scholarly journals A new look at the correction of COVID-19-mediated pulmonary gas exchange disorders

2021 ◽  
Vol 102 (3) ◽  
pp. 362-372
Author(s):  
I S Simutis ◽  
G A Boyarinov ◽  
M Yu Yuriev ◽  
D S Petrovsky ◽  
A I Kovalenko ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gas Exchange ◽  
Sodium Succinate ◽  
Intensive Therapy ◽  
Infusion Therapy ◽  
Control Group ◽  
Electrolyte Balance ◽  
Study Group ◽  
Coronavirus Infection

Aim. To assess the effect of meglumine sodium succinate on the effectiveness of basic therapy in correcting gas exchange abnormalities in patients with severe COVID-19 infection complicated by bilateral community-acquired pneumonia. Methods. The analysis of the effectiveness of therapy of 12 patients with a diagnosis of New coronavirus infection COVID-19 (confirmed), severe form U07.1. Complication: bilateral multifocal pneumonia was carried out. The patients were divided into two groups: 7 received, as part of standard therapy, a solution of meglumine sodium succinate in a daily dose of 5 ml/kg during stay in the intensive care unit; 5 patients received a similar volume of Ringer's solution and formed the control group. In the arterial and venous blood of all patients, the indicators of acid-base state and water-electrolyte balance, glycemia and lactatemia were measured at several stages: (1) at admission to the intensive care unit, (2) 24 hours after the start of intensive therapy, (3) after 812 hours, (4) after 24 hours. On the 28th day of observation, mortality, the duration of treatment in the intensive care unit and the incidence of thrombotic complications in the groups were assessed. The Friedman nonparametric hypothesis test was used to assess intragroup dynamics, and the nonparametric Mannhitney U test for intergroup comparisons. Results. In the group of patients who received meglumine sodium succinate, there was a significant decrease in the incidence of thromboembolic events during 28 days of treatment: myocardial ischemia event rate ratio from 0.89 [95% confidence interval (CI) 0.191.16] in the control group to 0.55 (95% CI 0.060.81) in the study group at p=0.043; pulmonary embolism event from 0.50 (95% CI 01.0) in the control group to 0.28 (95% CI 01.0) in the study group at p=0.041. There was also a decrease in the duration of intensive care unit length of stay to 6.11.1 days in the study group versus 8.91.3 days in the control group. Conclusion. Compared with standard infusion therapy, the use of meglumine sodium succinate leads to a faster normalization of ventilation-perfusion ratios in patients with severe coronavirus infection.

scholarly journals Effects of COVID-19 pandemic on breastfeeding rates in a neonatal intensive care unit

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Asli Okbay Gunes ◽  
Emre Dincer ◽  
Nilgun Karadag ◽  
Sevilay Topcuoglu ◽  
Guner Karatekin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Breast Milk ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Group ◽  
Study Group ◽  
Intake Rate ◽  
Informed Consent Form ◽  
Group 2

Abstract Objectives To find out if the expressed breast milk delivery rate to neonatal intensive care unit (NICU) for babies who were hospitalized for any reason other than COVID-19, and exclusive breastfeeding (EB) rates between discharge date and 30th day of life of those babies were affected by COVID-19 pandemic. Methods Babies who were hospitalized before the date first coronavirus case was detected in our country were included as control group (CG). The study group was divided into two groups; study group 1 (SG1): the mothers whose babies were hospitalized in the period when mother were asked not to bring breast milk to NICU, study group 2 (SG2): the mothers whose babies were hospitalized after the date we started to use the informed consent form for feeding options. The breast milk delivery rates to NICU during hospitalization and EB rates between discharge and 30th day of life were compared between groups. Results Among 154 mother-baby dyads (CG, n=50; SG1, n=46; SG2, n=58), the percentage of breast milk delivery to NICU was 100%, 79% for CG, SG2, respectively (p<0.001). The EB rate between discharge and 30th day of life did not change between groups (CG:90%, SG1:89%, SG2:75.9; p=0.075). Conclusions If the mothers are informed about the importance of breast milk, the EB rates are not affected by the COVID-19 pandemic in short term, even if the mothers are obligatorily separated from their babies. The breast milk intake rate of the babies was lowest while our NICU protocol was uncertain, and after we prepared a protocol this rate increased.

