scholarly journals Mortality among critical care patients with autoimmune diseases at a tertiary care center in Bogotá, Colombia

2015 ◽  
Vol 6 ◽  
Author(s):  
Carrizosa Jorge ◽  
Sanchez Alexander ◽  
De Zubiria Eduardo ◽  
De Zubiria Alberto
Keyword(s):  
Critical Care ◽  
Autoimmune Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Critical Care Patients

Defining the role of the pediatric critical care nurse practitioner in a tertiary care center

2000 ◽  
Vol 28 (7) ◽  
pp. 2626-2630 ◽  
Author(s):  
Shari L. Derengowski ◽  
Sharon Y. Irving ◽  
Pamela V. Koogle ◽  
Robert M. Englander
Keyword(s):  
Critical Care ◽  
Nurse Practitioner ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Pediatric Critical Care ◽  
Care Nurse ◽  
Critical Care Nurse

scholarly journals Cerebrospinal Fluid Pleocytosis in Critical Care Patients With Seizures

2017 ◽  
Vol 44 (4) ◽  
pp. 343-349
Author(s):  
Carly Scramstad ◽  
Alan C. Jackson
Keyword(s):  
Cerebrospinal Fluid ◽  
Critical Care ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Critical Care Units ◽  
Generalized Seizures ◽  
Csf Pleocytosis ◽  
Magnetic Resonance Imaging Mri ◽  
Critical Care Patients

AbstractObjectives: To assess the etiology of cerebrospinal fluid (CSF) pleocytosis in critical care patients with seizure(s) or status epilepticus (SE). Many previous studies, some performed decades ago, concluded that CSF pleocytosis may be entirely attributable to seizure activity. Methods: We undertook a retrospective chart review of adult patients with an admitting or acquired diagnosis of seizure(s) or SE in critical care units at the Winnipeg Health Sciences Centre between 2009 and 2012. Patients were identified through a critical care information database at a tertiary care center. We limited our study to patients who had lumbar punctures at our center within 5 days of seizure(s) or SE. Results: Of 426 patients with seizures in critical care units, 51 met the inclusion criteria. Seizure subtypes included focal seizures (5 or 10%), generalized seizures (14 or 27%), and SE (32 or 63%). Twelve (seven with SE) of the 51 (24%) were found to have CSF pleocytosis. A probable etiological cause for the CSF pleocytosis was identified in all 12 cases. Conclusions: We conclude that seizures do not directly induce a CSF pleocytosis. Instead, the CSF pleocytosis more likely reflects the underlying acute or chronic brain process responsible for the seizure(s). This was not readily apparent in early studies without magnetic resonance imaging (MRI) of the brain and currently available laboratory investigations. An etiological cause of CSF pleocytosis must always be sought when patients present with seizures and it should never be assumed that seizures are the cause.

scholarly journals Incidence, etiology, and course of hypercalcemia-induced AKI in a tertiary care center from northern India

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Nucksheeba Aziz Bhat ◽  
Farhat Mustafa ◽  
Rayees Yousuf Sheikh ◽  
Imtiyaz Wani
Keyword(s):  
Multiple Myeloma ◽  
Critical Care ◽  
Primary Hyperparathyroidism ◽  
Serum Creatinine ◽  
Serum Calcium ◽  
Care Setting ◽  
Care Center ◽  
Tertiary Care ◽  
Critical Care Setting ◽  
Tertiary Care Center

