scholarly journals Scenario of Sepsis in Intensive Care Unit in a Tertiary Care Hospital

2020 ◽  
Vol 18 (1) ◽  
pp. 99-102
Author(s):  
Ram Hari Ghimire ◽  
Sampanna Budhathoki ◽  
Rupesh Kumar Shreewastav
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Age Groups ◽  
Common Source ◽  
Care Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Source Of Infection

Background: Sepsis has been defined as life-threatening organ dysfunction caused by dysregulated host response to infection. Sepsis is an important cause of mortality in intensive care unit worldwide. The study aims to identify the outcome of sepsis patient admitted at tertiary care hospital.Methods: This is a descriptive cross-sectional hospital based study on 76 adult patients admitted at intensive care unit of Nobel Medical College with diagnosis of sepsis with an objective of estimating mortality of sepsis and identifying associated symptoms with it. Baseline demographics, clinical and laboratory data were collected and analyzed. Results: Out of 76 patients with sepsis, mean age of the patients was 50.07±18.15 years. Majority of patients 31.6% with sepsis were above age groups >60 years. The most common symptoms among the patients were fever, which was seen in 69 (90.8%) patients. The most common source of infection in those patients was found to be unknown, which was seen in 36.8% of patients. While analyzing the outcome, it was noted that 25 patients with sepsis (32.9%) died during treatment.Conclusions: Sepsis is related with high mortality. Elderly patients are at more risk. Fever is the commonest presentation and source is not identified in majority of cases. Keywords: Intensive care unit; mortality; sepsis.

scholarly journals Prescription pattern of patients admitted in the intensive care unit of a tertiary care hospital in Puducherry, India: a cross sectional study

2017 ◽  
Vol 6 (12) ◽  
pp. 2822
Author(s):  
B. Maharani ◽  
A. Lourdu Jafrin ◽  
M. Prakash ◽  
P. Priyadarshini
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Drug Use ◽  
Tertiary Care ◽  
Research Work ◽  
Essential Medicine ◽  
Demographic Characteristics ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prescription Pattern

Background: Patients with varied demographic characteristics, admission criteria and heterogeneous group are admitted to medical Intensive Care Unit (ICU) and are usually associated with co-morbid illnesses. Instituting rational pharmacotherapy is the need of the hour for saving the life of critically-ill patients while irrational drug use may be life threatening. Drug use patterns and prescribing behaviour are the essential tools to measure drug use in health care facilities.Methods: A record based, cross-sectional, observational study was done at medical ICU, IGMC and RI, Puducherry after obtaining IEC approval. Systemic random sampling was followed and data was collected for a period of one year. Data were analysed based on demographic characteristics, prescribing pattern and WHO drug use indicators.Results: The data of 151 patients were analysed. Mean age of the patients admitted in ICU was 52.9±17.7 years. Percentage of male patients (57.6) admitted in ICU were more when compared to female patients (42.4). Infective etiology was the most common factor for ICU admission followed by cardiac disorders. Diabetes mellitus and hypertension were the most common co-morbidities. The average length of stay in ICU was 4.11±2.99 days. Duration of stay in ICU ranged from 1-5 days (78.8% patients) to 15-20 days (0.1% patients). On an average 10.6±4.3 drugs were prescribed for each patient. Percentage of drugs prescribed by generic name was 45.8%. Majority of the drugs (87.4%) were from essential medicine list. Antibiotics in the prescription was 13.8% and 44.4% of drugs were administered in parenteral route. The prescription was complete in 145 case sheets (96%). Majority of the patients (68.9%) were discharged with improvement in the condition for which they were admitted.Conclusions: This drug utilization study has highlighted the strengths and shortcomings of the prescription pattern of patients who were admitted in the critical care setup. The information derived from this research work will be transmitted to the stakeholders for implementing the modifications wherever applicable for the betterment of the patient and the community.

scholarly journals Profile of Obstetric Morbidity Among Maternal Intensive Care Unit Patients

2014 ◽  
Vol 9 (2) ◽  
pp. 46-50
Author(s):  
B Shakya ◽  
P Chaudhary ◽  
M Tumbahangphe
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Multiorgan Failure ◽  
Tertiary Care ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Obstetric Hemorrhage ◽  
Cross Sectional ◽  
Hypertensive Disorders

