scholarly journals Computed tomography features of cerebrovascular complications in intensive care unit patients with severe COVID-19

2021 ◽  
Vol 54 (5) ◽  
pp. 283-288
Author(s):  
Vinícius de Padua Vieira Alves ◽  
Ananda Altoé ◽  
Vanessa Veloso ◽  
Clecia Lucia Santos Ferreira ◽  
Nina Ventura ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Protein Assay ◽  
Reactive Protein ◽  
Cerebrovascular Complications ◽  
Coagulation Testing ◽  
Function Testing ◽  
The Brain ◽  
Ct Features

Abstract Objective: To report the computed tomography (CT) features of acute cerebrovascular complications in severely ill patients with confirmed coronavirus disease 2019 (COVID-19) in the intensive care unit. Materials and Methods: We conducted a retrospective analysis of 29 intensive care unit patients with confirmed COVID-19 who underwent CT of the brain. We describe the CT features of the cerebrovascular complications of COVID-19, as well the demographic characteristics and clinical features, together with the results of laboratory tests, such as complete blood cell count, coagulation testing, renal function testing, and C-reactive protein assay. Results: Two patients were excluded because of brain death. Among the remaining 27 patients, CT revealed acute cerebrovascular complications in six (three men and three women; 49-81 years of age), whereas no such complications were seen in 21 (15 men and six women; 36-82 years of age). Conclusion: Radiologists should be aware of the risks of cerebrovascular complications of COVID-19 and the potential underlying etiologies. COVID-19-associated coagulopathy is likely multifactorial and may increase the risk of ischemic and hemorrhagic infarction.

scholarly journals The use of laboratory parameters and computed tomography score to determine intensive care unit requirement in COVID-19

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Halef Okan Doğan ◽  
Serkan Bolat ◽  
Seyit Ali Büyüktuna ◽  
Rağıp Sarıismailoğlu ◽  
Nazım Çetinkaya ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Stage ◽  
P Value ◽  
Predictive Values ◽  
Glucose Levels ◽  
Reactive Protein ◽  
Highly Correlated ◽  
D Dimer

Abstract Objectives It is vital to determine the intensive care unit (ICU) requirement at an early stage to reduce the mortality rate in COVID-19 patients. The aim of the study was to find reliable predictive markers to determine the ICU requirement. Methods We retrospectively reviewed the clinical and laboratory records of 151 COVID-19 patients. The predictive abilities of biochemical parameters and computed tomography (CT) score were evaluated to determine of ICU requirement. Results The area under curve (AUC) values for procalcitonin, D-Dimer, C reactive protein (CRP), glucose, lactate dehydrogenase (LDH) and CT score were found higher than those for other parameters in the prediction of ICU requirement. The negative predictive values of these markers were higher than their positive predictive values. CT score was found to be highly correlated with fibrinogen and CRP. The glucose levels [odd ratio (OR): 95% CI; 1.07, p-value: 0.014] and CT score [OR: 95% CI; 1.05, p-value: 0.022] were associated with ICU requirement in COVID-19 patients. Conclusions CT score, procalcitonin, D-Dimer, CRP, glucose, and LDH are potential predictors to rule out ICU requirement on hospital admission. Fibrinogen and CRP can be used to follow up and predict lung damages in patients with COVID-19.

Computed Tomography of the Chest in the Intensive Care Unit

1994 ◽  
Vol 10 (2) ◽  
pp. 267-275 ◽  
Author(s):  
Barry H. Gross ◽  
David L. Spizarny
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care

scholarly journals Long-term Outcome in Chest Trauma

2008 ◽  
Vol 109 (5) ◽  
pp. 864-871 ◽  
Author(s):  
Marc Leone ◽  
Fabienne Brégeon ◽  
François Antonini ◽  
Kathia Chaumoître ◽  
Aude Charvet ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Chest Trauma ◽  
Computed Tomography Scan ◽  
Walk Distance ◽  
Chest Computed Tomography ◽  
Tomography Scan

Background Currently, there are limited data available describing the long-term outcomes of chest trauma survivors. Here, the authors sought to describe chest trauma survivor outcomes 6 months and 1 yr after discharge from the intensive care unit, paying special attention to pulmonary outcomes. Methods A cohort of 105 multiple trauma patients with blunt chest trauma admitted to the intensive care unit was longitudinally evaluated. After 6 months, a chest computed tomography scan, pulmonary function testing (PFT), and quality of life were collected in 55 of these patients. A subgroup of 38 patients was followed up for 1 yr. Results At least one abnormal PFT result was found in 39 patients (71%). Compared with normalized data of the age- and sex-matched population, physical function was decreased in 38 patients (70%). The 6-min walk distance was reduced for 29 patients (72%). Although pathologic images were observed on the chest computed tomography scan from 33 patients (60%), no relation was found between PFT and computed tomography. A ratio of arterial oxygen pressure to inspired oxygen fraction less than 200 at admission to the intensive care unit predicted an abnormal PFT result at 6 months. One year after discharge from the intensive care unit, paired comparisons showed a significant increase in forced vital capacity (P = 0.02) and Karnofsky Performance Status (P < 0.001). Conclusions Survivors of multiple traumas including chest trauma demonstrate a persistent decrease in the 6-min walk distance, impairment on PFT, and reduced pulmonary-specific quality of life.