Abstract Background Hypercalcemia is known to cause acute kidney injury (AKI). Literature related to hypercalcemic AKI is predominantly in the form of case reports and case series. The purpose of this study is to find the incidence, etiology, and course of hypercalcemia-induced AKI in a non-critical care setting. To our knowledge, this is the first study done to look for the incidence, etiology, and course of hypercalcemia-induced AKI in a non-critical care setting. This is a prospective observational study conducted in the Department of Medicine in a tertiary care center from Jammu and Kashmir, India, from June 2010 to June 2012. Patients admitted with hypercalcemia were assessed for AKI and evaluated and treated for hypercalcemia. Renal function was monitored during hospitalization and at 1 month of discharge. AKI and hypercalcemia were arbitrarily defined as serum creatinine > 1.5 mg/dl and corrected serum calcium of ≥ 11.5 mg/dl (as per reference hospital lab), respectively. Results Thirty patients are included. Hyperparathyroidism and multiple myeloma accounted for 13(43.3%) and 10 (33.3%) cases, respectively. Mean ±SD corrected serum calcium at diagnosis and after treatment at 1 month was 13.56 ± 1.86 mg/dl and 9.49±1.35 mg/dl, respectively; p < 0.001. Mean ±SD serum creatinine at baseline and after treatment of hypercalcemia was 2.87 ±1.68 mg/dl and 1.49±1.34 mg/dl, respectively; p < 0.001. Twenty-three (76.7%) patients had AKI. AKI recovered after treating hypercalcemia in 25 (83.3 %) patients. Mean ± SD days taken for the decrease in serum creatinine to ≤ 1.5 mg/dl was 8.28 ± 4.17 days. Mean ± SD serum creatinine after treatment of hypercalcemia in hyperparathyroidism group versus non-parathyroid group was 0.97 ± 0.35 mg/dl and 1.88 ±1.67 mg/dl, respectively; p value 0.009. Conclusions Hypercalcemia is commonly associated with AKI. Primary hyperparathyroidism and multiple myeloma account for the majority of the cases. Hypercalcemic AKI with primary hyperparathyroidism is less common and the outcome is better, as compared to non-hyperparathyroidism-related causes. AKI is reversible in most cases.

The Importance of Ground Critical Care Transport

2016 ◽  
Vol 32 (2) ◽  
pp. 163-169 ◽  
Author(s):  
Susan R. Wilcox ◽  
Michael Ries ◽  
Ted A. Bouthiller ◽  
E. Dean Berry ◽  
Travis L. Dowdy ◽  
...  
Keyword(s):  
Critical Care ◽  
Life Support ◽  
Medical Center ◽  
Care Center ◽  
Tertiary Care ◽  
Respiratory Acidosis ◽  
Advanced Life Support ◽  
Integrated Approach ◽  
Tertiary Care Center ◽  
Transport Services

Critical care transport (CCT) teams are specialized transport services, comprised of highly trained paramedics, nurses, and occasionally respiratory therapists, offering an expanded scope of practice beyond advanced life support (ALS) emergency medical service teams. We report 4 cases of patients with severe acute respiratory distress syndrome from influenza in need of extracorporeal membrane oxygenation evaluation at a tertiary care center, transported by ground. Our medical center did not previously have a ground CCT service, and therefore, in these cases, a physician and/or a respiratory therapist was sent with the paramedic team. In all 4 cases, the ground transport team enhanced the intensive care provided to these patients prior to arrival at the tertiary care center. In 2 of the cases, although limited by the profound hypoxemia, the team decreased the pressures and tidal volumes in an effort to approach evidence-based ventilator goals. In 3 cases, they stopped bicarbonate drips being used to treat mixed metabolic and respiratory acidosis, and in 1 case, they administered furosemide. In 1 case, they started cisatracurium, and in 3 others, they initiated inhaled epoprostenol. Existing literature supports the use of CCT teams over ALS teams for transport of the most critically ill patients, and helicopter CCT is not always available or practical. Therefore, offering comparable air and ground options, with similar staffing and resources, is a hallmark of a mature medical system with an integrated approach to CCT.

scholarly journals Anemia among Pediatric Critical Care Survivors: Prevalence and Resolution

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Quang N. Ngo ◽  
Doreen M. Matsui ◽  
Ram N. Singh ◽  
Shayna Zelcer ◽  
Alik Kornecki
Keyword(s):  
Critical Care ◽  
Observational Study ◽  
Critical Care Unit ◽  
Prospective Observational Study ◽  
Care Center ◽  
Tertiary Care ◽  
Medical Intervention ◽  
Tertiary Care Center ◽  
Pediatric Critical Care ◽  
Discharge From Hospital