Abstract TP329: Early Initiation of Oral Antihypertensives Reduces Intensive Care Unit Stay and Hospital Cost in Patients With Hypertensive Intracerebral Hemorrhage

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Zhu Zhu ◽  
Matthew Bower ◽  
Sara Stern-Nezer ◽  
Steven Atallah ◽  
Dana Stradling ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intracerebral Hemorrhage ◽  
Resource Utilization ◽  
Hospital Cost ◽  
Early Initiation ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
Hypertensive Intracerebral Hemorrhage

Background and Purpose: Intravenous nicardipine infusion is effective for intensive blood pressure (BP) control in patients with hypertensive intracerebral hemorrhage (ICH). However, its use requires close hemodynamic monitoring in the intensive care unit (ICU). Prompt transition from nicardipine infusion to oral antihypertensives may reduce ICU length of stay (LOS). This study aimed to examine the effect of early verse late initiation of oral antihypertensives on hospital resource utilization in patients with hypertensive ICH. Methods: This is a retrospective study of patients with hypertensive ICH and initial systolic BP ≥ 180 mmHg from January 1, 2013 to December 31, 2017. Only patients who received nicardipine infusion were included. Based on timing of receiving oral antihypertensives within or after 24 hours of emergency department arrival, patients were divided into study or control group, respectively. Baseline characteristics, duration of nicardipine infusion, ICU and hospital LOS, functional outcome at hospital discharge, and the cost were compared between the 2 groups using univariate and multivariate analysis to adjust for dependent variables. Results: A total of 166 patients (90 in study group, 76 in control group) were identified. There was no significant difference in demographic features, past medical history or initial SBP between the 2 groups. Patients in study group had lower initial NIHSS and ICH scores but higher GCS score than those in the control group. Using multivariant regression analysisto adjust for initial SBP, NIHSS, GCS and ICH scores, early initiation of oral antihypertensives was associated with significant shorter ICU LOS (median 2 vs 5, p =0.004), decreased duration of nicardipine infusion (55.5 ±60.1 vs 121.6 ±141.3, P =0.002), less pharmaceutical cost (median $14207 vs $ 29299, p =0.007) and total hospital cost (median $ 24564 vs $ 47366, p =0.007). After adjustment of confounders, there was also no significant difference in functional independence (mRS 0-2, 42.2% vs 17.1%, p =0.112) or mortality (6.7% vs 13.2%, p = 0.789) between the 2 groups. Conclusions: Early initiation of oral antihypertensive therapy is associated with reduced resource utilization and hospital cost in patients with hypertensive ICH.

Role of Ischemia Modified Albumin Serum Levels as an Oxidative Stress Marker in Children with Diabetic Ketoacidosis

2019 ◽  
Vol 22 (8) ◽  
pp. 577-581
Author(s):  
Mutlu U. Yazıcı ◽  
Ganime Ayar ◽  
Senay Savas-Erdeve ◽  
Ebru Azapağası ◽  
Salim Neşelioğlu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Diabetic Ketoacidosis ◽  
Pediatric Patients ◽  
Serum Levels ◽  
Oxidative Stress Marker ◽  
Control Group ◽  
Study Group ◽  
Ischemia Modified Albumin

Aim and Objective: Ischemia modified albumin (IMA) is a biomarker that has been introduced recently for use in the evaluation of oxidative stress. The aim of this study was to measure the ischemia modified albumin serum levels in pediatric patients with diabetic ketoacidosis (DKA) during acidosis and after the patient recovered from acidosis and to compare these with the control group. Materials and Methods: Pediatric patients with Type I diabetes mellitus (T1DM) who were admitted to the pediatric intensive care unit with the diabetic ketoacidosis were assigned as the study group and healthy children who were admitted to the outpatient clinic and decided as healthy after clinic and laboratory evaluation were selected as the control group. IMA and adjusted IMA levels were evaluated in the blood samples from the control group and the study group when admitted first time to the intensive care unit during the acidosis period (DKA before treatment, DKA-BT), and after recovering from acidosis (DKA after treatment, DKA-AT). Results: A total of 24 pediatric patients with diabetic ketoacidosis and 30 healthy control children matching age and sex were included in the current study. The albumin levels in pediatric patients with T1DM during DKA-BT were higher than the albumin levels after acidosis (4.101±0.373, 3.854±0.369 g/dL, respectively) (p<0.05). However, there was no significant difference when these values were compared to the control group. Mean values of IMA and Adj-IMA were statistically higher in DKAAT compared to the control group (0.748±0.150 vs 0.591±0.099, p< 0.001; 0.708±0.125 vs 0.607±0.824, p< 0.001, respectively). IMA and adjusted IMA levels measured after recovered from acidosis were significantly higher compared to the level of IMA during DKA (0.748±0.150 vs 0.606±0.105 as absorbance unit, p<0.001; 0.708±0.125 vs 0.625±0.100, p<0.05, respectively). Conclusion: In children with T1DM, even though acidosis recovered following the treatment in diabetic ketoacidosis, which is an oxidative stress marker, the ischemia modified albumin levels and adjusted ischemia modified albumin levels were high.

