scholarly journals MORPHOFUNCTIONAL FEATURES OF THE PLACENTA OF NEWBORNS IN BIRTH-INDUCED CRITICAL CONDITIONS: THE RESULTS OF A RETROSPECTIVE COHORT STUDY

2017 ◽  
Vol 14 (3) ◽  
pp. 179-185
Author(s):  
Olga A. Senkevich ◽  
Klaudia E. Popova ◽  
Olga V. Kozharskaia ◽  
Denis V. Musatov
Keyword(s):  
Intensive Care ◽  
Apgar Score ◽  
Critical Condition ◽  
Blood Circulation ◽  
Comparison Group ◽  
Morphological Characteristics ◽  
Critical Conditions ◽  
Pathological Conditions ◽  
Microscopic Studies ◽  
The Relationship

Background.  The placenta condition is the health marker of newborns  and it can be considered  in the early diagnosis  of the development of severe pathological conditions in a child. Objective:  Our aim was to study the relationship between the placenta characteristics and the risk of a birth-induced critical condition in a child and the risk of having children with the APGAR score of < 4 points.Methods. The data of macro- and microscopic studies of the placenta of newborns who have experienced birth-induced critical conditions was retrospectively  analyzed. Birth-induced  critical conditions were the APGAR score at 1 min after birth < 4 points and/or the presence of severe perinatal hypoxia, cerebral ischemia requiring respiratory support and intensive care in the intensive care unit.Results.  We examined 92 placentas of mothers who gave birth to children in a critical condition. Depending on the APGAR score at 1 min after birth, the main group (n = 56, < 4 points) and the comparison  group (n = 36, > 4 points) were singled out. In multivariate analysis, it was established  that the appearance  of a birth-induced  critical condition with the APGAR score < 4 points was associated with pathological attachment of the umbilical cord (odds ratio, OR, 2.8, 95% confidence interval, CI, 1.1–7.0),  placenta weight (OR 5.4, 95% CI 1.9–14.9),  signs of chronic fetoplacental  insufficiency (OR 7.3, 95% CI 2.9–18.8), impaired blood circulation in the placenta (OR 13.7, 95% CI 4.7–39.3), placental hypoplasia (OR 8.9, 95% CI 2.4–32.4), fetal-placental  ratio (OR 8.9, 95% CI 2.4–32.4)  as well as low birth weight of a newborn (OR 2.9, 95% CI 1.2–6.9). Conclusion. Morphological characteristics of the placenta are prognostic markers for the development of critical conditions with the APGAR score at birth < 4 points.

scholarly journals The relationship between visit time management and patient's family satisfaction in the intensive care unit

2020 ◽  
Vol 1 ◽  
pp. 104-107
Author(s):  
Yuni Sudaryanto ◽  
Jebul Suroso
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Time Management ◽  
Family Satisfaction ◽  
Influential Factor ◽  
Critical Conditions ◽  
Spearman Rank ◽  
Life Threatening ◽  
The Relationship ◽  
Visiting Time

The Intensive Care Unit is an independent hospital part (an installation under the service director) with special staff and equipment for the observation, treatment and therapy of patients who suffer from life-threatening diseases, injuries or complications. Or potentially life-threatening. The policy of Intensive Care Unit by limiting the visiting times aims to maximize the care for patients with critical conditions. The satisfaction of the patient family is at the center point recognized as a measure of the quality of care services in the Intensive Care Unit. The purpose of this study was to determine the relationship between visiting time management and the satisfcation of the patient family It used a descriptive quantitative method, a correlation study with a cross sectional design. The sampling technique was total sampling with the respondents of the families, 40 respondents. They were then analyzed using Spearman Rank correlation statistical technique. The results of the Spearman rank analysis gave a p value of 0.044 <0.05, meaning there is a significant relationship between visiting-time management and the satisfaction of family patients.In conclusion he management of visiting-time can be an influential factor in determining the satisfaction of the patient family over the hospital services.

Newborns in intensive care: Apgar score predicts in fifth minute

2021 ◽  
Author(s):  
Emerson Rocha ◽  
Lucio FG Rodrigues ◽  
Luciana FC Moraes ◽  
Gabrielly Coelho ◽  
Josiel Souza ◽  
...  
Keyword(s):  
Intensive Care ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Invasive Mechanical Ventilation ◽  
Ventilatory Support ◽  
Tertiary Hospital ◽  
Abdominal Perimeter ◽  
Fetal Trauma ◽  
The Relationship ◽  
And Child Health

