scholarly journals Longitudinal study of a SARS-CoV-2 infection in an immunocompromised patient with X-linked agammaglobulinemia

2021 ◽  
Author(s):  
Laura Ciuffreda ◽  
José M. Lorenzo-Salazar ◽  
Julia Alcoba-Florez ◽  
Héctor Rodriguez-Pérez ◽  
Helena Gil-Campesino ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Viral Genome ◽  
Immunocompromised Patient ◽  
Multiorgan Failure ◽  
Immunocompromised Patients ◽  
Viral Shedding ◽  
Infection Event ◽  
Infection Control Guidelines

Abstract We describe the case of a 23-year-old immunocompromised male patient with clinically diagnosed X-linked agammaglobulinemia who was admitted to the hospital on the 14th April 2020 due to coronavirus disease of 2019 (COVID-19). Despite COVID-19 test negativizations, the patient was hospitalized most of the time and finally admitted to the intensive care unit where he died from multiorgan failure and shock. Over 149 days, 26 respiratory samples were collected, subjected to viral genome sequencing, and all assigned to the same lineage, supporting a single viral infection event. The accumulation of mutations throughout the course of the infection was accelerated and suggested the presence of compartmentalized viral subpopulations that evolved independently in the upper and lower respiratory airways. These results support that long-term viral shedding in immunocompromised patients is one possible mechanism for the emergence of variants of concern and provide evidence towards the infection control guidelines in these patients.

scholarly journals Longitudinal study of a SARS-CoV-2 infection in an immunocompromised patient with X-linked agammaglobulinemia

2021 ◽  
Author(s):  
Laura Ciuffreda ◽  
José M. Lorenzo-Salazar ◽  
Julia Alcoba-Florez ◽  
Héctor Rodriguez-Pérez ◽  
Helena Gil-Campesino ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Viral Genome ◽  
Immunocompromised Patient ◽  
Multiorgan Failure ◽  
Immunocompromised Patients ◽  
Viral Shedding ◽  
Infection Event ◽  
Infection Control Guidelines

Abstract We describe the case of a 23-year-old immunocompromised male patient with clinically diagnosed X-linked agammaglobulinemia who was admitted to the hospital on the 14th April 2020 due to coronavirus disease of 2019 (COVID-19). Despite COVID-19 test negativizations, the patient was hospitalized most of the time and finally admitted to the intensive care unit where he died from multiorgan failure and shock. Over 149 days, 26 respiratory samples were collected, subjected to viral genome sequencing, and all assigned to the same lineage, supporting a single viral infection event. The accumulation of mutations throughout the course of the infection was accelerated and suggested the presence of compartmentalized viral subpopulations that evolved independently in the upper and lower respiratory airways. These results support that long-term viral shedding in immunocompromised patients is one possible mechanism for the emergence of variants of concern and provide evidence towards the infection control guidelines in these patients.

Survival after cardiac surgery and long-term intensive care unit stay

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
C Schimmer ◽  
K Hamouda ◽  
M Özkur ◽  
SP Sommer ◽  
I Aleksic ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay

scholarly journals SARS-CoV-2 Persistent Viral Shedding in the Context of Hydroxychloroquine-Azithromycin Treatment

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 890
Author(s):  
Michel Drancourt ◽  
Sébastien Cortaredona ◽  
Cléa Melenotte ◽  
Sophie Amrane ◽  
Carole Eldin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Elderly Patients ◽  
Rare Event ◽  
Viral Shedding ◽  
Qrt Pcr ◽  
Viral Culture ◽  
D Dimer

SARS-CoV-2 nasopharyngeal shedding contributes to the spread of the COVID-19 epidemic. Among 3271 COVID-19 patients treated at the Hospital University Institute Méditerranée Infection, Marseille, France from 3 March to 27 April 2020, tested at least twice by qRT-PCR, the median SARS-CoV-2 nasopharyngeal shedding duration was 6 days (range 2–54 days). Compared with short shedders (qRT-PCR positivity < 10 days), 34 (1.04%) persistent shedders (qRT-PCR positivity ≥ 17 days; mean ± SD: 23.3 ± 3.8 days) were significantly older, with associated comorbidities, exhibiting lymphopenia, eosinopenia, increased D-dimer and increased troponin (p < 0.05), and were hospitalized in intensive care unit in 17.7% vs. 1.1% of cases (p < 0.0001). Viral culture was positive in six persistent shedders after day 10, including in one patient after day 17, and no viral co-pathogen was detected in 33 tested patients. Persistent shedders received azithromycin plus hydroxychloroquine ≥ 3 days in 26/34 (76.5%) patients, a figure significantly lower than in short shedders (86.6%) (p = 0.042). Accordingly, mortality was 14.7% vs. 0.5% (p < 0.0001). Persistent shedding was significantly associated with persistent dyspnea and anosmia/ageusia (p < 0.05). In the context of COVID-19 treatment, including treatment with azithromycin plus hydroxychloroquine, the persistence of SARS-CoV-2 nasopharyngeal shedding was a rare event, most frequently encountered in elderly patients with comorbidities and lacking azithromycin plus hydroxychloroquine treatment.

