scholarly journals Role of Early Rehabilitation for Perioperative Patients with Mechanical Ventilation in Intensive Care Units

2020 ◽  
Vol 40 (5) ◽  
pp. 504-509
Author(s):  
Makoto HASEGAWA ◽  
Hiroomi YAMAGUCHI ◽  
Chisato USAMI ◽  
Hiroshi HINOHARA ◽  
Shigeru SAITOH ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Early Rehabilitation

scholarly journals CUIDADOS DE ENFERMAGEM NA VENTILAÇÃO MECÂNICA: Percepções, atribuições e conhecimento dos profissionais Enfermeiros que atuam em unidades de terapia intensiva no Meio Oeste e Oeste de Santa Catarina

2019 ◽  
Vol 8 (1) ◽  
pp. 289-300
Author(s):  
Edson Luiz Stechinski ◽  
Mariane Carolina Almeida ◽  
Fabiana Meneghetti Dallacosta ◽  
Antuani Rafael Baptistella
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Santa Catarina ◽  
Professional Profile ◽  
Complete Form ◽  
Terapia Intensiva ◽  
The Difference ◽  
Nursing Professionals

Introdução: A ventilação mecânica (VM) é amplamente utilizada no tratamento de pacientes internados nas unidades de terapia intensiva (UTIs), e requer a atuação multiprofissional, com conhecimento desta ferramenta, para estabelecer rotinas e protocolos. Este estudo visou identificar a percepção dos enfermeiros que trabalham em UTI em relação ao seu papel nos cuidados da ventilação mecânica, as funções que realizam e os conhecimentos técnicos que possuem em relação ao tema. Métodos: Participaram desta pesquisa 25 enfermeiros assistenciais que atuam em unidades de terapia intensiva em hospitais do Meio Oeste e Oeste de Santa Catarina. Foi realizada a aplicação de questionário estruturado, para avaliar o perfil sociodemográfico e profissional, a percepção do papel do enfermeiro e seu conhecimento em relação à ventilação mecânica. Resultados: A idade média dos profissionais avaliados foi de 30,8 anos, variando de 23 a 43 anos, o tempo médio de conclusão da graduação é de 4,2 anos e o tempo médio de atuação em UTI é de 2 anos, sendo 32% especialistas em terapia intensiva. Em relação à função do enfermeiro na VM as respostas mais frequentes foram a de detectar problemas e montagem e teste do ventilador mecânico. Sobre os dados de ventilação mecânica estarem contemplados na evolução de enfermagem, 68% responderam que estão de forma parcial, enquanto 32% responderam que estão de forma completa. Quanto aos modos ventilatórios, 88% responderam que possuem conhecimento satisfatório; sobre a diferença entre as modalidades ventilatórias (PCV, VCV, SIMV e PSV), 72% responderam ter conhecimento, e 60% respondeu possuir conhecimento satisfatório sobre disparo e ciclagem. Em relação à PEEP, 96% responderam possuir conhecimento satisfatório e em relação ao ajuste de alarmes, essa resposta foi considerada satisfatória para 64% dos profissionais. Quando correlacionamos o tempo de experiência na UTI dos profissionais com o conhecimento que relatam possuir de VM, observamos que aqueles que trabalham por mais de 2 anos em UTI afirmam saber mais sobre os modos ventilatórios, disparo e ciclagem e ajustes de alarmes. No entanto, o fato de ter especialização na área não melhorou o conhecimento auto referido de VM pelos profissionais avaliados. Conclusão: Estes resultados reforçam a importância da formação e atualização nos cuidados em ventilação mecânica de todos os profissionais que atuam em terapia intensiva. Além disso, mais estudos são necessários para um melhor entendimento do conhecimento do profissional enfermeiro no tema.Palavras-chave: Ventilação mecânica; Enfermagem. Unidades de Terapia Intensiva. NURSING CARE IN MECHANICAL VENTILATION: PERCEPTIONS, ATTRIBUTIONS AND KNOWLEDGE OF NURSING PROFESSIONALS WHO WORK IN INTENSIVE CARE UNITS IN THE MIDWEST AND WEST OF SANTA CATARINA STATEABSTRACT: Background: Mechanical ventilation (MV) is widely used in the treatment of patients admitted to intensive care units (ICUs), and requires multi-professional work, with knowledge of this tool, to establish routines and protocols. This study aimed to identify the perception of nurses working in ICU in relation to their role in the care of mechanical ventilation, the functions they perform and the technical knowledge they possess in relation to the topic. Methods: Twenty-five nursing assistants who work in intensive care units in hospitals in the Midwest and West of Santa Catarina participated in this study. A structured questionnaire was applied to assess the sociodemographic and professional profile, the perception of the role of the nurse and his knowledge regarding mechanical ventilation. Results: The average age of the professionals evaluated was 30.8 years, ranging from 23 to 43 years, the average graduation time is 4.2 years and the average time working in ICU is 2 years, being 32% specialists in intensive care. Regarding the role of the nurse in the MV, the most frequent responses were to detect problems and assembly and test of the mechanical ventilator. Regarding mechanical ventilation data been contemplated in the nursing records, 68% answered that they are partially, while 32% answered that they are in complete form. Regarding ventilatory modes, 88% answered that they have satisfactory knowledge; on the difference between ventilatory modalities (PCV, VCV, SIMV and PSV), 72% answered that they had knowledge, and 60% answered that they had satisfactory knowledge about trigger and cycling. In relation to PEEP, 96% responded to have satisfactory knowledge and in relation to the adjustment of alarms, this answer was considered satisfactory for 64% of the professionals. When we correlate the time of experience in the ICU of professionals with the knowledge that they report having on MV, we observed that those who work for more than 2 years in ICU claim to know more about ventilator modes, trigger and cycling, and alarm settings. However, the fact of having specialization in the area did not improve the self-reported knowledge of MV by the evaluated professionals. Conclusion: These results reinforce the importance of training and updating in mechanical ventilation care of all professionals working in intensive care. In addition, more studies are needed to better understand the nurse practitioner's knowledge of the subject.Keywords: Mechanical ventilation; Nursing. Intensive Care Units.