Benefits of early enteral nutrition with glutamine and probiotics in brain injury patients

2004 ◽  
Vol 106 (3) ◽  
pp. 287-292 ◽  
Author(s):  
IRA S. FALCÃO DE ARRUDA ◽  
JOSÉ E. DE AGUILAR-NASCIMENTO
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Brain Injury ◽  
Infection Rate ◽  
Control Group ◽  
Early Enteral Nutrition ◽  
Study Group ◽  
Diet Control ◽  
Enteral Formula

Brain injury patients have higher energy and protein expenditures and are prone to infections. The aim of the present study was to evaluate the results of early enteral feeding with glutamine and probiotics in brain injury patients. Twenty-three brain injury patients (Glasgow score between 5–12 and therapeutic intervention scoring system>20) were studied. Three patients were excluded to leave 20 remaining patients. Patients were randomized to receive either an early enteral diet (control group, n=10) or the same formula with glutamine and probiotics added (study group, n=10) for a minimum of 5 days (range, 5–14 days). The diets were isocaloric and isonitrogenous [35 kcal·kg-1·day-1 (where 1 kcal≈4.184 kJ) and 1.5 g of protein·kg-1·day-1]. Main outcome measures were the incidence of infection, the length of stay in the intensive care unit and the number of days requiring mechanical ventilation. The two groups were homogeneous in gender, age, nutritional status and severity of trauma. There was no mortality during the study period. The infection rate was higher in controls (100%) when compared with the study group (50%; P=0.03) and the median (range) number of infections per patient was significantly greater (P<0.01) in the control group [3 (1–5)] compared with the study group [1 (0–3)]. Both the critical care unit stay [22 (7–57) compared with 10 (5–20) days; P<0.01; median (range)] and days of mechanical ventilation [14 (3–53) compared with 7 (1–15) days; P=0.04; median (range)] were higher in the patients in the control group than in the study group. We conclude that the enteral formula containing glutamine and probiotics decreased the infection rate and shortened the stay in the intensive care unit of brain injury patients.

scholarly journals Effect of cough assist device on blood gasses and period of mechanical ventilator for pneumonic children with general hypotonia

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Raheel Sanad ◽  
Shimaa Mohamed Refaat ◽  
Faten Hassan Abdelazeim ◽  
Bassant Meligy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Physical Therapy ◽  
Post Treatment ◽  
Control Group ◽  
Study Group ◽  
Mechanical Ventilator ◽  
Assist Device ◽  
Therapy Program ◽  
Physical Therapy Program

Abstract Background Cough assist devices play an important role with patients in the intensive care unit (ICU), particularly those with neuromuscular diseases which had abnormal muscle tone. It was previously thought to be the main technique for improving cough efficacy, which aids in weaning from mechanical ventilation and improves patient outcomes. So, we selected randomly the odd numbers from Abo El-Reesh hospital records, and 30 children of both sexes with pneumonia were selected, aged from 6 months to 3 years, who were selected from intensive care unit: fifteen children were the control group, who received the selected physical therapy program (postural drainage, percussion and resist diaphragm), and another fifteen children were the study group, who received previous physical therapy program, which was selected, and cough assist device. Results This study revealed the effect of cough assist device on blood gasses and the period of mechanical ventilator on children with pneumonia and general hypotonia. There was a significant decrease in pH, PaCO2, and HCO3 post treatment compared with that pretreatment in the study and control groups (p < 0.05). The percentage of decrease in pH, PaCO2, and HCO3 in study group A were 0.4, 38.26, and 30.28% respectively while that in the control group were 0.4, 32.56, and 25.48% for pH, PaCO2, and HCO3 respectively. There was a significant increase in PaO2 post treatment compared with that pretreatment in the study and control groups (p < 0.001). The percentage of increase in PaO2 in the study group was 32.13% and that in control group was 30.09%. There was no significant difference in pH, PaCO2, and HCO3 between both groups pre-treatment (p ˃ 0.05). Also, there was no significant difference between groups post treatment (p ˃ 0.05). The median (IQR) period of mechanical ventilation in the study group was 5 (7, 4) days while that in control group was 8 (18, 5) days. There was a significant decrease in period of mechanical ventilator of the study group compared with that of control group (p = 0.03). Conclusion The cough assist device and physical therapy program were selected for children in the intensive care unit which have the same effect on arterial blood gasses as they optimize pH, PO2, PCO2, and HCO3, but the cough assist device helps in accelerating weaning of mechanical ventilator so as decrease the period of mechanical ventilator.

