scholarly journals A study of clinical characteristics and outcome of obstetric patients in intensive care and high dependency unit of a tertiary centre of Jharkhand, India

2019 ◽  
Vol 9 (1) ◽  
pp. 394
Author(s):  
Samarina Kamal ◽  
Vandita Singh ◽  
Shashibala Singh
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Antenatal Care ◽  
Arterial Embolization ◽  
Postnatal Period ◽  
Primary Objective ◽  
Blood Product Transfusion ◽  
Tertiary Centre ◽  
High Dependency ◽  
A Prospective Study

Background: Few women during their pregnancy, labour and postnatal period require critical care related to the pregnancy itself, aggravation of a pre-existing illness and complications of the delivery. Pregnant patients account for a small number of ICU admission - 2-10% two main indications for admission are hypertensive disorders (17.2%-46%) and massive haemorrhage (10%-32.8%). The primary objective of the present study was to review the characteristics of the obstetric patients admitted to our ICU over a 2-year period.Methods: It was a prospective study conducted over 50 patients in high dependency and intensive care unit at Alam hospital over a period of 2 years (October 2014 to October 2016).Results: During the study period a total of 50 obstetric patients were transferred to the intensive care unit (ICU). Antenatal care played significant role in the obstetric outcome. 84% of patients transferred to the ICU during the study period had inadequate or no antenatal care, while 8% were booked in their pregnancy and had adequate antenatal care. ICU interventions included mechanical ventilation used in 20(40%) patients, blood and blood product transfusion in 35(70%) patients’ inotropes in 20 patients (40%) antihypertensive therapy in 20 patients (40%), arterial embolization in 2(4%) patients. Maternal mortality was seen in 10 patients (20%).Conclusions: There is a need for training in emergency obstetrics so that the complication can be managed right at the time of occurrence.

Frequency and Severity of Chlorothiazide-Induced Hyponatremia in the Neonatal Intensive Care Unit

2021 ◽  
Author(s):  
Maura Harkin ◽  
Peter N. Johnson ◽  
Stephen B. Neely ◽  
Lauren White ◽  
Jamie L. Miller
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Serum Sodium ◽  
Neonatal Intensive Care ◽  
Primary Objective ◽  
Severe Hyponatremia ◽  
Days Of Therapy ◽  
Neonates And Infants ◽  
Sodium Supplementation

Objective Although thiazide diuretics are commonly used in the neonatal intensive care unit (NICU), the risk of thiazide-induced hyponatremia in infants has not been well documented. The primary objective of this study was to determine the frequency and severity of hyponatremia in neonates and infants receiving enteral chlorothiazide. Secondary objectives included identifying: (1) percent change in serum sodium from before chlorothiazide initiation to nadir, (2) time to reach nadir serum sodium concentration, and (3) percentage of patients on chlorothiazide receiving sodium supplementation. Study Design This was a retrospective cohort study of NICU patients admitted between July 1, 2014 and July 31, 2019 who received ≥1 dose of enteral chlorothiazide. Mild, moderate, and severe hyponatremia were defined as serum sodium of 130 to 134 mEq/L, 120 to 129 mEq/L, and less than 120 mEq/L, respectively. Data including serum electrolytes, chlorothiazide dosing, and sodium supplementation were collected for the first 2 weeks of therapy. Descriptive and inferential statistics were performed in SAS software, Version 9.4. Results One hundred and seven patients, receiving 127 chlorothiazide courses, were included. The median gestational age at birth and postmenstrual age at initiation were 26.0 and 35.9 weeks, respectively. The overall frequency of hyponatremia was 35.4% (45/127 courses). Mild, moderate, and severe hyponatremia were reported in 27 (21.3%), 16 (12.6%), and 2 (1.6%) courses. The median percent decrease in serum sodium from baseline to nadir was 2.9%, and the median time to nadir sodium was 5 days. Enteral sodium supplements were administered in 52 (40.9%) courses. Sixteen courses (12.6%) were discontinued within the first 14 days of therapy due to hyponatremia. Conclusion Hyponatremia occurred in over 35% of courses of enteral chlorothiazide in neonates and infants. Given the high frequency of hyponatremia, serum sodium should be monitored closely in infants receiving chlorothiazide. Providers should consider early initiation of sodium supplements if warranted. Key Points