Aims: The objective of the study was to determine the outcome of the obstetric admissions to Maternal Intensive Care Unit in the setting of a tertiary care hospital. Methods: This was a cross-sectional study undertaken at Paropakar Maternity and Women’s Hospital from April 1, 2012 to March 31, 2013. Patient characteristics, gestational age, booking status, indication for intensive care unit admission, intervention, length of stay and outcome were analyzed. Results: During the study period, 19,247 deliveries occurred and 247 women were admitted to maternal intensive care unit. This accounts for 1.28% of all deliveries. The most common indication of admission to intensive care unit was hypertensive disorders in pregnancy (45.3%) followed by obstetric hemorrhage (39.27%). Sepsis was the cause in ten (4.04%) cases. Ten cases (4.04%) of postpartum hemorrhage were managed by balloon tamponade, seven (2.83%) by B-Lynch compression sutures and three (1.21%) necessitated cesarean hysterectomy. Among 18 cases of ruptured uterus, 13 (5.26%) were repaired while five (2.02%) required hysterectomy. Maternal mortality occurred in four (1.61%) of the cases. One was a case of severe preeclampsia who died on 4th post-operative day due to pulmonary embolism, another due to anesthetic complication and the other two died of septic shock and multiorgan failure. Conclusions: Hypertensive disorders of pregnancy and obstetric hemorrhage appeared as the major risk factors for admission to an intensive care unit thereby influencing maternal outcomes in obstetric patients. DOI: http://dx.doi.org/10.3126/njog.v9i2.11762 

scholarly journals Non-Invasive Ventilation in a Paediatric Intensive Care Unit (PICU) with Respiratory Failure: Experience at a Tertiary Care Hospital in Dhaka

2019 ◽  
Vol 30 (Number 1) ◽  
pp. 20-25
Author(s):  
S Hoque ◽  
ASM N U Ahmed
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Co2 Concentration ◽  
Care Hospital ◽  
Invasive Ventilation ◽  
Cross Sectional ◽  
The Mean

Noninvasive ventilation (NIV) has now become an integral tool within the treatment of both acute and chronic respiratory failure, and at an equivalent time reducing the necessity for invasive ventilation. A cross sectional, retrospective study based on a retrospective review of hospital medical records of patients who underwent NIV in the period between January 2017 and December 2019, to determinate the efficacy of NIV in pediatrics whom admitted to Pediatric intensive care unit (PICU) with respiratory failure (short term evaluation), demographic and clinical data were collected before and after applying the NIV. The data included heart rate (HR), respiratory rate (RR), oxygen concentration (P02) and CO2 concentration (PCO2). NIV was used for a total of 61 pediatric patients admitted to PICU during the period of the study. Pneumonia was the commonest indication for the NIV (n=25, 41.0%), and continuous positive airway pressure (CPAP) was used in 52(85.2%) patients. The mean duration of NIV was 817.2 days, there was a significant clinical improvement after one hour from application of NIV The mean improvement in RR was from 48.412.2 to 35.01I.5 (P=0.000), SPO2 was improved from 88.111.8 to 96.510.7 (P= 0.000), and the PCO2 was improved from 61.4±6.1 to 48.713 7 (P=0.002). Five patients were failing to respond to the NIV and shifted to mechanical ventilation. The NIV is a useful tool for treatment of respiratory failure in pediatrics, especially under the age of one year. Pneumonia was the commonest indication for the use of the NB!. More investigation is needed to fully evaluate the ramifications of increased use of this technology in the PICU.

scholarly journals Study of Antibiotic Susceptibility among Bacterial Isolates in Neonatal Intensive Care Unit of a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (231) ◽  
Author(s):  
Brajesh Raj Chaudhary ◽  
Kalpana Karmacharya Malla ◽  
Sajan Poudel ◽  
Brajesh Kumar Jha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Sepsis ◽  
Antibiotic Susceptibility ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Care Hospital ◽  
Cross Sectional ◽  
Gram Negative

