scholarly journals Tracheobronchopathia Osteochondroplastica

2019 ◽  
Author(s):  
Ehsan Sanaei ◽  
Fatemeh Aghaei Meybodi ◽  
Marzie Vaghefi
Keyword(s):  
Critical Care ◽  
Female Patient ◽  
Care Center ◽  
Benign Disorder ◽  
Retrosternal Pain ◽  
Tracheobronchopathia Osteochondroplastica

Tracheobronchopathia Osteochondroplastica (TPO) is a rare benign disorder of the lower part of the trachea and the upper part of the main bronchi. A 55-year-old female patient had been referring to our pulmonary and critical care center suffering from chronic dry cough and breathlessness on exertion and retrosternal pain for several months who was admitted to our center when she was complaining about breathlessness on exertion and chronic dry cough and retrosternal pain

Defining the role of the pediatric critical care nurse practitioner in a tertiary care center

2000 ◽  
Vol 28 (7) ◽  
pp. 2626-2630 ◽  
Author(s):  
Shari L. Derengowski ◽  
Sharon Y. Irving ◽  
Pamela V. Koogle ◽  
Robert M. Englander
Keyword(s):  
Critical Care ◽  
Nurse Practitioner ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Pediatric Critical Care ◽  
Care Nurse ◽  
Critical Care Nurse

Diagnostic, therapeutic, didactic, data bank utilization of computerized monitoring in a critical care center

Resuscitation ◽  
1984 ◽  
Vol 11 (3-4) ◽  
pp. 193-205 ◽  
Author(s):  
Sergio I. Magalini ◽  
Rodolfo Proietti ◽  
Francesco Lorino
Keyword(s):  
Critical Care ◽  
Care Center ◽  
Data Bank ◽  
Computerized Monitoring

Research Utilization in Critical Care: An Exemplar

1994 ◽  
Vol 5 (2) ◽  
pp. 124-132
Author(s):  
Marita G. Titler ◽  
Linda Moss ◽  
Jane Greiner ◽  
Michele Alpen ◽  
Gerry Jones ◽  
...  
Keyword(s):  
Critical Care ◽  
Pain Management ◽  
Research Utilization ◽  
Care Center ◽  
Tertiary Care ◽  
Practice Change ◽  
Research Committee ◽  
Staff Members ◽  
Number Of Patients ◽  
Management Protocol

The authors describe the process and outcome of implementing a research-based pain management protocol in four adult critical care units at a large, Midwestern tertiary care center. The project was initiated and directed by members of the divisional research committee. Strategies used to change practice included determining if pain management was a problem via quality assessment monitors, surveying nurses regarding their knowledge and attitude toward pain management, educating staff members about the research base for the practice change, using change champions in each unit, and developing a core group of nurses in each unit to facilitate the change. Outcomes of this research utilization project include a 41% decline in the number of patients in pain, a 44% decline in pain intensity, and improvement in nurses knowledge about pain

Twelve-year single critical care center experience of nicardipine prolonged-release implants in patients with subarachnoid hemorrhage: a propensity score matching analysis

2020 ◽  
Vol 12 (8) ◽  
pp. 774-776 ◽  
Author(s):  
Yasuhiro Kuroi ◽  
Hidenori Ohbuchi ◽  
Naoyuki Arai ◽  
Yuichi Takahashi ◽  
Shinji Hagiwara ◽  
...  
Keyword(s):  
Critical Care ◽  
Subarachnoid Hemorrhage ◽  
Side Effects ◽  
Propensity Score ◽  
Cerebral Infarction ◽  
Propensity Score Matching ◽  
Cerebral Vasospasm ◽  
Care Center ◽  
Prolonged Release ◽  
Significant Difference