Primary Casualty Reception Ship: the hospital within—Operation Granby

1992 ◽  
Vol 78 (2) ◽  
pp. 55-64
Author(s):  
E. P. Dewa
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Support Services ◽  
Persian Gulf ◽  
Medical Team ◽  
High Dependency Unit ◽  
Full Support ◽  
Hospital Facility ◽  
High Dependency

SummaryAs the build-up of Operation Granby forces developed in the Gulf, casualty estimates indicated the need for a 100-bed hospital facility to care for the possible maritime casualties. RF A Argus, the Air Training Ship, was identified as the potential Primary Casualty Reception Ship (PCRS) and at the end of September 1990 plans were drawn up to convert the forward hangar into a two-storey 100-bed hospital in collective protection (COLPRO).In the three weeks prior to deployment, the hospital was designed, built, equipped and staffed.Argus arrived in the Gulf in mid-November as the PCRS with, all in COLPRO, a 10-bed intensive care unit (ICU), a 14-bed high dependency unit (HDU), a 76-bed low dependency unit (LDU) plus four operating tables in two theatres with full support services.The hospital was staffed by a medical team of 136 personnel and supported by the Air department with four casualty evacuation helicopters, an RN Party and the staff of the RFA.One hundred and five patients were treated of which 78 were returned to duty. Argus as PCRS spent longer in the northern Persian Gulf than any other ship, UK or US.

Intensive Care Unit Volunteer “Transition Guides:” A prospective study on improving the patient transfer experience

2021 ◽  
Author(s):  
Luke J. Brindamour ◽  
Barbara S. Sarnoff Lee ◽  
Caroline P. Moore ◽  
Kathryn Z. Pape ◽  
Anne V. Grossestreuer ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Study ◽  
Patient Transfer ◽  
A Prospective Study

scholarly journals The effect of rectal progesterone on latency period as well as maternal and prenatal outcome between 24 to 33 weeks

2015 ◽  
Vol 2 (4) ◽  
pp. 97
Author(s):  
Fadwah Tahir ◽  
Mohammed Badawi ◽  
Abdulelah Nuqali ◽  
Yasir Katib ◽  
Irfanallah Muhammad Siddiqui ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Randomized Clinical Trials ◽  
Post Partum ◽  
Controlled Trial ◽  
Latency Period ◽  
Neonatal Morbidity ◽  
Primary Objective ◽  
Intrauterine Fetal Death

Preterm Premature Rupture Of Membranes (PPROM) is directly linked to prematurity associated with severe neonatal morbidity and mortality. Randomized clinical trials have shown that weekly injections of 17-alpha-hydroxyprogesterone (17P) or daily vaginal progesterone application decreases the number of preterm deliveries, particularly for women with a history of preterm delivery or those with a shortened cervix. However, no studies have yet been conducted to prove or disprove the effect of rectal progesterone on latency period. To address this issue,<strong> </strong>we will conduct a multicenter randomized triple-blind controlled trial of 216 participants (108 in each group) from January 1, 2016 to August 31, 2016. Inclusion criteria, exclusion criteria, data collection procedure, data analysis, and assessment of safety procedures are explained in the study protocol.<strong> </strong>The primary objective will be to determine the effect of rectal progesterone on the latency period in PPROM. The secondary objective will be to study the effect of rectal progesterone on maternal outcomes of hospitalization, intensive care unit admission, chorioamnionitis, post-partum hemorrhage, post-partum pyrexia, endometritis, and maternal death. In addition, we will evaluate prenatal birth weight, Apgar score, neonatal morbidity, duration of neonatal intensive care unit stay, intrauterine fetal death, and neonatal death associated with PPROM.

scholarly journals Experiences of the Intensive Care Unit of Hospital Raja PerempuanZainab II in handling the Massive Evacuation of Critically-Ill Patients during Flood Disaster.