scholarly journals Presentation the new surgicaly approach in the treatment of pediatric lung hydatid disease non–captonage procedure without closure of the communication bronchial opening

2019 ◽  
Vol 6 (1) ◽  
pp. 7-15
Author(s):  
Karavdic K ◽  
Mehic B ◽  
Guska S
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hydatid Disease ◽  
Control Group ◽  
Study Group ◽  
Clinical Center ◽  
Surgical Methods ◽  
Significant Difference ◽  
Residual Cavity ◽  
Time Required

Introduction: Treatment of pediatric lung hydatid disease is primarily surgical, and any suspicion on hydatid lung disease justified indication for surgical intervention. The aim of our research is to investigate efficacy and safety of treatment of residual cavity by "non-capitonage" method, without closure of communicating bronchial opening compared to the classic "capitonage" method with closure of communicating bronchial opening. Patients and Methods: The study included 80 patients of both sexes under aged 18 years, who were surgically treated at the Clinic for Child Surgery and the Department of Thoracic Surgery, Clinical Center University in Sarajevo (KCUS) and Childrens Surgical Clinic of the Institute of Children's Diseases, Clinical Center of Montenegro in Podgorica due to pulmonary echinococcosis, based on clearly defined criteria for inclusion and exclusion from the study. 40 patients (group A) were subjected to non-capitonnage treatment of residual cavity that remained after the removal of parasites and partial pericystectomy without closure of orificium of bronchial opening. The control group consisted of 40 patients who had done narrowing of residual pericystic cavity with closure of bronchial opening. This is a multicenter, open-targeted clinical comparative study of safety of surgery procedures and intraoperative findings. Important aspects of these procedures being assessed included: the duration of the surgical procedure, the amount of administered blood products, drainage length, the amount of secretion, duration of drainage fistula, the time required for reexpansion of lungs, and variables of complications (such as : occurrence of empyema, atelectasis, postoperative fever, postoperative wound infection). Postoperative effectiveness (efficacy) was measured by a record of length of stay in the intensive care unit and hospital stay, as well as radiological findings of the subjects lungs six months after surgery. Results: In the control group we observed that the overall time of surgery was longer compared to the study group. Man-Vitni’s U test confirmed a statistically significant difference between the results of the test and control groups, U = 285.50, z = 4.957, p = 0.0001. Additionally, we observed a slightly larger amount of fluid drained in the control group vs. the study group. Man-Vitni’s U test revealed a statistically significant difference in the amount of drained fluid between the study and control groups, U = 325.50, z = 4.583, p = 0.0001. In the study group there were no cases of postoperative pulmonary atelectasis, while in the control group were 16 (40.0%) patients with documented atelectasis. Mean time to reexpansion of the lung using the control radiological findings was 11 days in the study group (Md = 11.000 days, n = 40) vs. 16 days in the control group of patients (MD = 16.000 days, n = 40) . We also observed that the control group of subjects had significantly longer time in the intensive care unit compared with the experimental group (U = 426.00, z = 3.654, p = 0.0003). Subjects in the control group had significantly longer hospitalizations compared with the experimental group (U = 373.50, z = 4.112, p = 0.0001) as well. Conclusions: We report here meaningful differences in two surgical approaches to the managamanet of hydatid disease in our medical system. Non-capitonnage surgical methods resulted in a significantly shorter duration of surgery, smaller drainage of secretions, atelectasis and pleural empyema events, shorter time required for reexpansion of the surgically intervened lungs and better overall outcomes, vs. the control surgical approach 6 months postoperatively. In our experience, non-capitonnage surgical methods compared much more favorably when compared to the capitonnage method, as reflected in the significantly shorter postoperative stay of patients in the intensive care unit and in hospital. The treatment of any residual pericystic cavity of pulmonary echinoccocus in children, especially if it is a giant, complicated and multiple hydatid cysts should be the method of "non-closure" or "no-narrowing" (non-capitonnage) due to the rapid overlaying of residual pericystic cavity by epithelial cells originating from surrounding pleura and lung parenchyma

scholarly journals Application of Amniotic Tissue Matrix to Surgically Excised Hidradenitis Suppurativa Wounds: A Retrospective Review