Abstract Apgar Score (AS) < 7 is a predictor of mortality. Survival is shorter in newborns, with AS5min < 7 and the use of invasive mechanical ventilation (IMV). Thus, the objective of this study was to analyze whether maternal, obstetric, anthropometric, and postnatal variables of newborns admitted to the neonatal intensive care unit (NICU) may be associated with AS5min < 7. If this score is a predictor of morbidity and mortality, and if factors most associated with the worse AS interfere with survival. This observational, retrospective, and quantitative study used a descriptive and inferential approach to analyze the medical records of patients of both sexes treated in the NICU of a tertiary hospital which is a recognized reference center of maternal and child health, during 2017. Data were collected to verify the relationship between AS values ​​(AS5min < 7 and AS5min ≥ 7). AS5min < 7 was associated with hypertensive disorders of pregnancy (HDP), premature rupture of the amniotic membrane, vaginal delivery, fetal trauma at birth, abdominal perimeter, and ventilatory support. Among these, HDP and the use of IMV were predictors of lower survival. Conclusion: AS5min was associated with maternal, obstetric, anthropometric, and postnatal variables of neonates admitted to the NICU. Specific maternal and postnatal variables interfered with the survival of these newborns.

YENİDOĞAN YOĞUN BAKIM ÜNİTELERİNDE İŞ KAZALARI RİSKLERİ VE NEDENLERİNE YÖNELİK BİR ARAŞTIRMA

2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Haluk Tanrıverdi ◽  
Orhan Akova ◽  
Nurcan Türkoğlu Latifoğlu
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Physical Environment ◽  
Neonatal Intensive Care ◽  
Organizational Factors ◽  
Occupational Accidents ◽  
Neonatal Intensive Care Units ◽  
Work Related ◽  
Physical Conditions ◽  
The Relationship

This study aims to demonstrate the relationship between the qualifications of neonatal intensive care units of hospitals (physical conditions, standard applications, employee qualifications and use of personal protective equipment) and work related causes and risks, employee related causes and risks when occupational accidents occur. Accordingly, a survey was prepared and was made among 105 nurses working in 3 public and 3 private hospital's neonatal intensive care units, in the January of 2010. The survey consists of questions about the qualifications of neonatal intensive care units, work related causes and risks, and employee related causes and risks. From the regression analysis conducted, it has been found that confirmed hypotheses in several studies in the literature were not significant in this study. The sub-dimensions in which relationships has been found show that the improvement of the physical environment in workplace, the improvement of the employee qualifications and standard applications can reduce the rate of occupational accidents. According to the results of this study management should take care of the organizational factors besides to improvement of the physical environment in workplace, the improvement of the employee qualifications and standard applications.

Psychopathological Factors Associated With Burnout in Intensive Care Nurses: A Cross-Sectional Study

2021 ◽  
pp. 107839032199972
Author(s):  
Erman Yıldız
Keyword(s):  
Intensive Care ◽  
Emotional Exhaustion ◽  
Cross Sectional Study ◽  
Personal Accomplishment ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Anxiety Depression ◽  
The Relationship

BACKGROUND: Although previous studies have separately revealed that parameters such as anxiety, depression, and secondary traumatic stress (STS) are associated with burnout, there is still a limited understanding of the relationship between anxiety, depression, and STS and burnout in intensive care unit (ICU) nurses. AIMS: To investigate the relationship between levels of burnout, anxiety, depression, and STS in ICU nurses. METHOD: A cross-sectional study was conducted with ICU nurses ( N = 164) from a university hospital in eastern Turkey. The participants completed the anxiety, depression, STS, and burnout scales along with the descriptive characteristics form. The data were analyzed using descriptive statistics, correlation, and logistic regression analysis. RESULTS: The mean scores for STS, anxiety, depression, and burnout were 40.60 ± 13.77, 17.14 ± 12.90, 13.28 ± 9.75 and 41.39 ± 14.87, respectively. The results showed that, in the ICU nurses, anxiety, depression, and STS components explained 61% of emotional exhaustion, 38% of depersonalization, and 13% of personal accomplishment. CONCLUSIONS: While the present findings supported the paradigm that burnout in ICU nurses is associated with STS, anxiety, and depression, they also revealed some details about the psychopathological factors associated with burnout. These details were as follows: (1) individuals who resorted to avoidance as a component of STS on a high level were more likely to experience emotional exhaustion and depersonalization, (2) individuals with severe depressive symptoms were more likely to experience a decrease in their personal accomplishment, and (3) individuals with anxiety symptoms were more likely to experience both emotional exhaustion and personal accomplishment.

scholarly journals The Association Between Arterial Oxygen Level and Outcome in Neurocritically Ill Patients is not Affected by Blood Pressure

2021 ◽  
Author(s):  
Jaana Humaloja ◽  
Markus B. Skrifvars ◽  
Rahul Raj ◽  
Erika Wilkman ◽  
Pirkka T. Pekkarinen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Intensive Care ◽  
Brain Injury ◽  
Hemodynamic Instability ◽  
Arterial Oxygen ◽  
Admission Diagnosis ◽  
Secondary Brain Injury ◽  
Multivariable Logistic Regression Model ◽  
Mechanically Ventilated ◽  
The Relationship

