Isn't It the Right Time to Address the Impact of Pediatric Cardiac Intensive Care Units on Medical Education?

PEDIATRICS ◽  
2007 ◽  
Vol 120 (4) ◽  
pp. e1117-e1119 ◽  
Author(s):  
L. Su ◽  
R. Munoz
Keyword(s):  
Medical Education ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Cardiac Intensive Care ◽  
The Right ◽  
The Impact

The Impact of Dedicated Cardiac Intensive Care Units on Outcomes in Pediatric Cardiac Surgery: A Virtual Pediatric Systems Database Analysis

2020 ◽  
Author(s):  
Dayanand N. Bagdure ◽  
Jason W. Custer ◽  
Cortney B. Foster ◽  
William C. Blackwelder ◽  
Vladimir Mishcherkin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Mortality Rate ◽  
Intensive Care Units ◽  
Risk Category ◽  
Database Analysis ◽  
Cardiac Intensive Care ◽  
Outcomes For Children ◽  
The Impact ◽  
Risk Categories

AbstractCare of children undergoing cardiac surgery occurs in dedicated cardiac intensive care units (CICU) or mixed intensive care units. We analyzed data from Virtual Pediatric Systems (VPS, LLC) database (2009–2014) for children < 18 years of age undergoing cardiac surgery, classified according to Society of Thoracic Surgery–European Association of Cardiothoracic Surgery (STS-EACTS) risk category. We had 25,052 (52%) patients in 53 mixed units (mortality rate, 2.99%), and 22,762 (48%) patients in 19 dedicated CICUs (mortality rate, 2.62%). There was a direct relationship between STS-EACTS risk category and death rate in both units. By multivariable logistic and linear regression, there was no difference in mortality between mixed unit and CICU death rates within STS-EACTS risk categories. We found no difference in outcomes for children undergoing cardiac surgery based on the unit type (dedicated CICU or mixed unit).

scholarly journals Prevalence and prognosis impact of frailty among older adults in cardiac intensive care units

CJC Open ◽  
2021 ◽  
Author(s):  
Kim Volle ◽  
Clément Delmas ◽  
Jean Ferrières ◽  
Olivier Toulza ◽  
Stephanie Blanco ◽  
...  
Keyword(s):  
Older Adults ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Cardiac Intensive Care

Exploring the impact of 12-hour shifts on nurse fatigue in intensive care units

2019 ◽  
Vol 50 ◽  
pp. 151191 ◽  
Author(s):  
Fiona Yu ◽  
Deborah Somerville ◽  
Anna King
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Nurse Fatigue ◽  
The Impact

Communicating with parents in neonatal intensive care units: The impact on parental stress

2017 ◽  
Vol 100 (4) ◽  
pp. 710-719 ◽  
Author(s):  
Christian Enke ◽  
Andrés Oliva y Hausmann ◽  
Felix Miedaner ◽  
Bernhard Roth ◽  
Christiane Woopen
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Parental Stress ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
The Impact

Cardiopulmonary resuscitation: special considerations for infants and children with cardiac disease

2007 ◽  
Vol 17 (S4) ◽  
pp. 116-126 ◽  
Author(s):  
Stacie B. Peddy ◽  
Mary Fran Hazinski ◽  
Peter C. Laussen ◽  
Ravi R. Thiagarajan ◽  
George M. Hoffman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Cardiopulmonary Resuscitation ◽  
Intensive Care Units ◽  
Cardiac Disease ◽  
Paediatric Intensive Care ◽  
Cardiac Intensive Care Unit ◽  
Cardiac Intensive Care ◽  
Paediatric Intensive Care Units

AbstractPulseless cardiac arrest, defined as the cessation of cardiac mechanical activity, determined by unresponsiveness, apneoa, and the absence of a palpable central pulse, accounts for around one-twentieth of admissions to paediatric intensive care units, be they medical or exclusively cardiac. Such cardiac arrest is higher in children admitted to a cardiac as opposed to a paediatric intensive care unit, but the outcome of these patients is better, with just over two-fifths surviving when treated in the cardiac intensive care unit, versus between one-sixth and one-quarter of those admitted to paediatric intensive care units. Children who receive chest compressions for bradycardia with pulses have a significantly higher rate of survival to discharge, at 60%, than do those presenting with pulseless cardiac arrest, with only 27% surviving to discharge. This suggests that early resuscitation before the patient becomes pulseless, along with early recognition and intervention, are likely to improve outcomes. Recently published reports of in-hospital cardiac arrests in children can be derived from the multi-centric National Registry of Cardiopulmonary Resuscitation provided by the American Heart Association. The population is heterogeneous, but most arrests occurred in children with progressive respiratory insufficiency, and/or progressive circulatory shock. During the past 4 years at the Children’s Hospital of Philadelphia, 3.1% of the average 1000 annual admissions to the cardiac intensive care unit have received cardiopulmonary resuscitation. Overall survival of those receiving cardiopulmonary resuscitation was 46%. Survival was better for those receiving cardiopulmonary resuscitation after cardiac surgery, at 53%, compared with survival of 33% for pre-operative or non-surgical patients undergoing resuscitation. Clearly there is room for improvement in outcomes from cardiac resuscitation in children with cardiac disease. In this review, therefore, we summarize the newest developments in paediatric resuscitation, with an expanded focus upon the unique challenges and importance of anticipatory care in infants and children with cardiac disease.

scholarly journals Are morbidity and mortality case review practices in Scottish intensive care units aligned to national standards?

