Pulse-oximetry Derived Perfusion Index as a Predictor of the Efficacy of Rescue Analgesia After Major Abdominal Surgeries

2020 ◽  
Vol 14 (1) ◽  
pp. 101-107
Author(s):  
Ashraf Nabil Saleh ◽  
Raham Hasan Mostafa ◽  
Ahmad Nabil Hamdy ◽  
Amr Fouad Hafez
Keyword(s):  
Intensive Care ◽  
Pain Scale ◽  
Perfusion Index ◽  
Surgical Intensive Care Unit ◽  
P Value ◽  
Surgical Intensive Care ◽  
Rescue Analgesia ◽  
Clinical Indicators ◽  
Study Objective ◽  
Behavioural Pain Scale

Study Objective: The use of an easy to apply reliable tool is essential to assess pain in patients in intensive care units. This study aimed primarily to evaluate perfusion index usefulness as an objective indicator of pain. Methods and Measurements: Data were collected from 40 non-intubated adult patients admitted to the surgical intensive care unit postoperatively. The Masimo pulse co-oximetry perfusion index (PI) probe was attached to the patient. At the time of the first request for analgesia (T1), the Behavioural pain scale non-intubated scoring system (BPS-NI) was recorded with the PI and patients' haemodynamics following which rescue analgesia was given. Thirty minutes thereafter (T2), second measurements for the mentioned parameters were taken. Main Results: There was a statistically significant reduction in the BPS-NI score, blood pressure and heart rate after analgesic administration (P-values, <0.001, 0.039 and 0.001, respectively), together with a significant increase in the PI (P-value, 0.004). This means that the PI increases with adequate relief from pain, as indicated by a decrease in BPS-NI score and haemodynamics, but the correlation was not statistically significant between their changes. Conclusion: There was no statistically significant correlation between the PI and the pain score or other clinical indicators of pain either before or after the administration of analgesic.

VALIDATION OF A NEW ADULT BEHAVIORAL PAIN SCALE IN SURGICAL INTENSIVE CARE UNIT PATIENTS.

2006 ◽  
Vol 34 ◽  
pp. A83
Author(s):  
Daniel R Brown ◽  
Francis X Whalen ◽  
Mark T Keegan ◽  
Tuhin K Roy ◽  
Greg A Wilson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pain Scale ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Behavioral Pain Scale

scholarly journals Target calorie intake achievements for patients treated in the surgical intensive care unit

2020 ◽  
Author(s):  
Min Kyoon Kim ◽  
Yoo Shin Choi ◽  
Suk-Won Suh ◽  
Hyun Kang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nasogastric Tube ◽  
Calorie Intake ◽  
Surgical Intensive Care Unit ◽  
P Value ◽  
Clinical Factors ◽  
Tube Insertion ◽  
Surgical Intensive Care ◽  
Nasogastric Tube Insertion

Abstract BackgroundAdequate nutritional therapy in critically ill patients is integral to an optimal outcome. This study determined which clinical factors affect the target calorie approach during SICU admission.MethodsConsecutive patients that were provided with nutritional support during their hospitalization in the Chung-Ang university hospital SICU from August 2014 to July 2016 were included in this retrospective study. Data on demographics, supplied calorie amount and method, lengths of stay in the hospital and the intensive care unit, and mortality outcomes when discharged from the SICU were collected and analyzed. ResultsIn 279 patients, 36.9% approached target calorie intake during SICU stay. In multivariate regression analysis, patients’ sex and nasogastric tube insertion were significant factors affecting target calorie approach. (OR 2.00 for female sex, 2.03 for nasogastric tube insertion; p-value 0.012 and 0.024 for each, respectively) When we divide the patients into two groups by SICU stay length, nasogastric tube insertion is more important variable in ≤7days of SICU stay for achieve the target calorie goal. (OR 4.13; p-value 0.006) As higher amounts of calories are supplied to the patients, total lymphocyte count (TLC) and C-reactive protein (CRP) levels improved significantly without changes in mortality.ConclusionExistence of nasogastric tube and patient sex were important clinical factors to reach target calorie supply for SICU patients and their importance is different according to SICU stay length.

scholarly journals Nutritional status of trauma patients hospitalized at surgical intensive care unit