2021 ◽  
pp. 1-6
Author(s):  
Christopher J. Salgado ◽  
Christopher J. Salgado ◽  
Faris Hawatmeh ◽  
Lalama Maria ◽  
Genesis Navas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hidradenitis Suppurativa ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Control Group ◽  
Study Group ◽  
Surgical Wounds ◽  
The University ◽  
Tissue Matrix

Background: Hidradenitis suppurativa is a painful and disfiguring disease, which requires surgical management in severe cases. Improvements in management are necessary to decrease disease morbidity and improve outcomes. Aim: To determine the efficacy of applying amniotic tissue matrix to surgically-excised hidradenitis suppurativa wounds. Materials & Methods: A 5-year retrospective chart review of patients who underwent surgical treatment of perineal, perianal, and inguinal hidradenitis suppurativa at the University of Miami Hospital was completed. The study group consisted of 5 patients who had amniotic tissue matrix applied to their surgical wounds postoperatively. The control group, 18 patients, did not receive the amniotic tissue matrix application. Results: The average disease surface area in the study group was larger at 1278 ± 723 cm2 compared to 700 ± 555 cm2 for the control group. Duration of intensive care unit admission in the study group was shorter at 4.2 ± 4.3 days compared to 6.7 ± 8.8 days for the control group. Duration of inpatient admission was longer in the study group, 28.2 ± 12.4 days, compared to 24.6 ± 11.9 days for the control group. Postoperative hypergranulation tissue occurred more frequently in the control group (52.6%) than in the study group (20%). Conclusion: While further evaluation in a larger cohort of patients is necessary, application of amniotic tissue matrix to surgically-excised hidradenitis wounds appears to offer an adjunctive improvement to the treatment of hidradenitis.

scholarly journals Optimization of infusion-transfusion therapy in patients with traumatic brain injury

2020 ◽  
pp. 51-52
Author(s):  
R.I. Nasirova ◽  
А.А. Fatullaeva
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Intensive Therapy ◽  
Laboratory Data ◽  
The Body ◽  
Infusion Therapy ◽  
Control Group ◽  
Transfusion Therapy ◽  
Pharmacologically Active

Objective. Intensive therapy of severe traumatic brain injury belongs to the most difficult section of resuscitation. Therefore, the main purpose of intensive care during the implementation is to eliminate disorders of Rheosorbilact homeostasis. Materials and methods. We analyzed 30 patients with traumatic brain injury in the intensive care unit of the Republican Clinical Hospital between 2018 and 2019. All patients were divided into two groups: 1st – control group (16 patients) – received complex intensive therapy without Rheosorbilact, while 2nd group (14 patients), received Rheosorbilact in a comprehensive intensive therapy. The main pharmacologically active substances of the drug are sorbitol, basic cations (Na, K, Ca, Mg), and sodium lactate. Thanks to these components, the drug has a hyperosmolar effect, causing fluid from the intercellular space to enter the vascular channel and thus improves microcirculation and perfusion of brain tissue. In order to monitor the effectiveness of the therapy in the dynamics evaluated indicators of hemodynamics (level of consciousness and diuresis), laboratory data (hemotocrit, electrolyte composition of blood, acid-alkaline blood condition, coagulogram), and MRI data. Rheosorbilact was used as part of a complex therapy in an infusion-transfusion program in the amount of 200-400 ml daily intravenous drip. Results. In patients, whom after the beginning of complex intensive therapy was included Rheosorbilact, was observed earlier (the first 6 h) compared to the control group, which did not use Rheosorbilact, stabilization of hemodynamics. Conclusions. Infusion therapy with Rheosorbilact in patients with traumatic brain injury contributed primarily to stabilization of hemodynamics and faster normalization of vital functions of the body.

scholarly journals Possibilities of Hyperinflammation Correction in COVID-19

2021 ◽  
Vol 66 (3-4) ◽  
pp. 40-48
Author(s):  
I. S. Simutis ◽  
G. A. Boyarinov ◽  
M. Yu. Yuriev ◽  
D. S. Petrovsky ◽  
A. L. Kovalenko ◽  
...  
Keyword(s):  
Intensive Care ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Sodium Succinate ◽  
Intensive Therapy ◽  
Laboratory Data ◽  
Systemic Inflammatory Response ◽  
Control Group ◽  
Polyelectrolyte Solution ◽  
Number Of Patients