Urinary biomarkers to predict severe fluid overload after cardiac surgery: a pilot study

2021 ◽  
Author(s):  
Saban Elitok ◽  
Berend Isermann ◽  
Sabine Westphal ◽  
Prasad Devarajan ◽  
Christian Albert ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Pilot Study ◽  
Intensive Care Unit Admission ◽  
Fluid Overload ◽  
Predictive Ability ◽  
Urinary Biomarkers ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Reactive Protein

Aim: To assess the predictive ability of urinary and plasma biomarkers and clinical routine parameters for subsequent severe fluid overload. Patients & methods: In a pilot study, we studied 100 adult patients after cardiac surgery. On intensive care unit admission, we measured biomarkers in urine (midkine, IL-6, neutrophil gelatinase-associated lipocalin [NGAL], hepcidin-25) and plasma (creatinine, urea, B-type natriuretic peptide, lactate, C-reactive protein, leukocytes, IL-6, NGAL, hepcidin-25) to predict postoperative severe fluid overload. Results: Urinary midkine, IL-6, NGAL and hepcidin-25 (all AUCs ≥0.79) predicted postoperative severe fluid overload (N = 5 patients). Urinary NGAL/hepcidin-25 ratio (AUC 0.867) predicted postoperative severe fluid overload after adjustment to EuroScore and need for norepinephrine on surgery day (odds ratio: 2.4). Conclusion: Urinary biomarkers on intensive care unit admission might be helpful to predict subsequent severe fluid overload after cardiac surgery.

The role of IL-6 receptor inhibitor treatment in critical patient monitoring with COVID-19

2021 ◽  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lactate Dehydrogenase ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Group 2 ◽  
D Dimer

Objectives: The COVID-19 disease can manifest itself with acute respiratory distress syndrome, renal failure, and septic shock in critically ill patients. There are opinions that there is a correlation between high IL-6 levels and disease severity. In our intensive care unit, we evaluated the changes in the laboratory data and radiological involvement severity of our patients who underwent tocilizumab treatment and examined the appropriate laboratory parameter in the treatment follow-up and its effect on survival. Methods: In the critical patient follow-up of COVID-19, 17 of the 23 patients treated with tocilizumab had a mortal course (Group 1) and the remaining 6 (Group 2) were. The C-reactive protein, lactate dehydrogenase, IL-6, D-dimer, procalcitonin, albumin, and ferritin values, which were routinely screened in our clinic on the day of tocilizumab treatment and the 5th day after, were recorded. Both the change between the two groups and the change between days 1 and 5 were analyzed. Results: A total of 23 patients (55.35 ± 13.31 years) were included in the study. The computed tomography severity score assessed at the intensive care unit admission was statistically significantly higher in Group 2. The procalcitonin and lactate dehydrogenase values measured on day 5 after tocilizumab were significantly lower in Group 2. On the 5th day after treatment, the levels of C-reactive protein, ferritin, chest X-rays, IL-6 and D-dimer statistically significantly changed compared to the first day of the treatment. In correlation with the decrease in PCT as of the 5th day after tocilizumab administration, an increasing tendency was observed in 28-day survival. Conclusion: This study demonstrated that tocilizumab treatment may positively contribute to the treatment by decreasing cytokine levels. PCT and LDH follow-up before and after treatment in critically ill patients who are receiving tocilizumab treatment can give an idea about survival.

Innovative haematological parameters for early diagnosis of sepsis in adult patients admitted in intensive care unit

2017 ◽  
Vol 71 (4) ◽  
pp. 330-335 ◽  
Author(s):  
Sabrina Buoro ◽  
Barbara Manenti ◽  
Michela Seghezzi ◽  
Paola Dominoni ◽  
Tiziano Barbui ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Early Diagnosis ◽  
Area Under The Curve ◽  
Clinical Information ◽  
Operating Characteristics ◽  
Early Management ◽  
Reactive Protein ◽  
Icu Stay ◽  
Immature Platelet Fraction

AimsThis study was aimed to investigate the role of erythrocyte, platelet and reticulocyte (RET) parameters, measured by new haematological analyser Sysmex XN and C reactive protein (CRP), for early diagnosis of sepsis during intensive care unit (ICU) stay.MethodsThe study population consisted of 62 ICU patients, 21 of whom developed sepsis during ICU stay and 41 who did not. The performance for early diagnosing of sepsis was calculated as area under the curve (AUC) of receiver operating characteristics curves analysis.ResultsCompared with CRP (AUC 0.81), immature platelet fraction (IPF) (AUC 0.82) showed comparable efficiency for identifying the onset of sepsis. The association with the risk of developing sepsis during ICU stay was also assessed. One day before the onset of sepsis, a decreased of RET% was significantly associated with the risk of developing sepsis (OR=0.35, 95% CI 0.14 to 0.87), whereas an increased of IPF absolute value (IPF#) was significantly associated with the risk of developing sepsis (OR=1.13, 95% CI 1.03 to 1.24) 2 days before the onset of sepsis. The value of CRP was not predictive of sepsis at either time points.ConclusionsIPF# and RET% may provide valuable clinical information for predicting the risk of developing sepsis, thus allowing early management of patients before the onset of clinically evident systemic infections.

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