2020 ◽  
Vol 30 (2) ◽  
pp. 311-317
Author(s):  
Babak Hosseinzadeh Zoroufchi ◽  
Abolfazl Abdolahpour ◽  
Hamid Reza Hemmati
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nutritional Status ◽  
Clinical Status ◽  
Surgical Intensive Care Unit ◽  
P Value ◽  
Trauma Patients ◽  
Surgical Intensive Care ◽  
Cross Sectional ◽  
Significance Level

Malnutrition results from a decrease or increase or imbalance of energy, protein and other nutrients, leading to measurable negative effects on body tissue, body shape, organ function and clinical status. Research shows that nutritional support is one of the necessary processes for survival of traumatic patient hospitalized at surgical intensive care unit. The purpose of this study is to evaluate the nutritional status of trauma patients hospitalized at surgical intensive care unit of Kowsar Hospital in Semnan, Iran. This cross-sectional descriptive study was performed on patients older than 18 years with head, neck and femur injuries. Initial data were collected using a checklist containing demographic information questions, designed from the Ministry of Health and Medical Education's Nutrition Screening Form, which was available in the Nutrition Assessment Forms and Guidelines for Hospitalized Patients Approved in 2013. The data were analyzed using Chi-square or Fisher's exact tests, paired t-test and Pearson coefficient. The confidence level was 95% and significance level was less than 0.05 in all tests. The amount of energy determined by the intensive care unit for the patients, with a significantly lower relationship than the amount of energy required by the patients for 24 hours, based on the Harris Benedict formula was (918.20±474.80 calories vs. 1535.76±243.73 calories, respectively and P-value˂0.001). The amount of protein determined by the intensive care unit for the patients for 24 hours, with a significantly relationship lower than the protein required for the patients for 24 hours, was (51.68±34.39 vs. 106.57±13.67, respectively, and P-value˂ 0.001). There was a statistically significant relationship between the age of the patients and energy (P˂0.001) and protein (P˂0.001) determined by the intensive care unit for the patients for 24 hours and energy (P˂0.001) and protein (P˂0.001) required for the patients for 24 hours. The results of this study showed that both the amount of energy and the amount of protein determined by the intensive care unit for trauma patients for less than 24 hours were lower than the required level; therefore, dietary modification for these patients is recommended.

Complications Following Brachial Arterial Catheterization in the Surgical Intensive Care Unit

2020 ◽  
Vol 86 (10) ◽  
pp. 1260-1263
Author(s):  
Morgan Schellenberg ◽  
Lauren Hawley ◽  
Subarna Biswas ◽  
Damon H. Clark ◽  
J. Perren Cobb
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Brachial Artery ◽  
Surgical Intensive Care Unit ◽  
Arterial Line ◽  
Complication Rates ◽  
Surgical Intensive Care ◽  
Study Objective ◽  
Line Placement ◽  
Arterial Catheterization

Clinically, complication rates of brachial arterial catheterization appear to far exceed those of the radial or common femoral arteries. The study objective was to define the complication rate after brachial arterial line insertion. All patients undergoing arterial line placement to the brachial artery in the surgical intensive care units (SICUs) at our institution were retrospectively identified and included in the study (January 2016-December 2018). Demographics, complications (distal ischemia, thrombosis/dissection, brachial sheath hematoma, catheter-related sepsis, and inadvertent dislodgement), and outcomes were collected and analyzed. Over the study period, 53 patients underwent brachial arterial catheterization. Common admitting services were cardiothoracic surgery (n = 31, 58%), transplant surgery (n = 7, 13%), and neurosurgery (n = 4, 7%). The mean age was 55 ± 17 58 (24-84) years, and 58% (n = 31) were male. The hospital length of stay (LOS) was 37 ± 35 23 (1-132) days, and ICU LOS was 30 ± 27 20 (1-127) days. Mortality was 57% (n = 30). Complications of brachial arterial line placement occurred in 21 patients (40%). In summary, brachial arterial catheters were associated with high mortality and prolonged ICU length of stay. This likely reflects the critically ill nature of patients in whom conventional-site arterial line placement is not possible. Complications following brachial arterial catheterization were unacceptably high. On this basis, we recommend that the brachial artery be avoided whenever possible for arterial line placement in the SICU.

scholarly journals Nutritional status of trauma patients hospitalized at surgical intensive care unit