Objective. To evaluate the effect of sodium meglumine succinate on the severity of the systemic inflammatory response syndrome when used in complex therapy in patients with severe COVID-19.Material and Methods. The clinical and laboratory data of 12 patients with the diagnosis «Novel coronavirus infection COVID-19 complicated by community-acquired bilateral polysegmental interstitial pneumonia» were analyzed. All patients underwent intensive therapy with a limited volume of water load in the intensive care unit in accordance with the recommendations of the Ministry of Health of the Russian Federation. Seven patients (observation group) received a polyelectrolyte solution containing meglumine sodium succinate (Reamberin) as part of the therapy at a daily dose of 5 ml/kg during the entire period of stay in the ICU (3–10 days). The control group included 5 patients who received a similar volume of a conventional polyelectrolyte solution containing no metabolically active substrates. The study was pilot in nature due to the small number of patients. The laboratory parameters of arterial and venous blood were measured at the following stages: 1) upon admission to the ICU; 2) 2–4 hours after the completion of Reamberin infusion; 3) 8–12 hours after drug administration; 4) 24 hours after the start of intensive care. Mortality rate and the incidence of thrombotic complications in the groups were assessed on the 28th day of observation. The presence of the therapeutic intervention effect was established using multivariate analysis of variance (MANOVA).Results. A positive effect of the study drug on the severity of systemic inflammatory response syndrome (SIRS) against the background of ongoing etiotropic therapy was noted. Efficiency criteria were the correction of hyperfibrinogenemia, normalization of the platelet count, decrease in the level of C-reactive protein, ferritin, and leukocytosis. A significant decrease in the frequency of thromboembolic events was observed within 28 days of treatment, as well as a reduction in the length of time the patients spent in the ICU.Conclusion. Based on the results of the pilot study, it can be assumed that the antihypoxic and antiradical effects of the drug contribute to the reduction of pulmonary and systemic endotheliitis, which is characteristic of severe forms of the disease and, as a result, inhibits the development of the systemic inflammatory response syndrome. The data obtained can serve as a basis for further in-depth studies.

Topical Lidocaine Patch for Postthoracotomy and Poststernotomy Pain in Cardiothoracic Intensive Care Unit Adult Patients

2019 ◽  
Vol 39 (5) ◽  
pp. 51-57 ◽  
Author(s):  
Michael Liu ◽  
Mabel Wai ◽  
James Nunez
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Standard Care ◽  
Academic Medical Center ◽  
Adult Patients ◽  
Control Group ◽  
Lidocaine Group ◽  
Lengths Of Stay ◽  
Topical Lidocaine

Background Transdermal lidocaine patches have few systemic toxicities and may be useful analgesics in cardiac surgery patients. However, few studies have evaluated their efficacy in the perioperative setting. Objective To compare the efficacy of topical lidocaine 5% patch plus standard care (opioid and nonopioid analgesics) with standard care alone for postthoracotomy or poststernotomy pain in adult patients in a cardiothoracic intensive care unit. Methods A single-center, retrospective cohort evaluation was conducted from January 2015 through December 2015 in the adult cardiothoracic intensive care unit at a tertiary academic medical center. Cardiac surgery patients with new sternotomies or thoracotomies were included. Patients in the lidocaine group received 1 to 3 topical lidocaine 5% patches near sternotomy and/or thoracotomy sites daily. Patches remained in place for 12 hours daily. Patients in the control group received standard care alone. Results The primary outcome was numeric pain rating for sternotomy/thoracotomy sites. Secondary outcomes were cardiothoracic intensive care unit and hospital lengths of stay and total doses of analgesics received. Forty-seven patients were included in the lidocaine group; 44 were included in the control group. Mean visual analogue scores for pain did not differ between groups (lidocaine, 2; control, 1.9; P = .58). Lengths of stay were similar for both groups (cardiothoracic intensive care unit: lidocaine, 3.06 days; control, 3.11 days; P = .86; hospital: lidocaine, 8.26 days; control, 7.61 days; P = .47). Conclusions Adjunctive lidocaine 5% patches did not reduce acute pain in postthoracotomy and post-sternotomy patients in the cardiothoracic intensive care unit.

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