The Importance of Multidisciplinary Approach in Intensive Care Unit : Conservative Management of Two Cases following Isolated Splenic Rupture Due to Blunt Abdominal Injury

2015 ◽  
Vol 23 (4) ◽  
pp. 161-164
Author(s):  
Öznur Uludağ ◽  
Sadik Çağ ◽  
Ali Haydar Baykan
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Conservative Management ◽  
Multidisciplinary Approach ◽  
Splenic Rupture ◽  
Abdominal Injury ◽  
Blunt Abdominal Injury

scholarly journals Non-haemorrhagic causes of obstetrical intensive care unit admissions in tertiary care setting

2020 ◽  
Vol 9 (4) ◽  
pp. 1392
Author(s):  
Preet Kamal ◽  
Surinder Kaur ◽  
Harleen Kaur ◽  
Madhu Nagpal
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multidisciplinary Approach ◽  
Care Setting ◽  
Tertiary Care ◽  
Medical Illness ◽  
Tropical Diseases ◽  
Medical Disorders ◽  
Tropical Conditions ◽  
Tertiary Care Setting

Background: Management of critically ill obstetric patients involve intensive monitoring in intensive care unit. In present scenario there are significant number of obstetric patients with sepsis, tropical diseases and medical illness that require ICU care. The aim of this study was to evaluate in more detail the non-haemorrhagic causes of obstetric ICU admissions and to identify and adopt high risk strategies as prime learning objective.Methods: It is a prospective ongoing study conducted in 50 patients in SGRDUHS, Amritsar from December 2016 to October 2019, who were admitted in obstetric ICU, out of them 30 cases were attributed to non-haemorrhagic obstetric causes. All demographic parameters along with gestational age, diagnosis on admission, intervention done prior to shift to ICU and details of treatment given in ICU were evaluated. Patient outcome, review of mortality and area of improvement were also noted.Results: Majority of the patient (70.1%) were admitted in 3rd trimester. Obstetric sepsis (13.33%), infective diseases (16.66%), tropical conditions (16.66%), medical disorders (26.66%) and hypertensive disorders (26.66%) were the major causes of admission to obstetric ICU. There were 33.3% mortalities observed in present study and 40% were due to respiratory failure. In ICU mechanical ventilation was done in 63.3% cases and blood products were given in 33.3% of patients.Conclusions: A multidisciplinary approach is ideal to handle non-haemorrhagic situations especially related to medical disorders and tropical diseases. Review of the ICU admissions and periodic audit can improve management of morbidities as well as reduce maternal mortalities.

scholarly journals Management of Gestation with Abnormal Invasive Placenta Complicated by an Extra-preterm Premature Rupture of Membranes in a Tertiary Perinatal Centre

2020 ◽  
Vol 27 (3) ◽  
pp. 113-124
Author(s):  
N. V. Mingaleva ◽  
T. B. Makukhina ◽  
E. S. Lebedenko ◽  
T. A. Anikina ◽  
M. D. Kotleva ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Loss ◽  
Multidisciplinary Approach ◽  
Second Phase ◽  
Premature Rupture Of Membranes ◽  
Premature Rupture ◽  
Preterm Premature Rupture ◽  
Increased Risk ◽  
Invasive Placenta

Aim. Assessment of methods for prolonging gestation after an extra-preterm premature rupture of membranes (PROM) in a patient with abnormal invasive placenta and the efficacy of a multidisciplinary approach for treatment of a combined obstetric pathology in a tertiary perinatal centre.Results. A clinical case is reported of PROM at 22+6 weeks’ gestation in a patient with two caesarean scars on the uterus and abnormal invasive placenta. In a tertiary perinatal centre, pregnancy was prolonged to 36+3 weeks’ term. The period between PROM and delivery was 96 days. A planned caesarean section and metroplasty were performed in the setting of temporary balloon occlusion of common iliac arteries. Blood loss was 75 mL/kg. Placenta increta without chorioamnionitis was confirmed histologically. The patient stayed in the intensive care unit for two days and was discharged home on the 8th day. The newborn was assigned the Apgar score of 6/6. For two days, ventilatory support was rendered in a neonatal intensive care unit. The newborn was diagnosed with congenital pneumonia, the first-degree hypoxic-ischemic damage of the central nervous system and transferred to the second phase of nursing.Conclusions. A multidisciplinary approach and high technology facilities in the setting of a tertiary perinatal centre allow to reduce perinatal losses and provide high-quality care to patients with an increased risk of massive blood loss with the capacity to manage organ-preserving operative delivery with full rehabilitation in the postoperative period.

scholarly journals Delayed delivery of the two remaining fetuses of triplet pregnancy: Case Report

2016 ◽  
pp. 1 ◽  
Author(s):  
Ibrahim A. Abdelazim ◽  
Sulaiman Al-Munaifi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Case Report ◽  
Neonatal Intensive Care Unit ◽  
Conservative Management ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Triplet Pregnancy ◽  
Maternal Complications ◽  
Still Birth