Abstract Background In neurocritically ill patients, one early mechanism behind secondary brain injury is low systemic blood pressure resulting in inadequate cerebral perfusion and consequent hypoxia. Intuitively, higher partial pressures of arterial oxygen (PaO2) could be protective in case of inadequate cerebral circulation related to hemodynamic instability. Study purpose We examined whether the association between PaO2 and mortality is different in patients with low compared to normal and high mean arterial pressure (MAP) in patients after various types of brain injury. Methods We screened the Finnish Intensive Care Consortium database for mechanically ventilated adult (≥ 18) brain injury patients treated in several tertiary intensive care units (ICUs) between 2003 and 2013. Admission diagnoses included traumatic brain injury, cardiac arrest, subarachnoid and intracranial hemorrhage, and acute ischemic stroke. The primary exposures of interest were PaO2 (recorded in connection with the lowest measured PaO2/fraction of inspired oxygen ratio) and the lowest MAP, recorded during the first 24 h in the ICU. PaO2 was grouped as follows: hypoxemia (< 8.2 kPa, the lowest 10th percentile), normoxemia (8.2–18.3 kPa), and hyperoxemia (> 18.3 kPa, the highest 10th percentile), and MAP was divided into equally sized tertiles (< 60, 60–68, and > 68 mmHg). The primary outcome was 1-year mortality. We tested the association between hyperoxemia, MAP, and mortality with a multivariable logistic regression model, including the PaO2, MAP, and interaction of PaO2*MAP, adjusting for age, admission diagnosis, premorbid physical performance, vasoactive use, intracranial pressure monitoring use, and disease severity. The relationship between predicted 1-year mortality and PaO2 was visualized with locally weighted scatterplot smoothing curves (Loess) for different MAP levels. Results From a total of 8290 patients, 3912 (47%) were dead at 1 year. PaO2 was not an independent predictor of mortality: the odds ratio (OR) for hyperoxemia was 1.16 (95% CI 0.85–1.59) and for hypoxemia 1.24 (95% CI 0.96–1.61) compared to normoxemia. Higher MAP predicted lower mortality: OR for MAP 60–68 mmHg was 0.73 (95% CI 0.64–0.84) and for MAP > 68 mmHg 0.80 (95% CI 0.69–0.92) compared to MAP < 60 mmHg. The interaction term PaO2*MAP was nonsignificant. In Loess visualization, the relationship between PaO2 and predicted mortality appeared similar in all MAP tertiles. Conclusions During the first 24 h of ICU treatment in mechanically ventilated brain injured patients, the association between PaO2 and mortality was not different in patients with low compared to normal MAP.

Infection management processes in intensive care and their association with mortality

2021 ◽  
Author(s):  
Leigh P. Fitzpatrick ◽  
Bianca Levkovich ◽  
Steve McGloughlin ◽  
Edward Litton ◽  
Allen C. Cheng ◽  
...  
Keyword(s):  
Intensive Care ◽  
New Zealand ◽  
Hospital Mortality ◽  
Process Of Care ◽  
Infection Management ◽  
Hierarchical Logistic Regression ◽  
Management Processes ◽  
Patient Database ◽  
Improving Patient Care ◽  
The Relationship

Abstract Background ICU-specific tables of antimicrobial susceptibility for key microbial species (‘antibiograms’), antimicrobial stewardship (AMS) programmes and routine rounds by infectious diseases (ID) physicians are processes aimed at improving patient care. Their impact on patient-centred outcomes in Australian and New Zealand ICUs is uncertain. Objectives To measure the association of these processes in ICU with in-hospital mortality. Methods The Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database and Critical Care Resources registry were used to extract patient-level factors, ICU-level factors and the year in which each process took place. Descriptive statistics and hierarchical logistic regression were used to determine the relationship between each process and in-hospital mortality. Results The study included 799 901 adults admitted to 173 ICUs from July 2009 to June 2016. The proportion of patients exposed to each process of care was 38.7% (antibiograms), 77.5% (AMS programmes) and 74.0% (ID rounds). After adjusting for confounders, patients admitted to ICUs that used ICU-specific antibiograms had a lower risk of in-hospital mortality [OR 0.95 (99% CI 0.92–0.99), P = 0.001]. There was no association between the use of AMS programmes [OR 0.98 (99% CI 0.94–1.02), P = 0.16] or routine rounds with ID physicians [OR 0.96 (99% CI 0.09–1.02), P = 0.09] and in-hospital mortality. Conclusions Use of ICU-specific antibiograms was associated with lower in-hospital mortality for patients admitted to ICU. For hospitals that do not perform ICU-specific antibiograms, their implementation presents a low-risk infection management process that might improve patient outcomes.

scholarly journals Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations

2021 ◽  
Author(s):  
Gianmarco Secco ◽  
◽  
Marzia Delorenzo ◽  
Francesco Salinaro ◽  
Caterina Zattera ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Structure And Function ◽  
General Ward ◽  
Prognostic Role ◽  
Interstitial Syndrome ◽  
Lung Structure ◽  
And Function ◽  
The Relationship

AbstractBedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.

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