ObjectiveTo develop a nicardipine prolonged-release implant (NPRI) to prevent cerebral vasospasm in patients with subarachnoid hemorrhage in 1999, which may be used during craniotomy, and report the results of our recent 12-year single critical care center experience.MethodsOf 432 patients with aneurysmal subarachnoid hemorrhage treated between 2007 and 2019, 291 were enrolled. 97 Patients were aged >70 years (33%), 194 were female (67%), 138 were World Federation of Neurological Societies grades 1, 2, and 3 (47%), 218 were Fisher group 3 (75%), and 243 had an anterior circulation aneurysm (84%). Using a propensity score matching method for these five factors, the severity of cerebral vasospasm, occurrence of delayed cerebral infarction, and modified Rankin Scale (mRS) score at discharge were analyzed.ResultsOne hundred patients each with or without NPRI were selected, and the ratios of coil/clip were 0/100 and 88/12, respectively. Cerebral vasospasm and delayed cerebral infarction were both significantly less common in the NPRI group (p=0.004, OR=0.412 (95% CI 0.223 to 0.760) and p=0.005, OR=0.272 (95% CI 0.103 to 0.714, respectively); a significant difference was seen in the mRS score at discharge by Fisher’s exact test (p=0.0025). A mRS score of 6 (dead) was less common in the group with NPRI, and mRS scores of 0 and 1 were also less common. No side effects were seen.ConclusionsNPRIs significantly reduced the occurrence of cerebral vasospasm and delayed cerebral infraction without any side effects. The NPRI and non-NPRI groups showed different patterns of short-term outcomes in the single critical care center, which might have been due to selection bias and patient characteristics. Differences in outcomes may become clear in comparisons with patients treated by craniotomy.

A prospective analysis of hypovitaminosis D and mortality in 400 patients in the neurocritical care setting

2017 ◽  
Vol 127 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Jian Guan ◽  
Michael Karsy ◽  
Andrea A. Brock ◽  
Ilyas M. Eli ◽  
Holly K. Ledyard ◽  
...  
Keyword(s):  
Vitamin D ◽  
Critical Care ◽  
Hospital Mortality ◽  
Vitamin D Deficiency ◽  
Neurocritical Care ◽  
Care Center ◽  
Demographic Data ◽  
Hypovitaminosis D ◽  
Vitamin D Levels ◽  
The Impact

OBJECTIVEHypovitaminosis D is highly prevalent among the general population. Studies have shown an association between hypovitaminosis D and multiple negative outcomes in critical care patients, but there has been no prospective evaluation of vitamin D in the neurological critical care population. The authors examined the impact of vitamin D deficiency on in-hospital mortality and a variety of secondary outcomes.METHODSThe authors prospectively collected 25-hydroxy vitamin D levels of all patients admitted to the neurocritical care unit (NCCU) of a quaternary-care center over a 3-month period. Demographic data, illness acuity, in-hospital mortality, infection, and length of hospitalization were collected. Univariate and multivariable logistic regression were used to examine the effects of vitamin D deficiency.RESULTSFour hundred fifteen patients met the inclusion criteria. In-hospital mortality was slightly worse (9.3% vs 4.5%; p = 0.059) among patients with deficient vitamin D (≤ 20 ng/dl). There was also a higher rate of urinary tract infection in patients with vitamin D deficiency (12.4% vs 4.2%; p = 0.002). For patients admitted to the NCCU on an emergency basis (n = 285), higher Simplified Acute Physiology Score II (OR 13.8, 95% CI 1.7–110.8; p = 0.014), and vitamin D deficiency (OR 3.0, 95% CI 1.0–8.6; p = 0.042) were significantly associated with increased in-hospital mortality after adjusting for other factors.CONCLUSIONSIn the subset of patients admitted to the NCCU on an emergency basis, vitamin D deficiency is significantly associated with higher in-hospital mortality. Larger studies are needed to confirm these findings and to investigate the role of vitamin D supplementation in these patients.

scholarly journals Cerebrospinal Fluid Pleocytosis in Critical Care Patients With Seizures

2017 ◽  
Vol 44 (4) ◽  
pp. 343-349
Author(s):  
Carly Scramstad ◽  
Alan C. Jackson
Keyword(s):  
Cerebrospinal Fluid ◽  
Critical Care ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Critical Care Units ◽  
Generalized Seizures ◽  
Csf Pleocytosis ◽  
Magnetic Resonance Imaging Mri ◽  
Critical Care Patients