<p>The incidence of multiple gestations increased after introduction of assisted reproduction techniques. Traditionally; in twin and/or triplet pregnancies; if one baby delivered preterm, this situation managed by delivery of the second and/or the third fetuses. This case report represents the suggested conservative management during the delayed delivery of the two remaining fetuses of triplet pregnancy, its outcome, and benefits.<br />The studied woman is 35-years old, G3 P2, triplet pregnancy after intra-cytoplasmic sperm injection trial, presented with preterm premature rupture of membranes of the first fetus at 20+2 weeks` gestation, who delivered as fresh still birth. The couple informed, and agreed for the conservative management of the two remaining fetuses. After delivery of the first fetus; the umbilical cord ligated as high as possible in the cervix. She received systemic antibiotics for one week, with follow up of; infections, and consumptive coagulopathy parameters, and wellbeing of the fetuses through the conservative treatment. She received betamethasone to accelerate the lung maturity, and Mg-Sulphate for fetal neuro-protection at 24 weeks. The conservative management discontinued, and she delivered by cesarean section at 25 weeks+1 after attack of ante-partum hemorrhage. The delivered neonates admitted to neonatal intensive care unit on ventilator support, surfactant therapy, and antibiotics. 80 days after neonatal intensive care unit admission; the neonates discharged from the neonatal intensive care unit with corrected age of 36 weeks+, on complete oral feeding, and room air. <br />The first fetus delivered at 20 weeks+2, fresh still birth (410 g), while the second, and third fetuses delivered at 25 weeks+1 (34 days of the conservative management), 780, and 840 g; respectively. Both fetuses survived, discharged from the neonatal intensive care unit after 80 days, at 2.2, and 2.3 kg weight; respectively. <br />The birth weight, and the survival rate of both fetuses increased after the conservative management. The suggested conservative management of the delayed delivery may be associated with reduced neonatal mortalities without any maternal complications.</p>

scholarly journals Descending Necrotizing Mediastinitis: Analysis of 9 Cases in Our Hospital

2020 ◽  
pp. 014556132093396
Author(s):  
Peng Wu ◽  
Fan Ye ◽  
Ziheng Zhang ◽  
Linghao Zhang ◽  
Hailiang Lin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Surgical Treatment ◽  
Hospital Stay ◽  
Intensive Care Unit Stay ◽  
Multidisciplinary Approach ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Descending Necrotizing Mediastinitis ◽  
Hospital Deaths

Objectives: Descending necrotizing mediastinitis (DNM) is a serious and progressive infection involving the neck and chest and with high mortality if not treated quickly and properly. The aim of this study is to share our practices for managing this condition. Methods: We retrospectively evaluated 9 patients diagnosed with DNM in our hospital between January 2006 and October 2019. Age, gender, origin of infection, length of hospital stay, microorganisms present, type of surgical treatment, and clinical outcomes were reviewed. Results: All patients underwent surgery to drain neck and mediastinal secretions and collections. Three (33.3%) patients were treated with transcervical drainage alone, and 6 (66.7%) patients were treated with combined transcervical and transthoracic drainage. Reoperations were reported in 3 (33.3%) cases. The average length of hospital stay was 22.78 ± 10.05 days (range: 9-40 days). The average length of intensive care unit stay was 6.44 ± 10.10 days (range: 0-25 days). There were no in-hospital deaths, and all patients were discharged home with good outcomes. Conclusions: To improve the prognosis of DNM, we suggest early and adequate debridement of all affected areas along with the proper use of antibiotics. A multidisciplinary approach involving both cardiothoracic and ENT surgeons is also required.

scholarly journals Pheochromocytoma: Multidisciplinary Approach Perioperative Considerations

2021 ◽  
Vol 21 (3) ◽  
pp. 674-680
Author(s):  
Miryam Elizabeth Céspedes Morón ◽  
Roxana Camargo-Román ◽  
Nicanor Rodriguez-Gutarra ◽  
Alicia Mispireta-Castañeda
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Adrenal Gland ◽  
Multidisciplinary Approach ◽  
Perioperative Management ◽  
Perioperative Complications ◽  
Laparoscopic Technique ◽  
Left Adrenal Gland ◽  
Surgical Preparation ◽  
Rule Out

Patient scheduled for an adrenalectomy with laparoscopic technique, due to a tumor of the left adrenal gland. The diagnosis of chronic arterial hypertension was difficult to control, so a test was requested to rule out pheochromocytoma, resulting in a tumor of the left adrenal gland. The teamwork of the specialties involved in the care of the patient, effective communication, pre-surgical preparation and perioperative management, resulted in minimal perioperative complications in the patient, remaining in the intensive care unit for one day and reducing the hospital stay.

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