2018 ◽  
Vol 2 (4) ◽  
pp. 224
Author(s):  
WI Wan Nasruddin ◽  
ZA Nor Hidayah ◽  
A Nazri ◽  
WI Wan Azzlan ◽  
I Ruwaida ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Life Support ◽  
The State ◽  
Flood Disaster ◽  
Water Levels ◽  
Tertiary Centre ◽  
Set Up

In December 2014, Malaysia had suffered nationwide floods after unprecedented monsoon rains overwhelmed several parts of the country. The East Coast areas of Malaysia were especially badly affected, specifically for the state of Kelantan, whereby a total of 170,000 victims were evacuated to the evacuation centres. This was the worst flood in the last 40 years and has been referred to by the locals as ‘Bah Kuning’. As a tertiary centre for the state of Kelantan with a total number of hospital beds of 937, HRPZ II was also badly compromised during this time. The electricity supply to the main hospital building was shut-down during this period and the hospital had managed to maintain its operations hUP_(ÛT_e power from a generator which had faced the risk of being shut down if the water levels had increased further. These issues might have caused a worse impact viaa possible loss of electrical and oxygen supply and non-functional life support systems. In relation to this flood disaster, the Anaesthesiology and Intensive Care Unit of HRPZ II would like to share the experiences of handling ventilated and critically ill-patients for evacuation during the massive floods in 2014 from the ICU of Hospital Raja Perempuan Zainab II to “an open stage with no facilities”. During this time, we had a total of 19 patients in our 21-bedded Intensive Care Unit. The challenge was the need to evacuate all the critically ill patients and to set-up a new ICU in a safer place immediately at the time.International Journal of Human and Health Sciences Vol. 02 No. 04 October’18. Page : 224-227

scholarly journals A prospective study of foetomaternal outcome in placenta praevia

2019 ◽  
Vol 8 (10) ◽  
pp. 4028
Author(s):  
Somika Kaul ◽  
Bijal Rami
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Neonatal Death ◽  
Maternal Morbidity ◽  
Neonatal Intensive Care ◽  
Placenta Praevia ◽  
Bladder Injury ◽  
Control Group ◽  
A Prospective Study

Background: Placenta praevia is one of the serious obstetric problems with far reaching effects and a major cause of antepartum haemorrhage. The aim of the study was to evaluate the foetomaternal outcome of pregnancies with placenta praevia.Methods: The present study was a prospective case control study conducted in the Department of Obstetrics and Gynaecology, Lal Ded Hospital, Srinagar from August 2009 to October 2010.Results: Among the 100 cases of placenta praevia studied bleeding per vaginum was the most common presenting symptom. Major placenta praevia was more common (53%) than minor placenta praevia. 43% of the cases of placenta praevia delivered before 37 completed weeks as compared to only 6% in the control group. All cases of placenta praevia delivered by caesarean section. Maternal morbidity in terms of postpartum haemorrhage (32%), intraoperative bowel and bladder injury (2%) and intensive care unit admission (1%) was more in cases of placenta praevia. Foetal complications in terms of neonatal intensive care unit admission (19%), neonatal death (10%) and stillbirth (5%) were more in pregnancies with placenta praevia as compared to controls. 48% of patients with placenta praevia required transfusion of blood and blood products as compared to 4.5% among controls.Conclusions: There is a significant increase in maternal morbidity in pregnancies complicated with placenta praevia. Also, there is a higher incidence of foetal complications and neonatal death. Managing a case of placenta praevia is a challenge in present day obstetrics and it creates a huge burden on the health care system.

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