scholarly journals Admission Profile and Outcome of Patients in a Level III Intensive Care Unit: A Two-Year Comparative Study

2020 ◽  
Vol 42 (3) ◽  
pp. 52-56
Author(s):  
Sunil Pathak ◽  
Subhash P Acharya ◽  
Pragya Acharya ◽  
Binita Bhattarai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Stable Condition ◽  
Severity Of Illness ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Cross Sectional ◽  
Female Ratio ◽  
Number Of Patients ◽  
Male Preponderance

Introduction An Intensive Care Unit (ICU) is an area where critically ill patients are admitted and the highest level of care is provided with close intensive monitoring and management. Clinical audit is a must to measure indicators of the quality of care in ICU and benchmarking outcome. The main aim of the study was to evaluate the profile of patients admitted to ICU and assess their outcome of two consecutive years. MethodsA single-institutional, descriptive cross-sectional study was conducted on all adult patients admitted to the ICU of Tribhuvan University Teaching Hospital, Kathmandu, between April 2018 and April 2020 (Baisakh 2075 to Chaitra 2076). ResultsWith an average of 1.98 admissions per day, a total of 1447 patients were admitted to TUTH ICU over the period of two years. A male preponderance was noted with a male to female ratio of 1.19:1. Most of the patients admitted were neurosurgical cases 429 (29.6%). A total of 884 (61%) were shifted out of ICU in stable condition while the overall mortality was 458 (31.6%). ConclusionThis study shows that there is a higher severity of illness at admission as well as a comparatively high mortality rate. More number of patients were male, of age group of 15-65 years, with medical and neurosurgical conditions. This study of profile and outcome of patients admitted in ICU can serve as a quality indicator as well as evidence on which planning and policymaking can be based upon in the future.

scholarly journals High drug resistance among Gram-negative bacteria in sputum samples from an intensive care unit in Nepal

2021 ◽  
Vol 11 (1) ◽  
pp. 64-69
Author(s):  
R. Ghimire ◽  
H. A. Gupte ◽  
S. Shrestha ◽  
P. Thekkur ◽  
S. Kharel ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Sputum Culture ◽  
University Teaching ◽  
Cross Sectional ◽  
Icu Patients ◽  
Icu Discharge ◽  
Resistance Patterns

SETTING: Tribhuvan University Teaching Hospital, Kathmandu, Nepal.OBJECTIVES: 1) To report the number and proportion of Pseudomonas, Acinetobacter, Burkholderia, Stenotrophomonas (PABS) species among intensive care unit (ICU) patients with sputum culture; and 2) to assess antimicrobial resistance patterns, demographic and clinical characteristics associated with resistance to at least one antibiotic and ICU discharge outcomes among those patients with PABS species admitted to hospital between 14 April 2018 and 13 April 2019.DESIGN: This was a hospital-based, cross-sectional study using secondary data.RESULTS: Of 166 who underwent sputum culture, 104 (63%) had bacterial growth, of which, 67 (64%) showed PABS species. Of the positive cultures, Pseudomonas, Acinetobacter, Burkholderia and Stenotrophomonas were present in respectively 32 (30.7%), 31 (29.8%), 1 (1%) and 3 (2.8%). Pseudomonas showed a high level of resistance to levofloxacin (61%), cefepime (50%) and amikacin (50%). Acinetobacter was largely resistant to cefepime (95%), imipenem (92%) and levofloxacin (86%). Of the 67 with PABS infection, 32 (48%) died.CONCLUSION: The study showed a high prevalence of Pseudomonas and Acinetobacter and the emergence of Stenotrophomonas in sputum culture samples of ICU patients. This highlights the need for monitoring PABS and associated resistance patterns to reduce mortality in ICU patients.

scholarly journals Indications and outcomes of tracheostomy in intensive care unit

2020 ◽  
Vol 6 (8) ◽  
pp. 1430
Author(s):  
Mukhlesur Rahman ◽  
Mahmuda Begum ◽  
Mujibul Hoque Khan ◽  
Mostsfa Mahfuzul Anwar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cross Sectional Study ◽  
Anterior Wall ◽  
Safe Procedure ◽  
College Hospital ◽  
Cross Sectional ◽  
Female Ratio ◽  
Medical College ◽  
Life Threatening

