scholarly journals A study of dysnatremia in patients admitted in medical intensive care unit of a tertiary care teaching hospital

2021 ◽  
Vol 8 (2) ◽  
pp. 220
Author(s):  
Mantavya Patel ◽  
Sanjay Kumar Paliwal ◽  
Syed Javed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Tertiary Care ◽  
Female Ratio ◽  
Survival Status ◽  
Icu Stay ◽  
Significant Difference ◽  
Male Female Ratio ◽  
Medical Intensive Care

Background: Both dysnatremia at admission and that acquired in the intensive care unit (ICU) have been shown to have a direct influence on prognosis. The present was planned to study dysnatremia in adult patients admitting in medical intensive care unit (MICU).Methods: The present prospective observational study was conducted on patients admitted in medical ICU over a period of 1 year who developed dysnatremia during ICU stay. Patient’s age, sex, diagnosis at the time of diagnosis, comorbidities, serum sodium levels, risk factors, length of ICU stay, and survival status were noted.Results: Out of total 798 patients during the study period; 207 (25.94%) were found to have hypernatremia and 87 (10.9%) were hyponatremic. In hypernatremic group male/ female ratio was 125/82 and it was 50/37 in hyponatremic group. The mean ICU stay was significantly more in hypernatremic patients (4.76±3.57) compared to hyponatremic group (4.06±2.80). (p˂0.05) Mortality in both hypernatremic patients and hyponatremic patients was found significantly more in hypervolemic group which was 84.38% and 53.84% respectively. (p˂0.05)Conclusions: This study concluded that nowadays hypernatremia is more common with longer ICU stay. In both hypernatremia and hyponatremia mortality was found similar without any significant difference.

Changing the Time of Blood Collection to Determine Vancomycin Concentrations in Intensive Care Unit Patients

2018 ◽  
Vol 38 (1) ◽  
pp. 24-28
Author(s):  
Drayton A. Hammond ◽  
Taylor B. James ◽  
Lexis N. Atkinson ◽  
Jacob T. Painter ◽  
Katherine Lusardi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Sample ◽  
Medical Intensive Care Unit ◽  
Sample Collection ◽  
Blood Samples ◽  
Significant Difference ◽  
Vancomycin Trough ◽  
Medical Intensive Care ◽  
Trough Levels

BACKGROUND Clinical practice guidelines for initiation and therapeutic drug monitoring, but not timing, of vancomycin dosing exist at many institutions. Scheduling vancomycin trough measurements and doses around the morning blood sample collection could yield more interpretable troughs and increase patient safety. OBJECTIVE To evaluate the appropriateness of blood sample collection times for vancomycin trough measurements before and after an initiative to change the timing of blood sampling to determine vancomycin doses and trough levels in a medical intensive care unit. METHODS A retrospective cohort study was conducted of patients in a medical intensive care unit who received intravenous vancomycin at a scheduled interval. Differences in continuous and categorical data were compared between pre- and postintervention groups. The primary outcome was proportion of blood samples collected for vancomycin trough measurements within 30 minutes of the next scheduled vancomycin dose. RESULTS Baseline characteristics were similar between the preintervention (n = 68) and postintervention (n = 176) groups except for the percentage of blood samples drawn for trough measurements and morning laboratory tests (6% vs 81%; P < .001). Frequency of loading doses was similar between patients in the pre- and postintervention groups, as was weight-based maintenance dosing. There was no significant difference in the percentage of blood samples collected to measure vancomycin trough levels appropriately at 30, 60, or 75 minutes from the next scheduled dose. CONCLUSION Measuring vancomycin trough levels in morning blood samples did not affect the percentage of inappropriately collected blood samples used to measure vancomycin trough levels.

Management of an Outbreak of Vancomycin-Resistant Enterococci in the Medical Intensive Care Unit of a Cancer Center

2001 ◽  
Vol 22 (4) ◽  
pp. 217-219 ◽  
Author(s):  
Hend Hanna ◽  
Jan Umphrey ◽  
Jeffrey Tarrand ◽  
Michelle Mendoza ◽  
Issam Raad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Tertiary Care ◽  
Control Measures ◽  
Cancer Center ◽  
Infection Control Measures ◽  
Vancomycin Resistant Enterococci ◽  
Medical Intensive Care ◽  
Vancomycin Resistant

