scholarly journals Effect of Respiratory Rehabilitation for a Patient with Severe Pneumonia and Intensive Care Unit Acquired Weakness (ICU-AW) Due to COVID-19

2021 ◽  
Vol 36 (5) ◽  
pp. 747-752
Author(s):  
Shunsuke NAOI ◽  
Shunsuke NAKAZATO ◽  
Junya KAMESAKO ◽  
Shusuke SEKINE ◽  
Hitoshi IMAIZUMI
BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041184
Author(s):  
Dan Wang ◽  
Jin Li ◽  
Feilong Zhu ◽  
Qianqin Hong ◽  
Ming Zhang ◽  
...  

IntroductionBoth physical and mental disorders may be exacerbated in patients with COVID-19 due to the experience of receiving intensive care; undergoing prolonged mechanical ventilation, sedation, proning and paralysis. Pulmonary rehabilitation is aimed to improve dyspnoea, relieve anxiety and depression, reduce the incidence of related complications, as well as prevent and improve dysfunction. However, the impact of respiratory rehabilitation on discharged patients with COVID-19 is currently unclear, especially on patients who have been mechanically ventilated over 24 hours. Therefore, we aim to investigate the efficacy of respiratory rehabilitation programmes, initiated after discharge from the intensive care unit, on the physical and mental health and health-related quality of life in critical patients with COVID-19.Methods and analysisWe have registered the protocol on PROSPERO and in the process of drafting it, we strictly followed the checklist of Preferred Reporting Items for Systematic Review and Meta-Analysis Potocols. We will search the PubMed, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, WanFang, VIP information databases and Chinese Biomedical Literature Database. Additionally, ongoing trials in the WHO International Clinical Trials Registry Platform, ClinicalTrials.gov and ISRCTN registry will be searched as well. Studies in English or Chinese and from any country will be accepted regardless of study design. Two review authors will independently extract data and assess the quality of included studies. Continuous data are described as standard mean differences (SMDs) with 95% CIs. Dichotomous data from randomised controlled trials are described as risk ratio(RR) with 95% CIs; otherwise, it is described as odds ratio(OR) with 95% CIs. I2 and the Cochrane’s Q statistic will be used to conduct heterogeneity assessment. The quality of evidence of main outcomes will be evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation(GRADE) criteria. When included studies are sufficient, we will conduct subgroup analysis and sensitivity analysis; the publication bias will be statistically analysed using a funnel plot analysis and Egger’s test.Ethics and disseminationOur review, planning to include published studies, does not need the request to the ethical committee. The final results of this review will be published in a peer-reviewed journal after completion.Patient and public involvementNo patient involved.PROSPERO registration numberCRD42020186791.


2012 ◽  
Vol 186 (4) ◽  
pp. 325-332 ◽  
Author(s):  
Sang-Ho Choi ◽  
Sang-Bum Hong ◽  
Gwang-Beom Ko ◽  
Yumi Lee ◽  
Hyun Jung Park ◽  
...  

2014 ◽  
Vol 19 (39) ◽  
Author(s):  
N Cassir ◽  
S Hraiech ◽  
A Nougairede ◽  
C Zandotti ◽  
P E Fournier ◽  
...  

We herein describe and analyse the first outbreak of severe pneumonia caused by human adenovirus type 1 (HAdV C type 1), which included immunocompetent patients in an intensive care unit (ICU) of Marseille, France, and occurred between September and October 2012. Seven successive patients were diagnosed by HAdV specific real-time polymerase chain reaction with a positive bronchoalveolar lavage. After the collection of nasopharyngeal swabs from healthcare workers, three nurses working night shifts tested positive for HAdV C including one that had exhibited respiratory signs while working one week before the outbreak. She was the most likely source of the outbreak. Our findings suggest that HAdV-1 could be considered as a possible cause of severe pneumonia even in immunocompetent patients with a potential to cause outbreaks in ICUs. HAdV rapid identification and typing is needed to curtail the spread of this pathogen. Reinforcing hand hygiene with antiseptics with demonstrated activity against non-enveloped viruses and ensuring that HCWs with febrile respiratory symptoms avoid direct patient contact are critical measures to prevent transmission of HAdV in healthcare settings.


Author(s):  
Loganathan Palanivel ◽  
Chidambaranathan Sivaprakasam ◽  
Logesvar Palanisamy

Background: In underdeveloped countries, lower respiratory tract infection (LRTI) remains the leading cause of under-five mortality. Judicious use of antibiotics prevents the emergence of multidrug resistant organisms, but appropriate selection is vital in the child requiring intensive care.Methods: The study in conducted prospectively in the paediatric wards and intensive care unit, Rajah Muthiah Medical College and Hospital, Chidambaram. Fifty children were enrolled in the study using simple random sampling. Data regarding the demographic details, mean duration of stay, antibiotics given, immunisation status, intensive care unit admission and complications were collected. Statistical analysis is done using the Microsoft excel 2010.Results: The complications (n=3) is more among the female children (n=2) belonging to the age group one to two years (n=2) with mean duration of stay of more than seven days (n=2) and non-immunized for age children (n=3).Conclusions: The gram positive and atypical pneumonia in Chidambaram is found to be sensitive to aminopenicillin with penicillinase resistant penicillin and macrolide respectively.


2021 ◽  
Vol 1 (2) ◽  
pp. 116-131
Author(s):  
Zikanovelia Zikanovelia ◽  
Ngakan Putu Parsama Putra ◽  
Yani Jane Sugiri ◽  
Harun Al Rasyid

Background: Severe pneumonia accompanied with sepsis could increase death ratio by 7.6%. Lactate clearance is used in assessing the success of early resuscitation in treating sepsis. Presepsin is a biomarker that is sensitive and specific to the bacterial infection that causes sepsis. The purpose of this study was to analyze the effect of presepsin levels and lactate clearance on mortality in pneumonic patients accompanied with sepsis after fourteen day of observation. Methods: Prospective cohort study was done on 42 patients who were admitted to intensive care unit of dr. Saiful Anwar Public Hospital, from March 2019 until May 2019. Blood samples were collected on the first, second, and third day of treatment to measure lactate clearance and presepsin levels. Mortality was observed on the 14th day after admittance. Results: Out of 42 patients, 25 patients lived (59.5%), and 17 patients died (40.5%). Logistic regression analysis performed on the presepsin levels on the third day with a cut-off 957 ng/L had a significant effect on mortality after 14th day (p=0.034). However, presepsin levels on the first day with a cut-off 957 ng/L had no significant effect on mortality (p=0.24). Likewise, the lactate clearance with cut-off 10% did not significantly influence the mortality status (p=0.136). Conclusion: There is a significant effect between presepsin level on the third day in patient mortality, however lactate clearance and presepsin level assessed on the first day had no significant effect on the mortality after fourteen day of observation.


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