not significantly associated with hospital or intensive care unit admission rate or 7-day all-cause readmissions, although length of stay was reduced (P < .001).

Use of hospital resources in the care of patients with intermediate risk pulmonary embolism

2020 ◽  
pp. 204887262092160
Author(s):  
Alexander E Sullivan ◽  
Tara Holder ◽  
Tracy Truong ◽  
Cynthia L Green ◽  
Olamiji Sofela ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Pulmonary Embolism ◽  
Intensive Care ◽  
High Risk ◽  
Length Of Stay ◽  
Intensive Care Unit Admission ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Intermediate Risk ◽  
Risk Patients

Background Risk stratification and management of hemodynamically stable pulmonary embolism remains challenging. Professional societies have published stratification schemes, but little is known about the management of patients with intermediate risk pulmonary embolism. We describe the care of these patients at an academic health system. Methods Patient encounters from 1 January 2016 to 30 June 2017 were retrospectively identified utilizing a multihospital, electronic health record-based data warehouse. Using the 2019 European Society of Cardiology criteria, differences in hospital resource utilization, defined as intensive care unit admission, use of invasive therapies, and length of stay, were examined in patients with intermediate risk characteristics. Results A cohort of 322 intermediate risk patients, including 165 intermediate–low and 157 intermediate–high risk patients, was identified. Intermediate–high risk patients more often underwent catheter-directed therapy (14.0% vs. 1.8%; P<0.001) compared to intermediate–low risk patients and had a 50% higher rate of intensive care unit admission (relative risk 1.50; 95% confidence interval 1.06, 2.12; P=0.023). There was no difference in median intensive care unit length of stay (2.7 vs. 2.0 days; P=0.761) or hospital length of stay (5.0 vs. 5.0 days; P=0.775) between intermediate–high risk and intermediate–low risk patients. Patients that underwent invasive therapies had a 3.8-day shorter hospital length of stay (beta –3.75; 95% confidence interval –6.17, –1.32; P=0.002). Conclusion This study presents insights into the hospital resource utilization of patients with intermediate risk pulmonary embolism. The 2019 European Society of Cardiology risk stratification criteria are a clinically relevant scheme that identifies patients more often treated with intensive care unit admission and advanced therapies.

A clinical pathway in a post-anaesthesia care unit to reduce length of stay, mortality and unplanned intensive care unit admission

2011 ◽  
Vol 28 (12) ◽  
pp. 859-866 ◽  
Author(s):  
Alain-S. Eichenberger ◽  
Guy Haller ◽  
Nicole Cheseaux ◽  
Vincent Lechappe ◽  
Philippe Garnerin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Unit Admission ◽  
Clinical Pathway ◽  
Post Anaesthesia Care Unit ◽  
Anaesthesia Care

scholarly journals High Intensive Care Unit Admission Rate for 2013–2014 Influenza Is Associated with a Low Rate of Vaccination

2014 ◽  
Vol 189 (4) ◽  
pp. 485-487 ◽  
Author(s):  
Jelena Catania ◽  
Loretta G. Que ◽  
Joseph A. Govert ◽  
John W. Hollingsworth ◽  
Cameron R. Wolfe
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Admission Rate ◽  
High Intensive Care Unit ◽  
Low Rate

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 Intensive care unit admission protocol controlled by intensivists can reduce transfer delays from the emergency department in critically ill patients

2018 ◽  
Vol 26 (2) ◽  
pp. 84-90 ◽  
Author(s):  
Ji Eun Kim ◽  
Seul Lee ◽  
Jinwoo Jeong ◽  
Dong Hyun Lee ◽  
Jin-Heon Jeong
Keyword(s):  
Intensive Care Unit ◽  
Emergency Department ◽  
Intensive Care ◽  
Length Of Stay ◽  
Intensive Care Unit Admission ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Unit Length ◽  
Intensive Care Unit Length ◽  
Before And After

Background: Delayed transfer of patients from the emergency department to the intensive care unit is associated with adverse clinical outcomes. Critically ill patients with delayed admission to the intensive care unit had higher in-hospital mortality and increased hospital length of stay. Objectives: We investigated the effects of an intensive care unit admission protocol controlled by intensivists on the emergency department length of stay among critically ill patients. Methods: We designed the intensive care unit admission protocol to reduce the emergency department length of stay in critically ill patients. Full-time intensivists determined intensive care unit admission priorities based on the severity of illness. Data were gathered from patients who were admitted from the emergency department to the intensive care unit between 1 April 2016 and 30 November 2016. We retrospectively analyzed the clinical data and compared the emergency department length of stay between patients admitted from the emergency department to the intensive care unit before and after intervention. Results: We included 292 patients, 120 and 172 were admitted before and after application of the intensive care unit admission protocol, respectively. The demographic characteristics did not differ significantly between the groups. After intervention, the overall emergency department length of stay decreased significantly from 1045.5 (425.3–1665.3) min to 392.0 (279.3–686.8) min (p < 0.001). Intensive care unit length of stay also significantly decreased from 6.0 (4.0–11.8) days to 5.0 (3.0–10.0) days (p = 0.015). Conclusion: Our findings suggest that introduction of the intensive care unit admission protocol controlled by intensivists successfully decreased the emergency department length of stay and intensive care unit length of stay among critically ill patients at our institution.

scholarly journals Prevalence and clinical consequences of atelectasis in SARS-CoV-2 pneumonia: a computed tomography retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Álvaro Mingote ◽  
Andrea Albajar ◽  
Paulino García Benedito ◽  
Jessica Garcia-Suarez ◽  
Paolo Pelosi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Hospital Stay ◽  
Lung Volume ◽  
Oxygen Therapy ◽  
Admission Rate ◽  
Clinical Severity ◽  
Mortality Data

Abstract Background The aim of the study is to estimate the prevalence of atelectasis assessed with computer tomography (CT) in SARS-CoV-2 pneumonia and the relationship between the amount of atelectasis with oxygenation impairment, Intensive Care Unit admission rate and the length of in-hospital stay. Patients and methods Two-hundred thirty-seven patients admitted to the hospital with SARS-CoV-2 pneumonia diagnosed by clinical, radiology and molecular tests in the nasopharyngeal swab who underwent a chest computed tomography because of a respiratory worsening from Apr 1 to Apr 30, 2020 were included in the study. Patients were divided into three groups depending on the presence and amount of atelectasis at the computed tomography: no atelectasis, small atelectasis (< 5% of the estimated lung volume) or large atelectasis (> 5% of the estimated lung volume). In all patients, clinical severity, oxygen-therapy need, Intensive Care Unit admission rate, the length of in-hospital stay and in-hospital mortality data were collected. Results Thirty patients (19%) showed small atelectasis while eight patients (5%) showed large atelectasis. One hundred and seventeen patients (76%) did not show atelectasis. Patients with large atelectasis compared to patients with small atelectasis had lower SatO2/FiO2 (182 vs 411 respectively, p = 0.01), needed more days of oxygen therapy (20 vs 5 days respectively, p = 0,02), more frequently Intensive Care Unit admission (75% vs 7% respectively, p < 0.01) and a longer period of hospitalization (40 vs 14 days respectively p < 0.01). Conclusion In patients with SARS-CoV-2 pneumonia, atelectasis might appear in up to 24% of patients and the presence of larger amount of atelectasis is associated with worse oxygenation and clinical outcome.

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