Exercise in intensive care units, safety and hemodynamic monitoring

2020 ◽  
Vol 19 (1) ◽  
pp. 3
Author(s):  
Giulliano Gardenghi
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Hemodynamic Monitoring ◽  
Artificial Respiration ◽  
Exercise Physiology ◽  
Ventilatory Support ◽  
Early Mobilization ◽  
Cycle Ergometer ◽  
Search Terms

Introduction: Patients in the intensive care unit (ICU) have several deleterious effects of immobilization, including weakness acquired in the ICU. Exercise appears as an alternative for early mobilization in these patients. Objective: This work aims to highlight the hemodynamic repercussions and the applicability of exercise in the ICU. Methods: An integrative literature review was carried out, with articles published between 2010 and 2018, in the Lilacs, PubMed and Scielo databases, using the following search terms: exercise, cycle ergometer, intensive care units, early mobilization, mechanical ventilation, artificial respiration. Results: 13 articles were included, addressing hemodynamic monitoring and the role of exercise as early mobilization, with or without ventilatory support. The exercise sessions were feasible and safe within the ICU environment. Conclusion: Physical exercise can be performed safely in an ICU environment, if respecting a series of criteria such as those presented here. It is important that the assistant professional seeks to prescribe interventions based on Exercise Physiology that can positively intervene in the functional prognosis in critically ill patients.Keywords: exercise, intensive care units, patient safety.

scholarly journals Otolaryngology activity in two hospitals in northern and central Italy differently affected by COVID-19 pandemic

2021 ◽  
Vol 104 (2) ◽  
pp. 003685042199848
Author(s):  
Antonio Minni ◽  
Francesco Pilolli ◽  
Massimo Ralli ◽  
Niccolò Mevio ◽  
Luca Roncoroni ◽  
...  
Keyword(s):  
Intensive Care ◽  
Severe Acute Respiratory Syndrome ◽  
Intensive Care Units ◽  
Healthcare System ◽  
Central Italy ◽  
Northern Italy ◽  
Public Hospitals ◽  
Geographical Differences ◽  
Italian Regions

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic had a significant impact on the Italian healthcare system, although geographical differences were present; regions in northern Italy have been the most severely affected while regions in the south of the country were relatively spared. Otolaryngologists were actively involved in the management of the pandemic. In this work, we analyzed and compared the otolaryngology surgical activity performed during the pandemic in two large public hospitals located in different Italian regions. In northern Italy, otolaryngologists were mainly involved in performing surgical tracheotomies in COVID-19 positive patients and contributed to the management of these patients in intensive care units. In central Italy, where the burden of the infection was significantly lower, otolaryngologists focused on diagnosis and treatment of emergency and oncology patients. This analysis confirms the important role of the otolaryngology specialists during the pandemic, but also highlights specific differences between two large hospitals in different Italian regions.