Introduction: Neonatal sepsis is a major cause of neonatal morbidity and mortality worldwide, especially in developing countries like Nepal. Antibiotic resistance among microorganisms poses new challenges in the treatment of neonatal sepsis. The present study is conducted with the objectives of determining clinico-bacteriological profile and antibiotic susceptibility among isolated bacteria in a neonatal intensive care unit. Methods: A descriptive cross-sectional study was conducted from January 1, 2017, to December 31, 2019, in the neonatal intensive care unit of a tertiary care hospital after obtaining ethical clearance from Institutional Review Committee (Reference Number: 2020-064). The sample size was calculated and 77 neonates with culture-proven sepsis were included in the study. The antibiotic susceptibility tests of the isolates were done by Kirby-Bauer disc diffusion method. Data entry was done in Statistical Packages for the Social Sciences version 20. Results: Of the 841 specimens (blood, cerebrospinal fluid, urine, tracheal aspirate and pus) processed for culture, bacteria were isolated in 84 (10.0%) specimens. Among the 84, gram-negative bacilli were the predominant isolates 76 (90.5%); of which Acinetobacter baumannii was the most common 27 (32.1%). Both the Gram-negative and the Gram-positive bacteria showed high resistance to Penicillin and Cephalosporins. Gram-negative bacteria showed maximum sensitivity to Colistin, Carbapenems, Tigecycline and Fluoroquinolones. Gram-positive bacteria showed maximum susceptibility to Amikacin, Vancomycin and Carbapenems. Conclusions: Judicious use of antibiotics based on the updated knowledge of prevalent organisms in the local hospital setting and their antibiotic sensitivity pattern is of utmost importance for the effective treatment of neonatal sepsis.

scholarly journals Isolation of Acinetobacter species and their antimicrobial resistance pattern in a tertiary care hospital in Dhaka, Bangladesh

2017 ◽  
Vol 10 (1) ◽  
pp. 18-21
Author(s):  
Jannatul Ferdous ◽  
Mohammad Murshed ◽  
Sabeena Shahnaz ◽  
Syeda Sharmin Duza ◽  
Prothoma Rahman Siddique
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Control Strategies ◽  
Tertiary Care ◽  
Tracheal Aspirate ◽  
Resistance Pattern ◽  
Care Hospital ◽  
Acinetobacter Species ◽  
Medical College

Acinetobacter species are important opportunistic and nosocomial pathogens capable of causing both community and health careassociated infections (HAIs). The clinical specimens obtained from patients admitted in Holy Family Red Crescent Medical College and Hospital (HFRCMCH) from July 2013 to June 2015. All laboratory works were performed in department of microbiology and immunology of HFRCMCH. The infection rate was maximum in blood (67.7%) followed by urine (12.9%), tracheal aspirate (8.8%) and wound swab (3.32%). Most of the Acinetobacter were isolated from Intensive care unit (ICU) and Neonatal intensive care unit ( NICU). Acinetobacter displayed higher resistance to many antibiotics like Ampicillin which showed 96% resistance, Ceftriaxone 72%, Amikacin 72%, Imipenem 55%, Meropenem 60%, Tetraclycline 64%, Ciprofloxacin 60% and Cotrimoxazole showed 38% resistance. In conclusion, there was a high resistant rate to available and common antibiotics. It seems that infection control strategies may help to control the evolving problem of Acinetobacter infections and prevent an epidemic nosocomial life threatening infections.Bangladesh J Med Microbiol 2016; 10 (1): 18-21

scholarly journals Antimicrobial Resistance Pattern of Bacterial Isolates from Intensive Care Unit of a Tertiary Care Hospital in Bangladesh

2017 ◽  
Vol 8 (1) ◽  
pp. 7-11
Author(s):  
Taslima Akter ◽  
Mohammad Murshed ◽  
Taslima Begum ◽  
Kamrun Nahar ◽  
Syeda Sharmin Duza ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Resistance Pattern ◽  
Care Hospital ◽  
College Hospital ◽  
Antibiotic Susceptibility Pattern ◽  
Medical College ◽  
Highly Active ◽  
The Common

Infections with resistant strain are one of the leading causes of morbidity and mortality in hospitalized patients especially the critically ill patients in intensive care unit (ICU). The present study was conducted to know the changing pattern of antibiotic resistance of the common isolates from blood, urine, respiratory secretions and pus/ wound swab of patients admitted in ICU at Holy Family Red Crescent Medical College hospital over a two years period from January 2012 to December 2013. A total of 1282 samples were analyzed. Out of which 301 (23.5%) samples were positive for growth of organisms. The predominant isolates were E.coli (28%), Klebsiella (27%), Acinetobacter (17.3%), Pseudomonas (9.6%), Staphylococcus aureus (5.3%) & candida (6%). Majority isolates were resistant to Cephalosporin and Amoxycillin, (>70-90%). Carbapenem were still highly active against E.coli. However, Klebsiella, Pseudomonas and Acinetobacter were showing alarming resistance (55-60%) towards those drugs. Aminoglycosides resistance has also increased for Pseudomonas and Klebsiella. The percentage of Cloxacillin resistant for staphylococcus was near about 40%. The most active drug against Pseudomonas was piperacillin/Tazobactam. The positive result from this study was that organisms showed decreased resistance towards Tetracycline, Cotrimoxazole and Ciprofloxacin. The sensitivity of Nitrofurantoin for urinary isolates was good. Regular surveillance of antibiotic susceptibility pattern & judicious use of antibiotics is very important for reducing the infection rate and antimicrobial resistance.Bangladesh J Med Microbiol 2014; 08 (01): 07-11

