<p>Evidence-Based Guideline for Adult Sedation, Pain Assessment, and Analgesia in a Low Resource Setting Intensive Care Unit: Review Article</p>

IntroductionBabies born preterm often have challenges in feeding, temperature control and breathing difficulty and are prone to infection during the neonatal period. These usually necessitate admission to the neonatal intensive care unit (NICU). Admission to NICU disrupts the mother–baby bonding.ObjectiveThis study explored the lived experiences of mothers with preterm babies admitted to NICU in a low-resource setting.Study designThis was a qualitative study where 16 participants took part in indepth interviews and 35 in focus group discussions. We included mothers who delivered and were caring for preterm babies at the NICU of Mulago National Referral Hospital.Study settingData were collected from a public hospital, which works as a district and national referral hospital located in the capital of Uganda.ParticipantsFifty-one mothers with preterm babies in the NICU were sampled and recruited after informed consent. Data were analysed using manual thematic analysis.ResultsThere were six themes on the experiences of mothers of preterm babies in NICU: constant worry and uncertainty about the survival of their babies, baby feeding challenges, worries of discharge, communication gaps between mothers and nurses, community acceptability and disdain for preterm babies, and financial challenges.Conclusions and recommendationsMothers of preterm babies admitted to NICU in a low-resource setting still need a lot of support other than the medical care given to their babies. Support groups in the hospital and community are recommended to help in dealing with these challenges.

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Pediatric Pain Assessment in the Intensive Care Unit: An Evidence-Based Algorithm

Pain Management Nursing ◽

10.1016/j.pmn.2020.10.005 ◽

2020 ◽

Author(s):

Elyse L. Laures ◽

Debra Bruene ◽

Lindsay R. Fayram ◽

Amanda Houston ◽

Karreen Kephart ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pain Assessment ◽

Evidence Based ◽

Pediatric Pain

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VENTILATOR ASSOCIATED PNEUMONIA-REVIEW ARTICLE

10.36106/ijar/8502169 ◽

2021 ◽

pp. 64-65

Author(s):

Bharti Choudhary ◽

Nishchint Sharma

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Mechanical Ventilation ◽

Intensive Care ◽

Review Article ◽

Evidence Based ◽

Ventilator Associated Pneumonia ◽

Evidence Based Practices ◽

Prolonged Duration ◽

Vap Bundle

Ventilator-associated pneumonia (VAP) is one of the most frequent ICU-acquired infections and a leading cause of death among patients in Intensive Care Unit (ICU). VAP is associated with prolonged duration of mechanical ventilation and ICU stay. The estimated mortality of VAP is around 10%. There are many risk factors including host related, device related and personnel related. For prevention of VAP it is recommended to minimize the exposure to mechanical ventilation and encouraging early liberation. VAP bundle as a group of evidence-based practices that, results in decrease in the incidence of VAP should be used. Patients should be reassessed daily to conrm ongoing suspicion of disease, antibiotics should be guided by cultures reports, and clinicians should consider stopping antibiotics if cultures are 1 negative.

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Patient-centred rehabilitation for non-communicable disease in a low-resource setting: study protocol for a feasibility and proof-of-concept randomised clinical trial

BMJ Open ◽

10.1136/bmjopen-2018-025732 ◽

2019 ◽

Vol 9 (4) ◽

pp. e025732 ◽

Cited By ~ 2

Author(s):

Martin Heine ◽

Brittany Leigh Fell ◽

Ashleigh Robinson ◽

Mumtaz Abbas ◽

Wayne Derman ◽

...

Keyword(s):

South Africa ◽

Communicable Disease ◽

Chronic Respiratory Disease ◽

Rehabilitation Programme ◽

Activity Level ◽

Future Research ◽

Evidence Based ◽

Low Resource ◽

Resource Setting ◽

Low Resource Setting

IntroductionNon-communicable diseases (NCDs) are the leading cause of death globally. Even though NCD disproportionally affects low-to-middle income countries, these countries including South Africa, often have limited capacity for the prevention and control of NCDs. The standard evidence-based care for the long-term management of NCDs includes rehabilitation. However, evidence for the effectiveness of rehabilitation for NCDs originates predominantly from high-income countries. Despite the disproportionate disease burden in low-resourced settings, and due to the complex context and constraints in these settings, the delivery and study of evidence-based rehabilitation treatment in a low-resource setting is poorly understood. This study aims to test the design, methodology and feasibility of a minimalistic, patient-centred, rehabilitation programme for patients with NCD specifically designed for and conducted in a low-resource setting.Methods and analysisStable patients with cancer, cardiovascular disease, chronic respiratory disease and/or diabetes mellitus will be recruited over the course of 1 year from a provincial day hospital located in an urban, low-resourced setting (Bishop Lavis, Cape Town, South Africa). A postponed information model will be adopted to allocate patients to a 6-week, group-based, individualised, patient-centred rehabilitation programme consisting of multimodal exercise, exercise education and health education; or usual care (ie, no care). Outcomes include feasibility measures, treatment fidelity, functional capacity (eg, 6 min walking test), physical activity level, health-related quality of life and a patient-perspective economic evaluation. Outcomes are assessed by a blinded assessor at baseline, postintervention and 8-week follow-up. Mixed-method analyses will be conducted to inform future research.Ethics and disseminationThis study has been approved by the Health Research and Ethics Council, Stellenbosch University (M17/09/031). Information gathered in this research will be published in peer-reviewed journals, presented at national and international conferences, as well as local stakeholders.Trial registration numberPACTR201807847711940; Pre-results.

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Predicting Candida Infection in Pediatric Intensive Care Unit using Candida Score in a Low-Resource Setting

Global Pediatric Health ◽

10.1177/2333794x21999152 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2199915

Author(s):

Dicky Ari Risandy ◽

Desy Rusmawatiningtyas ◽

Firdian Makrufardi ◽

Elisabeth Siti Herini ◽

Nurnaningsih

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Candida Infection ◽

Control Group ◽

Case Group ◽

Resource Setting ◽

Low Resource Setting ◽

Candida Score

Candida infection was previously thought to be rare in intensive care. With the increased use of broad-spectrum antibiotics, the incidence of candida infection increased significantly. Case-control study was done in patients ≤18 years of age treated for 3 days or more in Pediatric Intensive Care Unit (PICU) Dr. Sardjito General Hospital, Yogyakarta from January 2014 to December 2016. Overall, 43 children were included in this study as a case group with positive candida culture and 43 children as a control group with no candida culture. Cut off point of candida score is ≥3 from our subjects. The area under curve (AUC) value for cut off ≥3 was moderate (0,72). Candida score ≥3 has an odd ratio (OR) 6.8 (95% CI 2.4-18.6) with P < .05. All of confounding factors in candida infection have no association with P > .05. Candida score can be used as predictor of candida infection in PICU.

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