AbstractObjectives: To assess the etiology of cerebrospinal fluid (CSF) pleocytosis in critical care patients with seizure(s) or status epilepticus (SE). Many previous studies, some performed decades ago, concluded that CSF pleocytosis may be entirely attributable to seizure activity. Methods: We undertook a retrospective chart review of adult patients with an admitting or acquired diagnosis of seizure(s) or SE in critical care units at the Winnipeg Health Sciences Centre between 2009 and 2012. Patients were identified through a critical care information database at a tertiary care center. We limited our study to patients who had lumbar punctures at our center within 5 days of seizure(s) or SE. Results: Of 426 patients with seizures in critical care units, 51 met the inclusion criteria. Seizure subtypes included focal seizures (5 or 10%), generalized seizures (14 or 27%), and SE (32 or 63%). Twelve (seven with SE) of the 51 (24%) were found to have CSF pleocytosis. A probable etiological cause for the CSF pleocytosis was identified in all 12 cases. Conclusions: We conclude that seizures do not directly induce a CSF pleocytosis. Instead, the CSF pleocytosis more likely reflects the underlying acute or chronic brain process responsible for the seizure(s). This was not readily apparent in early studies without magnetic resonance imaging (MRI) of the brain and currently available laboratory investigations. An etiological cause of CSF pleocytosis must always be sought when patients present with seizures and it should never be assumed that seizures are the cause.

scholarly journals Treatment outcomes of patients with non-variceal upper gastrointestinal bleeding in emergency and critical care center

2014 ◽  
Vol 25 (1) ◽  
pp. 1-8
Author(s):  
Makoto Onodera ◽  
Yasuhisa Fujino ◽  
Yoshihiro Inoue ◽  
Satoshi Kikuchi ◽  
Shigeatsu Endo
Keyword(s):  
Critical Care ◽  
Gastrointestinal Bleeding ◽  
Treatment Outcomes ◽  
Upper Gastrointestinal Bleeding ◽  
Care Center ◽  
Upper Gastrointestinal

scholarly journals Incidence, etiology, and course of hypercalcemia-induced AKI in a tertiary care center from northern India

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Nucksheeba Aziz Bhat ◽  
Farhat Mustafa ◽  
Rayees Yousuf Sheikh ◽  
Imtiyaz Wani
Keyword(s):  
Multiple Myeloma ◽  
Critical Care ◽  
Primary Hyperparathyroidism ◽  
Serum Creatinine ◽  
Serum Calcium ◽  
Care Setting ◽  
Care Center ◽  
Tertiary Care ◽  
Critical Care Setting ◽  
Tertiary Care Center

Abstract Background Hypercalcemia is known to cause acute kidney injury (AKI). Literature related to hypercalcemic AKI is predominantly in the form of case reports and case series. The purpose of this study is to find the incidence, etiology, and course of hypercalcemia-induced AKI in a non-critical care setting. To our knowledge, this is the first study done to look for the incidence, etiology, and course of hypercalcemia-induced AKI in a non-critical care setting. This is a prospective observational study conducted in the Department of Medicine in a tertiary care center from Jammu and Kashmir, India, from June 2010 to June 2012. Patients admitted with hypercalcemia were assessed for AKI and evaluated and treated for hypercalcemia. Renal function was monitored during hospitalization and at 1 month of discharge. AKI and hypercalcemia were arbitrarily defined as serum creatinine > 1.5 mg/dl and corrected serum calcium of ≥ 11.5 mg/dl (as per reference hospital lab), respectively. Results Thirty patients are included. Hyperparathyroidism and multiple myeloma accounted for 13(43.3%) and 10 (33.3%) cases, respectively. Mean ±SD corrected serum calcium at diagnosis and after treatment at 1 month was 13.56 ± 1.86 mg/dl and 9.49±1.35 mg/dl, respectively; p < 0.001. Mean ±SD serum creatinine at baseline and after treatment of hypercalcemia was 2.87 ±1.68 mg/dl and 1.49±1.34 mg/dl, respectively; p < 0.001. Twenty-three (76.7%) patients had AKI. AKI recovered after treating hypercalcemia in 25 (83.3 %) patients. Mean ± SD days taken for the decrease in serum creatinine to ≤ 1.5 mg/dl was 8.28 ± 4.17 days. Mean ± SD serum creatinine after treatment of hypercalcemia in hyperparathyroidism group versus non-parathyroid group was 0.97 ± 0.35 mg/dl and 1.88 ±1.67 mg/dl, respectively; p value 0.009. Conclusions Hypercalcemia is commonly associated with AKI. Primary hyperparathyroidism and multiple myeloma account for the majority of the cases. Hypercalcemic AKI with primary hyperparathyroidism is less common and the outcome is better, as compared to non-hyperparathyroidism-related causes. AKI is reversible in most cases.

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