Sportliche Leistung von Pferden, die als Fohlen intensivmedizinischer Behandlung bedurften

2019 ◽  
Vol 47 (06) ◽  
pp. 399-399
Author(s):  
Lukas Demattio
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sich Eine ◽  
Factors Associated ◽  
Intensivmedizinische Behandlung ◽  
Sportliche Leistung

Studies AC, Chidlow H, Ere SG et al. Factors associated with long-term athletic outcome in Thoroughbred neonates admitted to an intensive care unit. Equine Vet J 2019; 51: 716–719 Für viele Pferdezüchter stellt sich immer wieder die Frage, wie viel Geld in ein Fohlen investiert werden soll, wenn dieses tierärztlicher Behandlung bedarf. Lohnt sich eine intensivmedizinische Behandlung für ein Fohlen, das für eine sportliche Nutzung vorgesehen ist? Diese Frage versuchten die Autoren in der Studie zu beantworten.

scholarly journals Completeness of the operating room to intensive care unit handover: a matter of time?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fabian Dusse ◽  
Johanna Pütz ◽  
Andreas Böhmer ◽  
Mark Schieren ◽  
Robin Joppich ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Information Transfer ◽  
Time Pressure ◽  
Intraoperative Complications ◽  
Patient Characteristics ◽  
Information Loss ◽  
Ensure Patient Safety ◽  
Underlying Diseases

Abstract Background Handovers of post-anesthesia patients to the intensive care unit (ICU) are often unstructured and performed under time pressure. Hence, they bear a high risk of poor communication, loss of information and potential patient harm. The aim of this study was to investigate the completeness of information transfer and the quantity of information loss during post anesthesia handovers of critical care patients. Methods Using a self-developed checklist, including 55 peri-operative items, patient handovers from the operation room or post anesthesia care unit to the ICU staff were observed and documented in real time. Observations were analyzed for the amount of correct and completely transferred patient data in relation to the written documentation within the anesthesia record and the patient’s chart. Results During a ten-week study period, 97 handovers were included. The mean duration of a handover was 146 seconds, interruptions occurred in 34% of all cases. While some items were transferred frequently (basic patient characteristics [72%], surgical procedure [83%], intraoperative complications [93.8%]) others were commonly missed (underlying diseases [23%], long-term medication [6%]). The completeness of information transfer is associated with the handover’s duration [B coefficient (95% CI): 0.118 (0.084-0.152), p<0.001] and increases significantly in handovers exceeding a duration of 2 minutes (24% ± 11.7 vs. 40% ± 18.04, p<0.001). Conclusions Handover completeness is affected by time pressure, interruptions, and inappropriate surroundings, which increase the risk of information loss. To improve completeness and ensure patient safety, an adequate time span for handover, and the implementation of communication tools are required.

The Impact of Implementing a “Pain, Agitation, and Delirium Bundle” in a Pediatric Intensive Care Unit: Improved Delirium Diagnosis

2021 ◽  
Author(s):  
Lise D. Cloedt ◽  
Kenza Benbouzid ◽  
Annie Lavoie ◽  
Marie-Élaine Metras ◽  
Marie-Christine Lavoie ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Post Intervention ◽  
Number Of Patients ◽  
Implementation Period ◽  
Short And Long Term ◽  
The Impact

AbstractDelirium is associated with significant negative outcomes, yet it remains underdiagnosed in children. We describe the impact of implementing a pain, agitation, and delirium (PAD) bundle on the rate of delirium detection in a pediatric intensive care unit (PICU). This represents a single-center, pre-/post-intervention retrospective and prospective cohort study. The study was conducted at a PICU in a quaternary university-affiliated pediatric hospital. All patients consecutively admitted to the PICU in October and November 2017 and 2018. Purpose of the study was describe the impact of the implementation of a PAD bundle. The rate of delirium detection and the utilization of sedative and analgesics in the pre- and post-implementation phases were measured. A total of 176 and 138 patients were admitted during the pre- and post-implementation phases, respectively. Of them, 7 (4%) and 44 (31.9%) were diagnosed with delirium (p < 0.001). Delirium was diagnosed in the first 48 hours of PICU admission and lasted for a median of 2 days (interquartile range [IQR]: 2–4). Delirium diagnosis was higher in patients receiving invasive ventilation (p < 0.001). Compliance with the PAD bundle scoring was 79% for the delirium scale. Score results were discussed during medical rounds for 68% of the patients in the post-implementation period. The number of patients who received opioids and benzodiazepines and the cumulative doses were not statistically different between the two cohorts. More patients received dexmedetomidine and the cumulative daily dose was higher in the post-implementation period (p < 0.001). The implementation of a PAD bundle in a PICU was associated with an increased recognition of delirium diagnosis. Further studies are needed to evaluate the impact of this increased diagnostic rate on short- and long-term outcomes.

Management of long-term hypothyroidism: a potential marker of quality of medicines reconciliation in the intensive care unit

2012 ◽  
Vol 20 (5) ◽  
pp. 303-306 ◽  
Author(s):  
Nicholas A. Barrett ◽  
Andrew Jones ◽  
Craig Whiteley ◽  
Sarah Yassin ◽  
Cathrine A. McKenzie
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Potential Marker ◽  
Medicines Reconciliation

scholarly journals Outcomes of Chronic Hemodialysis Patients in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-7
Author(s):  
Melanie Chan ◽  
Marlies Ostermann
Keyword(s):  
Intensive Care Unit ◽  
Renal Function ◽  
Intensive Care ◽  
Kidney Injury ◽  
Chronic Hemodialysis ◽  
Current Evidence ◽  
Icu Outcome ◽  
Stage Renal Disease ◽  
End Stage

Patients with end-stage renal disease (ESRD) experience higher rates of hospitalisation, cardiovascular events, and all-cause mortality and are more likely to require admission to the intensive care unit (ICU) than patients with normal renal function. Sepsis and cardiovascular diseases are the most common reasons for ICU admission. ICU mortality rates in patients requiring chronic hemodialysis are significantly higher than for patients without ESRD; however, dialysis patients have a better ICU outcome than those with acute kidney injury (AKI) requiring renal replacement therapy suggesting that factors other than loss of renal function contribute to their prognosis. Current evidence suggests, the longer-term outcomes after discharge from ICU may be favourable and that long-term dependence on dialysis should not prejudice against prompt referral or admission to ICU.

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