scholarly journals Improving pregnancy outcomes in tertiary care institution in India through obstetric intensive care unit: three-year analysis

2020 ◽  
Vol 9 (5) ◽  
pp. 1965
Author(s):  
Ashish V. Gokhale ◽  
Shonali Agarwal ◽  
Dimpi Modi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Maternal Mortality ◽  
Post Partum ◽  
Tertiary Care ◽  
Health Care Facilities ◽  
Utilization Rate ◽  
High Dependency ◽  
Tertiary Care Institution ◽  
Obstetric Population

Background: To analyse the requirement of high dependency unit (HDU)/intensive care unit (ICU) in an obstetric population in terms of utilization rate, indications for admission, interventions required and gestational outcome.Methods: Retrospective observational study was carried out from April 2015 to September 2018 at department of obstetrics and gynecology SSG Hospital, Vadodara India. Data related to indications for ICU admission, interventions required, length of stay and outcomes were collected, and results were analyzed.Results: Obstetric ICU utilization rate was 130 per 1000 deliveries.  The major obstetric indications for admission were hypertensive disorders of pregnancy (42%) followed by anemia (25%) and post-partum hemorrhage (3%). In the rest of the patient’s majority (50%) had cardiovascular problems. Maternal mortality among these critically ill women was 3.76%. The death rate in the present study was high among patients admitted for non-obstetric (74.54%) as opposed to obstetric indications (25.46%).Conclusions: Establishment of well managed high dependency and intensive care unit in health care facilities dealing with high volumes of high-risk maternity cases reduces the maternal mortality significantly and results in improved maternal outcomes.

scholarly journals Evaluation of maternal admission to intensive care unit in a tertiary care hospital of Kashmir valley

2021 ◽  
Vol 10 (11) ◽  
pp. 4283
Author(s):  
Rehana Rashid ◽  
Saniyah Khan Galzie ◽  
Javid Ahmed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Health Care Facilities ◽  
Near Miss ◽  
Care Hospital ◽  
Kashmir Valley ◽  
Mortality And Morbidity ◽  
Icu Admission ◽  
Obstetric Haemorrhage

Background: Management of critically ill obstetric women at an ICU is a challenge to both physicians and obstetricians due to physiological adaptations and progress of diseases during pregnancy and puerperium. There has been a striking association between the number of maternal deaths and the accessibility to ICU care. Obstetric patients get admitted to the ICU approximately at 0.1-0.9% times of all deliveries. Objective was to evaluate the occurrence, indication and outcome of patients admitted in the ICU of an obstetric tertiary care hospital.Methods: This retrospective study was carried out from August 2020 to January 2021 at Lalla Ded Hospital, a tertiary care Obstetrics and Gynaecology Hospital of Kashmir valley. Data for this study was collected retrospectively from hospital records. The demographic details, indication for ICU admission, co-morbidities, ante natal care records were noted on admission to the ICU.Results: The total ICU admission during this time period was 212 (1.44%) with obstetric patients being 194 (91.5%) and gynaecologic patients 18 (8.5%). Obstetric haemorrhage (38.2) followed by hypertensive disorders of pregnancy (24.1%) were the most common indications for ICU admission. 26.9% patients needed mechanical ventilation during ICU admission.Conclusions: Analysing intensive care unit utilization during pregnancy can be an accepted approach to identify severe and near miss maternal morbidity. Development and upliftment of primary health care facilities with involvement of multi-disciplinary teams and referral of high risk pregnancies to higher health centres is the key to decrease maternal mortality and morbidity.

scholarly journals Drug utilization study in medicine intensive care unit in tertiary care hospital

2019 ◽  
Vol 9 (1) ◽  
pp. 151
Author(s):  
Siddharth Suryakant Athawale ◽  
Madhuri D. Kulkarni
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Utilization Rate ◽  
Valuable Insight ◽  
Care Hospital ◽  
Life Threatening ◽  
Potassium Clavulanate ◽  
Medical Intensive Care ◽  
The Mean

Background: The medical intensive care unit (MICU) is a setting were patients who are critically ill are admitted and thus usually receive a large number of drugs of different pharmacological classes due to life threatening illnesses which may be fatal. The various drugs used in MICU and there clinical outcome was investigated in this study.Methods: Patients admitted between January 2017 to June 2018 in Medicine ICU of GMC Aurangabad were included in this study.Results: Total of 351 prescriptions was analyzed from the medicine intensive care unit. Out of 351 patients 243 (69.23%) were male, while 108 (30.77%) were female. The mean age of the patients admitted in MICU was 42.78±18.14 years. The most common type of patients admitted in MICU have the diagnosis of organophosphorous poisoning (25.36%), followed by cerebrovascular accident (15.95%), pneumonitis (10.26%), snake bite (7.12%), chronic kidney disease (5.98%), diabetic ketoacidosis (5.70%) and seizure disorder (3.42%). The most common drugs used were ranitidine (99.71%) and ondansetron (99.43%). Among antibiotics cephalosporins were most commonly used, ceftriaxone (39.03%), cefotaxim (40.46%), cefoperazone and sulbactum (24.22%). Other antibiotics most commonly used were metronidazole (61.25%), amoxicillin and potassium clavulanate (26.78%), piperacillin and tazobactum (11.68%), meropenem (11.40%).Conclusions: In conclusion, we found that in MICU utilization rate of gastroprotective (ranitidine), antiemetic (ondansetron) and antibiotics (cephalosporins) was high. The present study provides valuable insight about the overall pattern of drugs used in medicine intensive care unit.

scholarly journals Severe Maternal Morbidity: Admission Shift From Intensive Care Unit to Obstetric High-dependency Unit