<p><strong> </strong></p><p class="abstract"><strong>Background:</strong> Tracheostomy is a commonly performed surgical procedure in the intensive care unit (ICU) in which creation of a stoma between the skin and the anterior wall of the trachea where there is need for prolong mechanical ventilation. Tracheostomy has considered a safe procedure in ICU but has been found to lead to life threatening complications intra and post operatively.</p><p class="abstract"><strong>Methods:</strong> This is a cross sectional study, was carried out in ICU, Chittagong Medical College Hospital, Chattogram from January 2018 to December 2019. A total of 120 patients irrespective of age and sex whose tracheostomy has done after admission in ICU by ENT surgeons.  </p><p class="abstract"><strong>Results:</strong> Out of 120 patients maximum 34 (28.33%) were from 21-30 years age group and male to female ratio was 1.79:1, male patients were 77 (64.16%) and female patients were 43 (35.83%). The most common indication for tracheostomy in ICU was head injury and history of RTA 34 (28.33%) followed by post-operative case of intracranial space occupying lesion 30 (25%). Post tracheostomy complication was surgical emphysema 4 (3.33%). The rate of complication of tracheostomy in ICU was 10.83% in this study. Regarding benefits of tracheostomy over endotracheal tube in ICU, we found that 100% patients had greater comfort.</p><p class="abstract"><strong>Conclusions:</strong> Tracheostomy in ICU is an important and safe procedure if prolonged endotracheal in tubation is advised for varying underlying causes.</p>

Screening of Hearing in Infants at Risk in a Tertiary Care Centre: A Descriptive Cross- sectional Study

2020 ◽  
Vol 3 (2) ◽  
pp. 3-7
Author(s):  
Bijaya Kharel ◽  
Yogesh Neupane ◽  
Prashant Tripathi ◽  
Pabina Rayamajhi ◽  
Sureshwor Lal Karna ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
At Risk ◽  
Hearing Loss ◽  
Intensive Care ◽  
Birth Weight ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ototoxic Drugs

Background: Screening of hearing impairment in children facilitates earlier identification, management and prevention of disability. The objective of this study was to perform a screening of hearing in infants at risk in Tribhuvan University Teaching Hospital. Methods: A descriptive cross-sectional study was done among 228 infants who were at risk of hearing loss. All ‘at risk’ infants born to mothers in Tribhuvan University Teaching Hospital and ‘at risk’ children below one year of age admitted in the pediatric ward and intensive care unit were screened for hearing loss by automated otoacoustic emission (OAE) and automated auditory brainstem reflex (ABR). The results were categorized as pass or refer (fail). The association between hearing loss and the potential risk factors was analyzed. Results: Out of 228 infants screened, 117 (51%) were male and 111 (49%) were female. Seventy (30.7%) failed OAE and 44 (19.3%) failed ABR. Univariate analysis (Pearson Chi-square test) showed that the failure rate for ABR was significantly associated with preterm babies (p = 0.009), low birth weight (p = 0.009), usage of ototoxic drugs (p = 0.03), and intensive care unit stay of more than five days (p = 0.03). Only preterm birth was significantly associated with failed OAE test (p = 0.03). Conclusion: Premature birth (gestational age < 34 weeks) was associated with failure of the ABR and OAE tests. The infants with low birth weight, history of ototoxic drugs, ICU stay more than 5 days were only associated with ABR test failure.

scholarly journals Admission Patterns in the Children’s Emergency Room of Enugu State University Teaching Hospital, during the COVID-19 Pandemic

2021 ◽  
pp. 86-92
Author(s):  
Ndu I. K. ◽  
Asinobi I. N. ◽  
Nduagubam O. C.
Keyword(s):  
Emergency Room ◽  
Teaching Hospital ◽  
Severity Of Illness ◽  
Cross Sectional Study ◽  
University Teaching ◽  
Peak Time ◽  
State University ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Enugu State

Aims: This study aimed to compare the difference in admission rates and severity of illness in 2019 and during the peak time period of the global SARS-CoV-2 pandemic of 2020 in children presenting at the Children’s emergency room (CHER) of Enugu State University Teaching Hospital, Enugu. Study Design: This was a cross-sectional study. Place and Duration of Study: Children’s emergency room (CHER) of Enugu State University Teaching Hospital, Enugu, from June 1 to August 31, 2019 and 2020 were reviewed, respectively. Methodology: The admission records of all the children that were admitted into CHER of Enugu State University Teaching Hospital (ESUTH), Enugu, over a three-month period from June 1 to August 31, 2019 and 2020 respectively were reviewed. Results: A total of 310 and 184 patients were seen during the study period for 2019 and 2020, respectively (40.6% decrease). A significant number of patients spent two days on admission in the children’s emergency room in 2020 than in 2019 (P < .001). Emergency admissions were 3 times more in year 2020 than in year 2019 (OR = 2.624, 95% C.I = 1.797 – 3.833, P < .001). Conclusion: Although this study reported decreased emergency room admissions, there was an increase in the mortality rate and emergency presentations.

Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

2020 ◽  
Vol 35 (2) ◽  
pp. 100-104
Author(s):  
Maksudur Rahman ◽  
Mohammad Abdullah Al Mamun ◽  
MAK Azad Chowdhury ◽  
Abu Sayeed Munsi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cardiac Intensive Care Unit ◽  
Cross Sectional ◽  
Cardiac Intensive Care ◽  
Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

scholarly journals Nurses' Knowledge and Responsibility toward Nutritional Assessment for Patients in Intensive Care Units

2014 ◽  
Vol 4 (2) ◽  
pp. 90-96
Author(s):  
Mahmoud Al Kalaldeh ◽  
Mahmoud Shahein
Keyword(s):  
Intensive Care ◽  
Nutritional Assessment ◽  
Severity Of Illness ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Under Nutrition ◽  
History Of ◽  
History Of Nutrition ◽  
And Function ◽  
Nurses Knowledge

Introduction: Nutritional assessment is a prerequisite for nutritional delivery. Patients in intensive care suffer from under-nutrition and nutritional failure due to poor assessment. Nursing ability to early detect nutritional failure is the key for minimizing imparities in practice and attaining nutritional goals. Aim of this article is to examine the ability of Jordanian ICU nurses to assess the nutritional status of critically ill patients, considering biophysical and biochemical measures.Methods: This cross sectional study recruited nurses from different health sectors in Jordan. ICU nurses from the governmental sector (two hospitals) and private sectors (two hospitals) were surveyed using a self-administered questionnaire. Nurses' knowledge and responsibility towards nutritional assessment were examined.Results: A total of 220 nurses from both sectors have completed the questionnaire. Nurses were consistent in regard to knowledge, responsibility, and documentation of nutritional assessment. Nurses in the governmental hospitals inappropriately perceived the application of aspiration reduction measures. However, they scored higher in applying physical examination and anthropometric assessment.  Although both nurses claimed higher use of biochemical measurements, biophysical measurements were less frequently used. Older nurses with longer clinical experience exhibited better adherence to biophysical measurement than younger nurses.Conclusion: Nursing nutritional assessment is still suboptimal to attain nutritional goals. Assessment of body weight, history of nutrition intake, severity of illness, and function of gastrointestinal tract should be considered over measuring albumin and pre-albumin levels.  A well-defined evidence-based protocol as well as a multidisciplinary nutritional team for nutritional assessment is the best to minimize episodes of under-nutrition.

scholarly journals Invasive candidiasis in a Brazilian neonatal intensive care unit

2021 ◽  
Vol 21 (2) ◽  
pp. 547-552
Author(s):  
Henrique Yuji Watanabe Silva ◽  
Felipe Teixeira de Mello Freitas
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Invasive Candidiasis ◽  
Neonatal Intensive Care ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Antibiotics Use ◽  
Elbw Neonates

Abstract Objectives: to describe the epidemiology of invasive candidiasis in a neonatal intensive care unit. Methods: cross-sectional study that included all neonates with invasive candidiasis confirmed by blood culture from April 2015 to June 2018. Demographic, clinical and microbiological data were analyzed, comparing neonates with extreme low birth weight (ELBW) with neonates ≥ 1000g birth weight, considering a p <0.05 as statistically significant. Results: there were 38 cases of invasive candidiasis, resulting in an overall incidence of 2.5%. Twelve (32%) were ELBW neonates and 26 (68%) neonates ≥ 1000g birth weight, an incidence of 4.4% and 2.0%, respectively. Abdominal surgery was more frequent among neonates with birth weight ≥ 1000g compared to ELBW neonates (85% vs. 17%; p <0.01), as well as the median in days of antibiotics use (18 vs. 10.5; p = 0.04). The median in days of mechanical ventilation was more frequent among ELBW neonates (10 vs. 5.5; p = 0.04). The majority of Candida species were non-albicans (64%). Fatality rate was 32%. Conclusions: the incidence of invasive candidiasis among neonates with birth weight ≥ 1000g was higher than that found in the literature. This group has a higher proportion of gastrointestinal malformations that require surgery. Thus, fluconazole prophylaxis may be necessary for a broader group of neonates.

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