2017 ◽  
Vol 19 (3) ◽  
pp. 264-268
Author(s):  
Mohammed(Mo) Faik Al-Haddad ◽  
Andrew Cadamy ◽  
Euan Black ◽  
Kate Slade
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
National Standards ◽  
Morbidity And Mortality ◽  
Case Review ◽  
Allied Health Professionals ◽  
Telephone Interviews ◽  
Significant Events ◽  
Mortality Case ◽  
Cardiac Intensive Care

Introduction Both Scottish and UK standards guidelines recommend that intensive care units should hold regular, structured, multidisciplinary morbidity and mortality meetings. The aim of this survey was to ascertain the nature of current practice with regards to morbidity and mortality case reviews and meetings in all intensive care units in Scotland. Methods Semi-structured telephone interviews were conducted with a consultant from all Scottish intensive care units. A list of intensive care units in Scotland was obtained from the Scottish Intensive Care Society Audit Group annual report. Results All 24 intensive care units (100%) in Scotland were surveyed. The interviews took an average of 20 min. The three cardiac intensive care units were excluded from analysis. All other intensive care units had morbidity and mortality meetings and 18 units had a morbidity and mortality clinical lead. Nineteen intensive care units held joint morbidity and mortality meetings, eight of which were regular. In all intensive care units, meetings were attended by consultants and trainees. In 14 intensive care units, meetings were attended by nurses, seven by allied health professionals, 1 by a manager and 11 by other professionals. All mortality cases in intensive care unit were discussed in 19 intensive care units, in the other two intensive care units, 10–20% of mortality cases were discussed. Conclusion There is a wide variation in the processes of reviewing mortality cases and significant events in intensive care units across Scotland, and in the way morbidity and mortality meetings are organised and held. Based on this survey, there is scope for improving the consistency of approach to morbidity and mortality case reviews and meetings in order to improve education and facilitate shared learning.

scholarly journals Feasability of Diaphragmatic Speckle Tracking In Intensive Care Units

2021 ◽  
Author(s):  
Michael Poette ◽  
Laure Crognier ◽  
Fanny Vardon-Bounes ◽  
Stéphanie Ruiz ◽  
Bernard Georges ◽  
...  
Keyword(s):  
Intensive Care ◽  
Strain Rate ◽  
Intensive Care Units ◽  
Strongly Correlated ◽  
Diaphragmatic Dysfunction ◽  
Good Reliability ◽  
Diaphragmatic Function ◽  
Strain And Strain Rate ◽  
Measured Strain ◽  
The Right

Abstract Background: Diaphragmatic dysfunction is a common condition in intensive care units (ICU). Its presence correlates with prolonged weaning from mechanical ventilation and mortality. Diaphragmatic excursion (EXdi) and thickening fraction (TFdi) are the 2 main measures currently described in diaphragmatic ultrasound, but each has its limitations. Strain and strain rate are already used cardiac sonography and could be of interest in the assessment of diaphragmatic function in ICU. The aim of this work was to evaluate the feasibility of diaphragmatic strain and strain rate in ICU and to describe their distribution, reproducibility and agreement with existing parameters. Methods: All patients who underwent a T-tube weaning test were prospectively included. Ultrasound loops were recorded on each side of the patient during the last 30 minutes of the weaning test. Two operators measured strain, strain rate, EXdi, and TFdi blind to each other in post-treatment analysis. Results: Thirty patients were analyzed. The median values for strain and strain rate were -6.74% and -0.23.s-1 on the left side and -8.17% and -0.22.s-1 on the right side. Concerning strain and strain rate, intra-class coefficients showed systematically a very good reliability between operators. Conclusion: Diaphragmatic strain and strain rate measurements appeared feasible in an ICU environment and seemed reproducible and not strongly correlated with EXdi and TFdi. An improvement of the analysis software is needed to improve the ease of interpretation. The interest of these parameters in clinical practice should be explored in forthcoming studies.

The rate and impact of substance misuse in psychiatric intensive care units (PICUs) in the UK

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hattie Catherine Ann Moyes ◽  
Lana MacNaboe ◽  
Kate Townsend
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Substance Misuse ◽  
Well Being ◽  
Training Programme ◽  
Content Type ◽  
National Quality ◽  
Improvement Programme ◽  
The Uk ◽  
The Impact

Purpose This paper aims to understand the current scale of substance misuse in psychiatric intensive care units (PICUs), identify how substance misuse affects members of staff, patients and the running of wards and explore with staff what resources would be most useful to more effectively manage substance misuse and dual diagnosis on PICUs. Design/methodology/approach The paper used a mixed-methods approach, using a quantitative survey to determine the extent of substance use in PICUs and a co-design workshop to understand the impact of substance misuse on PICU wards, staff and patients. Findings The estimated rate of substance misuse in PICUs over a 12-month period is 67%, with cannabis the most frequently used substance. Despite the range of problems experienced on PICUs because of substance misuse, the availability of training and resources for staff was mixed. Research limitations/implications The findings may not be fully generalisable as research participants were members of a national quality improvement programme, and therefore, may not be representative of all PICUs. Data was collected from clinicians only; if patients were included, they might have provided another perspective on substance misuse on PICUs. Practical implications This paper emphasises the importance of substance misuse training for PICU staff to adequately respond to patients who misuse substances, improve the ward environment, staff well-being and patient outcomes. Originality/value This paper provides an updated estimation of rates of substance misuse in PICUs over a 12-month period and make suggestions for a training programme that can better support staff to address substance misuse on PICUs.

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