2021 ◽  
Author(s):  
Ning Gu ◽  
Yaning Zheng ◽  
Yimin Dai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Apache Ii Score ◽  
High Dependency Unit ◽  
Chi Square ◽  
Icu Admission ◽  
Hypertensive Disorders ◽  
High Dependency ◽  
Obstetric Population ◽  
Length Of Icu Stay

Abstract Background: To study temporal trends of intensive care unit (ICU) admission in obstetric population after the introduction of obstetric high-dependency unit (HDU).Methods: This is a retrospective study of consecutive obstetric patients admitted to the ICU/HDU in a provincial referral center in China from January 2014 to December 2019. The collected information included maternal demographic characteristics, indications for ICU and HDU admission, the length of ICU stay, the total length of in-hospital stay and APACHE II score. Chi-square and ANOVA tests were used to determine statistical significance. The temporal changes were assessed with chi-square test for linear trend.Results: A total of 40 412 women delivered and 447 (11.1‰) women were admitted to ICU in this 6-year period. The rate of ICU admission peaked at 15.9‰ in 2016 and then dropped to 6.7‰ in 2019 with the introduction of obstetric HDU. The average APACHE II score increased significantly from 6.8 to 12.3 (P<0.001) and the average length of ICU stay increased from 1.7 to 7.1 days (P<0.001). The main indications for maternal ICU admissions were hypertensive disorders in pregnancy (39.8%), cardiac disease (24.8%), and other medical disorders (21.5%); while the most common reasons for referring to HDU were hypertensive disorders of pregnancy (46.5%) and obstetric hemorrhage (43.0%). After adjusting for the proportion of high-risk pregnancies, the establishment of HDU reduced 20% of ICU admission (aOR = 0.804, 95% CI =0.666-0.972).Conclusions: The introduction of HDU helps to reduce ICU utilization in obstetric population.

scholarly journals Why Obstetric Patients are admitted to Intensive Care Unit? A Retrospective Study

2012 ◽  
Vol 4 (2) ◽  
pp. 90-92
Author(s):  
Sunita Ghike ◽  
Prashant Asegaonkar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Maternal Mortality ◽  
South Asian ◽  
Medical Illness ◽  
High Dependency Unit ◽  
Icu Admission ◽  
High Dependency ◽  
Number Of Patients

ABSTRACT Pregnant women are often young and in their reproductive years. In majority of them, pregnancy and labor usually progresses uneventfully. Sudden complications occurring during this period may lead to maternal mortality. Though obstetric admission forms a small proportion of ICU admission, mortality among them is high. Proper antenatal care is still the mainstay of preventing complications in pregnant woman. This study was conducted to evaluate the obstetric admission to intensive care unit and causes and outcome of them. Two years retrospective review of all the obstetric admissions (Antenatal and postnatal up to 6 weeks post delivery) were done. Total number of patients admitted to ICU in this period, total number of deliveries in study period and total obstetric patients admitted to ICU were noted. The data included demographic details, obstetric history, indications for ICU admission, pre-existing medical illness and pregnancy complications necessitating ICU admissions. Total obstetric patients admitted to ICU were 1.04% of all deliveries. 48.53% women had pre-existing medical illness. 87.24% were antenatal and 12.67% were postnatal patients. 70.21% women had obstetric/medical illnesses during pregnancy which ICU admissions. Maternal mortality was observed in 31.91%. There was.changing trend in causes of maternal mortality, i.e. tropical diseases like dengue and malaria are found to be the cause of mortality in developing countries like India. Thus, there is need of obstetric high dependency unit (OHDU) at every center. How to cite this article Ghike S, Asegaonkar P. Why Obstetric Patients are admitted to Intensive Care Unit? A Retrospective Study. J South Asian Feder Obst Gynae 2012;4(2):90-92.

EPIDEMIOLOGICAL AND CLINICAL PROFILE OF NON COVID 19 PATIENTS ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT OF A TERTIARY CARE REFERRAL CENTRE DURING COVID 19 PANDEMIC

2021 ◽  
pp. 13-15
Author(s):  
Shalini G N ◽  
Isha Deshmukh ◽  
Rajesh Kulkarni ◽  
Aarti Kinikar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Virus Disease ◽  
Tertiary Care ◽  
Ventilatory Support ◽  
Pediatric Intensive Care ◽  
Health Care Facilities ◽  
Care Hospital ◽  
The Impact

Objective: To study the impact of lockdown during the corona virus disease 2019 pandemic, considering the limited healthcare and transport facilities while reaching the tertiary care hospital. It was a hospital based; observational study done over a period of 12 month consisting of pre lockdown period (December 2019 to March 2020), Lockdown (April 2020 to June 2020) and post lock-down (July 2020 to November 2020) period data of COVID-19 negative reported children admitted to pediatric intensive care unit (PICU). 0ut of 1019 enrolled children, total number of admissions prior lockdown was 534, during lockdown 240 and post lock down 243. Admissions from rural was signicantly less during lockdown i.e., urban =80% and rural=20% whereas prior lockdown 56% from urban and 44% from rural Pune. Percentage of male children admitted was signicantly more during lockdown compared to prelockdown (62.3% male and 37.7% females). The mortality rate was 6.7% and discharge against medical advice rate was signicantly high during lockdown compared to pre- and post-lockdown. Our study has shown that covid-19 pandemic has strongly affected the number of PICU admissions, pattern of diseases, requirement of ventilatory support and mortality. Provision for good healthcare transport facility and availability of primary and routine health care facilities may have led to good outcome of PICU hospitalizations in terms of recovery and mortality.

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

2020 ◽  
Author(s):  
Catherine M. Groden ◽  
Erwin T. Cabacungan ◽  
Ruby Gupta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Code Blue ◽  
Neonatal Resuscitation Program

Objective The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes. Study Design This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann–Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event. Results In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups. Conclusion Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU. Key Points

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