scholarly journals Continuous EEG Monitoring in the Intensive Care Unit

1998 ◽  
Vol 25 (S1) ◽  
pp. S12-S15 ◽  
Author(s):  
John Kay
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Eeg Monitoring ◽  
General Icus ◽  
Continuous Eeg ◽  
Nonconvulsive Seizures ◽  
Continuous Eeg Monitoring ◽  
Clinical Problems

AbstractBackground:Electroencephalography (EEG) is playing an increasingly important role in the management of comatose patients in the intensive care unit.Methods:The techniques of EEG monitoring are reviewed. Initially, standard, discontinuous recordings were performed in intensive care units (ICUs). Later, continuous displays of “raw EEG” (CEEG) were used. More recently, the addition of quantitative techniques allowed for more effective reading.Results and Conclusions:Applications of continuous EEG to clinical problems are discussed. The most useful role of CEEG appears to be the detection and management of nonconvulsive seizures. There is a need for controlled studies to assess the role for CEEG in neuro-ICUs and general ICUs.

Mucormycosis: A Black Fungus- Post Covid Complications

2021 ◽  
Author(s):  
Prithiv Kumar KR
Keyword(s):  
Mechanical Ventilation ◽  
T Cells ◽  
Intensive Care ◽  
Fungal Infection ◽  
Intensive Care Units ◽  
Respiratory System ◽  
Cd8 T Cells ◽  
Transmitted Disease ◽  
Global Pandemic

Human to human transmitted disease is the game of coronavirus disease (COVID-19) transmission and it had been declared an emergency global pandemic that caused major disastrous in the respiratory system to more than five million people and killing more than half a billion deaths across the globe. Besides lower acute respiratory syndrome, there is damage to the alveolar with severe inflammatory exudation. COVID-19 patients often have lower immunosuppressive CD4+ T and CD8+ T cells and most patients in intensive care units (ICU) need mechanical ventilation, hence longer stay in hospitals. These patients have been discovered to develop fungal co-infections. COVID-19 patients develop what is known as mucormycosis a black fungal infection that is deadly leading to loss of sight and hearing and eventually death. This chapter will focus on mucormycosis, a black fungus caused during post covid complications.

scholarly journals Candidemia in an intensive care unit

Medicina ◽  
2008 ◽  
Vol 45 (5) ◽  
pp. 351
Author(s):  
Dalia Adukauskienė ◽  
Aida Kinderytė ◽  
Asta Dambrauskienė ◽  
Astra Vitkauskienė
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Risk Factor ◽  
Intensive Care ◽  
Urinary Bladder ◽  
Intensive Care Units ◽  
Severe Disease ◽  
Candida Spp ◽  
Lethal Outcome ◽  
Bladder Catheter

Candidemia is becoming more actual because of better survival of even critically ill patients, wide use of antimicrobials, and increased numbers of invasive procedures and manipulations. Diagnosis of candidemia remains complicated, and costs of treatment and mortality rates are increasing. Objective. To evaluate the pathogens of candidemia, risk factors and their influence on outcome. Material and methods. Data of 41 patients with positive blood culture for Candida spp., who were treated in the intensive care units at the Hospital of Kaunas University of Medicine, were analyzed retrospectively. Results. Candidemia was caused by Candida albicans (C. albicans) in 48.8% (n=20) of patients and by non-albicans Candida in 51.2% (n=21) of patients. The main cause of candidemia was C. albicans in 2004 (83.3%, n=5), but in 2005 (63.6%, n=7), in 2006 (57.1%, n=4), and in 2007 (52.9%, n=9), the main cause was non-albicans Candida spp. The number of candidemia cases caused by C. albicans was decreased in 2005, 2006, and 2007 as compared with 2004, and the number of candidemia caused by non-albicans Candida spp. was decreased, respectively (P<0.05). More than 65% (n=34) of patients had severe disease (P<0.05). Lethal outcome was recorded in 58.5% of patients with candidemia. Mechanical ventilation was used in 76.9% (n=20) and urinary bladder catheter in 72.1% (n=19) of non-survivors and in 23.1% (n=6) and 26.9% (n=7) of survivors, respectively (P<0.05). Conclusions. There is an increase in the prevalence of candidemia in the intensive care units during the 4-year period; half of candidemia cases were caused by non-albicans Candida spp., and patients with candidemia caused by non-albicans Candida spp. are at higher risk of mortality. Therefore, for the empirical treatment of septic conditions in an intensive care unit, when invasive fungal infection is suspected, we recommend using an antifungal agent of non-azole class until a pathogen of candidemia is determined. Severe disease is evaluated as a risk factor for candidemia. Patients with oncological diseases are at significantly higher risk for candidemia caused by non-albicans Candida spp. Use of mechanical ventilation and urinary bladder catheter is a risk factor for lethal outcome.