2020 ◽  
Author(s):  
Babak Hosseinzadeh Zoroufchi ◽  
Abolfazl Abdolahpour ◽  
Hamid Reza Hemmati
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nutritional Status ◽  
Clinical Status ◽  
Surgical Intensive Care Unit ◽  
P Value ◽  
Trauma Patients ◽  
Surgical Intensive Care ◽  
Cross Sectional ◽  
Significance Level

Malnutrition results from a decrease or increase or imbalance of energy, protein and other nutrients, leading to measurable negative effects on body tissue, body shape, organ function and clinical status. Research shows that nutritional support is one of the necessary processes for survival of traumatic patient hospitalized at surgical intensive care unit. The purpose of this study is to evaluate the nutritional status of trauma patients hospitalized at surgical intensive care unit of Kowsar Hospital in Semnan, Iran. This cross-sectional descriptive study was performed on patients older than 18 years with head, neck and femur injuries. Initial data were collected using a checklist containing demographic information questions, designed from the Ministry of Health and Medical Education's Nutrition Screening Form, which was available in the Nutrition Assessment Forms and Guidelines for Hospitalized Patients Approved in 2013. The data were analyzed using Chi-square or Fisher's exact tests, paired t-test and Pearson coefficient. The confidence level was 95% and significance level was less than 0.05 in all tests. The amount of energy determined by the intensive care unit for the patients, with a significantly lower relationship than the amount of energy required by the patients for 24 hours, based on the Harris Benedict formula was (918.20±474.80 calories vs. 1535.76±243.73 calories, respectively and P-value˂0.001). The amount of protein determined by the intensive care unit for the patients for 24 hours, with a significantly relationship lower than the protein required for the patients for 24 hours, was (51.68±34.39 vs. 106.57±13.67, respectively, and P-value˂ 0.001). There was a statistically significant relationship between the age of the patients and energy (P˂0.001) and protein (P˂0.001) determined by the intensive care unit for the patients for 24 hours and energy (P˂0.001) and protein (P˂0.001) required for the patients for 24 hours. The results of this study showed that both the amount of energy and the amount of protein determined by the intensive care unit for trauma patients for less than 24 hours were lower than the required level; therefore, dietary modification for these patients is recommended.

scholarly journals RISK FACTORS AND OUTCOMES OF NEW ONSET ARRHYTHMIA IN SURGICAL INTENSIVE CARE UNIT: A RETROSPECTIVE STUDY

2021 ◽  
Vol 71 (5) ◽  
pp. 1880-84
Author(s):  
Sadaf Hanif ◽  
Faisal Shamim ◽  
Muhammad Sohaib
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Stay ◽  
Cardiac Arrhythmias ◽  
University Hospital ◽  
Surgical Intensive Care Unit ◽  
P Value ◽  
Surgical Intensive Care ◽  
New Onset

Objective: To assess the frequency of new-onset cardiac arrhythmias among patients admitted in surgical intensive care unit as well as associated risk factors. Study Design: Retrospective observational study. Place and Duration of Study: Surgical Intensive Care Unit, Aga Khan University Hospital, Karachi, from Jan 2018 to Dec 2019. Methodology: The medical record numbers of all patients admitted in surgical intensive care unit were obtained from Surgical intensive care unit case log entries and reviewed. Patients` and healthcare providers` identification were kept confidential. Data was analyzed using SPSS version 19. Results: Only 13/1076 patients included in the study had cardiac arrhythmias during their stay in Surgical intensive care unit. Among all patients with arrhythmias (n=13), atrial fibrillation was the most common type of arrhythmia 7 (53.8%). The study found higher occurrence of arrhythmias among the patients in the age category of 66 years or above 8 (4.6%) and when compared to younger patients with age categories 18-40 years 2 (0.3%) and 41-65 years 3 (0.3%) respectively (p-value<0.05). Similarly, arrhythmias were higher among patients who had relatively prolong intensive care unit stay and post-operative status as the primary cause of intensive care unit admission. Conclusion: Occurrence of cardiac arrhythmias is relatively low among patients admitted to surgical intensive care patient population. Patients age (>65 years), prolong intensive care unit stay, post-operative status are positively associated with development of cardiac arrhythmias among critically ill patients admitted in surgical intensive care unit.

Sign in / Sign up

Export Citation Format

Share Document