AbstractBetween November 1996 and February 1997, 17 episodes of vancomycin-resistant enterococci (VRE) infection or colonization (9 infections, 8 colonizations), all with the same or a similar genomic DNA pattern, were identified in the medical intensive care unit (MICU) of a tertiary-care cancer hospital. The cases were genotypically traced to a patient who was admitted to the hospital in September 1996 and who, by December 1996, had four different admissions to the MICU. Multifaceted infection control measures, including decontamination of the environment and of nondisposable equipment, halted the nosocomial transmission of VRE in the MICU.

scholarly journals Antibiotic utilization, sensitivity, and cost in the medical intensive care unit of a tertiary care teaching hospital in Nepal

2021 ◽  
Vol 9 ◽  
pp. 205031212110437
Author(s):  
Nirmal Raj Marasine ◽  
Shakti Shrestha ◽  
Sabina Sankhi ◽  
Nabina Paudel ◽  
Ashish Gautam ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Teaching Hospital ◽  
Medical Intensive Care Unit ◽  
Tertiary Care ◽  
Defined Daily Dose ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Antibiotic Utilization ◽  
Medical Intensive Care

Background: High utilization and irrational use of antibiotics in an intensive care unit increases microbial resistance, morbidity, mortality, and costs. Objective: This study aimed to evaluate the utilization, sensitivity and cost analysis of antibiotics used in the medical intensive care unit of a tertiary care teaching hospital of Nepal. Methods: A prospective cohort study was conducted on patients admitted to the medical intensive care unit at a tertiary care teaching hospital in central Nepal from July to September 2016. Antibiotic utilization, defined daily dose per 100 bed-days and the cost of antibiotics per patient were calculated. Descriptive statistics were performed using IBM-SPSS 20.0. Results: A total of 365 antibiotics were prescribed in 157 patients during the study period, with an average of 2.34 prescriptions per patient. Total antibiotic utilization in terms of defined daily dose per 100 bed-days was 49.5. Piperacillin/tazobactam (45.2%) was the most commonly prescribed antibiotic, and meropenem was the most expensive antibiotics (US$4440.70). The median (interquartile range) cost of antibiotics used per patient was US$47.67 (US$63.73). Escherichia coli, Acinetobacter, and Pseudomonas sp. were the common organisms isolated and were found to be resistant to some of the commonly used antibiotics. Conclusion: This study suggests that the utilization and cost of antibiotics are high in medical intensive care unit of the hospital and E. coli was resistant to multiple antibiotics. The findings highlight an urgent need for the implementation of antibiotic stewardship program in order to improve antibiotic utilization in such hospital settings.

scholarly journals Mortality Profile of Critical Patients in Medical Intensive Care Unit of Government Medical College of Central India

2021 ◽  
Author(s):  
Jyoti Tiwari ◽  
Sumit Rawat ◽  
Anju Jha ◽  
Ramesh Pandey
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Central India ◽  
P Value ◽  
Elderly Male ◽  
Female Ratio ◽  
Medical College ◽  
Medical Intensive Care ◽  
One Year

Introduction: Mortality rate is always very high in Intensive Care Units (ICU) even with the best possible set ups, we should try to cater the need of the society according to the disease burden so that better care can be provided. Aim: To estimate the prevalence of various medical disease mortality profile of critically ill patients admitted in Medical Intensive Care Unit (MICU) of our institution. Materials and Methods: This was a retrospective observational study done at MICU of Bundelkhand Medical College and Hospital Sagar, Madhya Pradesh, India for a duration of one year (1st January 2019 to 31st December 2019). Data was retrieved from Medical Records Department (MRD) and total data of 349 deaths were registered. Disease was classified based upon ICD 10 (International Statistical classification of Diseases and related health problems) Score. Results: A total of 349 deaths occurred in MICU during the period of one year at the institution, out of which male deaths were 55.9% and Female deaths were 44.1%. MICU deaths occurred in higher numbers in males with Male: Female ratio of 1.2:1. This difference in ratio of male and female mortality was not statistically significant (p-value >0.05). Mean age of males at time of death was 58.4±16.3 years whereas mean age of females were 55.2±19.7 years. This difference in mortality with age and gender was not statistically significant (p-value >0.05). In present study, most common systemic causes of mortality were cardiovascular (29.8%), followed by respiratory (17.5%), renal (16.5%) and cerebrovascular diseases (13.8%). Mortality was documented in 276 (79%) individuals within duration of seven days of admission, whereas mortality in 46 (13.1%) and 27 (7.7%) cases were documented within 8 to 14 days and >14 days, respectively. The present study documented no statistically significant association between length of stay and age of patients (p-value >0.05). Conclusion: Cardiovascular diseases are the most common causes leading to mortality especially in elderly male patients. Also, higher number of deaths is reported within seven days of admission signifying severity of illness at the time of admission.

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