The role of neurovascular ultrasound in intensive care units

2015 ◽  
Vol 126 (9) ◽  
pp. e178
Author(s):  
D. Jovanović ◽  
M. Stefanović Budimkić
Keyword(s):  
Intensive Care ◽  
Intensive Care Units

scholarly journals Overview on the Prevalence of Fungal Infections, Immune Response, and Microbiome Role in COVID-19 Patients

2021 ◽  
Vol 7 (9) ◽  
pp. 720
Author(s):  
Maryam Roudbary ◽  
Sunil Kumar ◽  
Awanish Kumar ◽  
Lucia Černáková ◽  
Fatemeh Nikoomanesh ◽  
...  
Keyword(s):  
Immune Response ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Fungal Infections ◽  
Fungal Species ◽  
Fungal Diseases ◽  
Severe Illness ◽  
Rising Incidence ◽  
Cryptococcus Spp

Patients with severe COVID-19, such as individuals in intensive care units (ICU), are exceptionally susceptible to bacterial and fungal infections. The most prevalent fungal infections are aspergillosis and candidemia. Nonetheless, other fungal species (for instance, Histoplasma spp., Rhizopus spp., Mucor spp., Cryptococcus spp.) have recently been increasingly linked to opportunistic fungal diseases in COVID-19 patients. These fungal co-infections are described with rising incidence, severe illness, and death that is associated with host immune response. Awareness of the high risks of the occurrence of fungal co-infections is crucial to downgrade any arrear in diagnosis and treatment to support the prevention of severe illness and death directly related to these infections. This review analyses the fungal infections, treatments, outcome, and immune response, considering the possible role of the microbiome in these patients. The search was performed in Medline (PubMed), using the words “fungal infections COVID-19”, between 2020–2021.

scholarly journals Making ICU Research Happen: a Qualitative Descriptive Study About the Role of the Research Nurse in New Zealand Level III Intensive Care Units

2021 ◽  
Author(s):  
◽  
Diane Margaret Mackle
Keyword(s):  
Intensive Care ◽  
New Zealand ◽  
Intensive Care Units ◽  
Shared Responsibility ◽  
Research Nurse ◽  
Primary Role ◽  
High Quality Research ◽  
Qualitative Descriptive ◽  
Research Nurses

<p>This study explored the role of the research nurse in New Zealand (NZ) Level III intensive care units (ICU). Little was known about this role in NZ prior to this study. A qualitative, descriptive approach, using semi-structured interviews was used. The study was conducted in six Level III ICUs throughout NZ, who employed a research nurse. Interviews were conducted with research nurses (n = 11), the doctors they work with (principal investigators) (n = 6) and nurse managers (n = 6) for the ICUs, and the findings were triangulated. The views across all ICUs and stakeholders were generally similar, with differences only being in some operational areas. This study found that the primary role of the research nurse was trial management, where they coordinated all elements of trial conduct. Almost half of the research nurses were also involved in trial design through their positions on management committees. Research nurses also played a vital role in patient and trial advocacy, and they bridged the knowledge gap by bringing research to staff nurses, patients and their families. The issue of consent for clinical trials in the ICU setting was significant, as this was a process which research nurses were very involved in. Consenting patients was a shared responsibility of research nurses and doctors. There was a perception that research nurses were senior nurses, but not necessarily because of their role in research. The majority of research nurses reported to a nursing line manager, and also had an informal accountability to the principal investigator (PI). Research nurses and PIs worked closely in the pursuit of rigorous research for ICU patients, and research nurses were highly regarded by PIs. This study provides clarity about the research nurse‟s role and showcases their key contribution in ensuring that NZ ICUs undertake high quality research, thus contributing to potential improvements for future patients‟ outcomes.</p>

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