scholarly journals Evaluation of Drug Use Patterns in Intensive Care Unit of Tertiary Care Hospital: A Descriptive Cross-Sectional Study

2021 ◽  
Vol 10 (1) ◽  
pp. 31-35
Author(s):  
Rinku Ghimire ◽  
Rupesh Kumar Shreewastav
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prescription Patterns ◽  
Male Predominance ◽  
The Mean

Background: Prescription of rational drugs is needed to save critically ill patients. This study was conducted to assess the prescription patterns of drugs in the intensive care unit. Materials and Methods: A descriptive cross-sectional study among patients admitted in intensive care unit from March 2020 to February 2021 after approval from the Institutional Review Committee (ref no. 344 /2019). Demographic profile, prescription patterns, the average number of drugs used, route of administration, and duration of hospitalization were recorded based on the pre-structured questionnaires. Convenient sampling was chosen. Data were analyzed by SPSS, version 20. Results: Prescription patterns of 225 were analyzed. The mean age was 55.60 ± 20.16 years with a male predominance of 131(58.2%). Cardiac disorders 57(25.3%) were the most common admitting diagnosis followed by pulmonary, neurological, and kidney disorders. The average length of hospital stay was 4.14 days (range 1-38 days). A total of 887 drugs were prescribed. The mean number of drugs prescribed per patient was 7.71 ± 1.92. Parenteral drugs accounted for 81.39%. Antibiotics were prescribed to all patients. Intravenous fluids were given to 62.2% of patients, blood and blood products to 21.33%. Thromboprophylaxis was used in 15 (6.7%) patients. Seven hundred twenty-two (81.39%) drugs were injectables, 129(14.54%) were used by the oral or nasogastric route and 36 (4.05%) were inhaled drugs. Conclusion: Newer generations antibiotics were the most commonly prescribed drugs. Pantoprazole, Metoclopramide, and Hydrocortisone were the top three most commonly prescribed individual drugs. There was marked underuse of thromboprophylaxis, analgesics, and sedatives.  

scholarly journals Nosocomial Blood Stream Infections in Pediatric Intensive Care Unit of Fauji Foundation Hospital, Rawalpindi Pakistan

2020 ◽  
Vol 9 (4) ◽  
pp. 269-274
Author(s):  
Iqra Ayaz ◽  
Hira Hameed ◽  
Wajeeha Amber ◽  
Talal Zafar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Blood Stream ◽  
Care Hospital ◽  
Cross Sectional ◽  
Blood Stream Infections ◽  
Time Of Admission

OBJECTIVE: To determine the frequency of most common bacterial organisms in nosocomial blood stream infections STUDY DESIGN: A Cross-sectional descriptive study PLACE AND DURATION:                In  Department of Paediatric Medicine, Fauji Foundation Hospital, Rawalpindi, Tertiary care hospital over a period of 06 months from 6th July 2017 to 6th Jan  2018 METHODOLOGY: Total 385 patients admitted in PICU were included in the study according to the inclusion criteria. Patients were monitored from the time of admission to their final outcome for development of hospital acquired infections, based on standard definitions. Blood sample for culture were collected aseptically according to the protocol of the microbiology laboratory. The bottles were incubated for 7 days. Patients were monitored from time of the blood culture yielding growth until culture report becomes available. Data was calculated through a structured Performa confidentiality of patient was maintained. RESULTS: Pseduomonas Aeruginosa and Salmonellia Tpyhi were the most common bacterial organism 83 (21.6) in nosocomial blood stream infection whereas E.Coli and Klebsiella found in 77 (20.0) and 67 (17.4) patients respectively. CONCLUSION: The study concluded that the frequency of most common bacterial organisms in nosocomial blood stream infections is substantial. Thus, early initiation of appropriate antibiotic therapy help in contributing significantly towards decrease in mortality rates due to blood stream infections. KEYWORDS: Nosocomial, Bloodstream infection, Intensive care unit

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