scholarly journals Medications in Bronchospasm and Asthma among the Critically Ill Patients: A Drug Utilization Study from Southern India

1970 ◽  
Vol 1 (2) ◽  
pp. 57-59
Author(s):  
Lisha Jenny John ◽  
Jenny John ◽  
Padmini Devi ◽  
Mohamed Arifulla ◽  
Shoba Guido

Objective: Critically ill patients are prone for altered reactivity of the airway and drug therapy has pivotal role in the management of bronchospasm. The objective of the study was to evaluate the prescribing patterns and adverse effects of therapeutic agents for bronchospasm and asthma in the medical ICU.Methods: A prospective observational study was carried out among inpatients of the medical ICU receiving drugs for bronchospasm and asthma.Results: 220 patients received drugs for bronchospasm and asthma. Male preponderance was noticed (60.5%). Salbutamol (R03AC02) 92.7% was the most common bronchodilator prescribed. Ipratropium plus salbutamol (R03AK04) 55.5% was most frequently used bronchodilator combination. All bronchodilators were administered by inhalational route (nebulization) except methylxanthines Conclusion: Utilization patterns of drugs for bronchospasm and asthma were in concordance with treatment guidelines.Key words: Bronchospasm; Asthma; Southern IndiaDOI: http://dx.doi.org/10.3126/nje.v1i2.5136 Nepal Journal of Epidemiology 2011;1 (2):57-59

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Mohd Basri Mat Nor ◽  
Azrina Md Ralib

Introduction. Serum procalcitonin (PCT) diagnosed sepsis in critically ill patients; however, its prediction for survival is not well established. We evaluated the prognostic value of dynamic changes of PCT in sepsis patients.Methods. A prospective observational study was conducted in adult ICU. Patients with systemic inflammatory response syndrome (SIRS) were recruited. Daily PCT were measured for 3 days. 48 h PCT clearance (PCTc-48) was defined as percentage of baseline PCT minus 48 h PCT over baseline PCT.Results. 95 SIRS patients were enrolled (67 sepsis and 28 noninfectious SIRS). 40% patients in the sepsis group died in hospital. Day 1-PCT was associated with diagnosis of sepsis (AUC 0.65 (95% CI, 0.55 to 0.76)) but was not predictive of mortality. In sepsis patients, PCTc-48 was associated with prediction of survival (AUC 0.69 (95% CI, 0.53 to 0.84)). Patients with PCTc-48 > 30% were independently associated with survival (HR 2.90 (95% CI 1.22 to 6.90)).Conclusions. PCTc-48 is associated with prediction of survival in critically ill patients with sepsis. This could assist clinicians in risk stratification; however, the small sample size, and a single-centre study, may limit the generalisability of the finding. This would benefit from replication in future multicentre study.


Critical Care ◽  
2010 ◽  
Vol 14 (2) ◽  
pp. R64 ◽  
Author(s):  
Michael Fischer ◽  
Stephan Rüegg ◽  
Adam Czaplinski ◽  
Monika Strohmeier ◽  
Angelika Lehmann ◽  
...  

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G A Gerges ◽  
H M M Elazzazi ◽  
M H S A Elsersi ◽  
S A R Mustafa ◽  
M A Saeed

Abstract Background While administration of fluid can be lifesaving, it has been suggested that the fluid accumulation after initial resuscitation and hemodynamic stabilization can contribute to potentially avoidable adverse effects and less favorable outcomes. Objective The aim of this study is to assess whether positive fluid balance in comparison with negative or even fluid balance is associated with increased morbidity and mortality rates in critically ill patients. Patients and Methods This prospective observational study was performed on 145 Patients older than 18 years admitted to intensive care units at Helwan university hospitals and Ain shams university hospitals during the period from November 2017 till May 2018. Results A total of 145 patients with an ICU mortality rate of 14.5% were enrolled. The median cumulative fluid balance of the 124 patients who survive was -110 ml (IQR -2.1-2.2 L) after the fourth day following randomization while the median cumulative fluid balance of the 21 patients who not survive was 3800 ml (IQR 1.7-5.2 L) after the fourth day in ICU. In our study critically ill patients with fluid balance more than 1.2 litres per day had higher ICU complications: increased risk of AKI, longer ICU and hospital stays, and mechanical ventilation, and fluid balance was independently associated with mortality. Conclusion In the view of this study, we concluded that:Zero fluid balance and negative fluid balance independently associated with decrease mortality and morbidity rates in critically ill patients after 4 days from admission in ICU.There was higher cumulative fluid balance in non survivors compared to survivors. Cumulative fluid balance after 4 days from admission was independently predictive of mortality in a heterogeneous group of critically ill patients.96 hour negative fluid balance in critically ill patients was associated with less length of stay at ICU and less mechanical ventilation duration.Positive fluid balance, mechanical ventilation, vasopressors, and high admission SAPS II, SOFA, APACHE II and KIDGO were significantly associated with high mortality.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Aiko Tanaka ◽  
Akinori Uchiyama ◽  
Yu Horiguchi ◽  
Ryota Higeno ◽  
Ryota Sakaguchi ◽  
...  

AbstractThe cuff leak test (CLT) has been widely accepted as a simple and noninvasive method for predicting post-extubation stridor (PES). However, its accuracy and clinical impact remain uncertain. We aimed to evaluate the reliability of CLT and to assess the impact of pre-extubation variables on the incidence of PES. A prospective observational study was performed on adult critically ill patients who required mechanical ventilation for more than 24 h. Patients were extubated after the successful spontaneous breathing trial, and CLT was conducted before extubation. Of the 191 patients studied, 26 (13.6%) were deemed positive through CLT. PES developed in 19 patients (9.9%) and resulted in a higher reintubation rate (8.1% vs. 52.6%, p < 0.001) and longer intensive care unit stay (8 [4.5–14] vs. 12 [8–30.5] days, p = 0.01) than patients without PES. The incidence of PES and post-extubation outcomes were similar in patients with both positive and negative CLT results. Compared with patients without PES, patients with PES had longer durations of endotracheal intubation and required endotracheal suctioning more frequently during the 24-h period prior to extubation. After adjusting for confounding factors, frequent endotracheal suctioning more than 15 times per day was associated with an adjusted odds ratio of 2.97 (95% confidence interval, 1.01–8.77) for PES. In conclusion, frequent endotracheal suctioning before extubation was a significant PES predictor in critically ill patients. Further investigations of its impact on the incidence of PES and patient outcomes are warranted.


Medicine ◽  
2019 ◽  
Vol 98 (1) ◽  
pp. e13937 ◽  
Author(s):  
Joerg C. Schefold ◽  
Anna S. Messmer ◽  
Stefanie Wenger ◽  
Lionel Müller ◽  
Stephan von Haehling ◽  
...  

2019 ◽  
Vol 52 ◽  
pp. 75-79 ◽  
Author(s):  
Sofie A.M. Dhaese ◽  
Alexander D.J. Thooft ◽  
Andras Farkas ◽  
Jeffrey Lipman ◽  
Alain G. Verstraete ◽  
...  

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