To determine the incidence of anemia among pediatric critical care survivors and to determine whether it resolves within 6 months of discharge.Design. A prospective observational study. Patients with anemia upon discharge from the pediatric critical care unit (PCCU) underwent in hospital and post hospital discharge followup (4–6 months) for hemoglobin (Hb) levels.Setting. A medical-surgical PCCU in a tertiary care center.Patients. Patients aged 28 days to 18 years who were treated in the PCCU for over 24 hours.Measurements and Main Results. 94 (24%) out of 392 eligible patients were anemic at time of discharge. Patients with anemia were older, median 8.0 yrs [(IQR 1.0–14.4) versus 3.2 yrs (IQR 0.65–9.9) (P<0.001)], and had higher PeLOD [median 11 (IQR 10–12) versus 1.5 (1–4) (P<0.001)], and PRISM [median 5 (IQR 2–11) versus 3 (IQR 0–6) (P<0.001)] scores. The Hb level normalized in 32% of patients before discharge from hospital. Of the 28 patients who completed followup, all had normalization of their Hb in the absence of medical intervention.Conclusions. Anemia is not common among patients discharged from the PCCU and recovers spontaneously within 4–6 months.

Nursing Challenges in the Care of Very Low Birth Weight Infants (<1,000 Grams)

1994 ◽  
Vol 5 (3) ◽  
pp. 231-241
Author(s):  
Carole Kenner ◽  
Carol Hetteberg
Keyword(s):  
Critical Care ◽  
Birth Weight ◽  
Very Low Birth Weight ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
Care Needs ◽  
Low Birth Weight Infants ◽  
Gestational Period ◽  
Neonatal Population

It is not unusual for neonates to be born before the 24th week of gestation and weigh less than 1,000 g. These neonates are surviving to be transferred to a tertiary care center, and many are discharged eventually to home. When one considers that these infants arc only “half developed” by the standard 40-week gestational period, it is understandable that the challenges for nurses caring for them are enormous. In this article, the authors review gestational development and the critical care needs of this special neonatal population

CRITICAL CARE NURSES OPINION AND KNOWLEDGE ABOUT THE ORGANIZATIONAL CHANGE OF CLOSING AN OPEN ICU IN A TERTIARY CARE CENTER

CHEST Journal ◽  
2007 ◽  
Vol 132 (4) ◽  
pp. 546C
Author(s):  
Hesham H. El Gamal ◽  
Patricia Pollack ◽  
Deborah S. Schramko ◽  
Anders Jacobson ◽  
Kim Baumgartner ◽  
...  
Keyword(s):  
Organizational Change ◽  
Critical Care ◽  
Care Center ◽  
Tertiary Care ◽  
Critical Care Nurses ◽  
Tertiary Care Center

scholarly journals Mental health in patients with rheumatic diseases related to COVID-19 pandemic: Experience in a tertiary care center in Latin America

Lupus ◽  
2021 ◽  
pp. 096120332110380
Author(s):  
Jessica González-Rangel ◽  
Brenda Pérez-Muñoz ◽  
Daniela Casillas-Santos ◽  
Ana Barrera-Vargas ◽  
Paola Vázquez-Cardenas ◽  
...  
Keyword(s):  
Mental Health ◽  
Autoimmune Diseases ◽  
Symptom Score ◽  
Lupus Erythematosus ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center ◽  
General Anxiety Disorder ◽  
General Anxiety ◽  
Patient Health

Objective To determine the factors associated with anxiety, depression, and concern within the COVID-19 pandemic in a population with autoimmune diseases. Methods A telephonic survey was conducted during the early stages of the pandemic in a tertiary care center, which included patients with systemic autoimmune diseases. Mental health variables were assessed with Patient Health Questionnaire 2, General Anxiety Disorder 7 scores, and pandemic-related concern questions. Sociodemographic aspects were also evaluated. Results Of the total 334 participants, 291 (87.1%) were women, with a median age of 46 years; systemic lupus erythematosus (SLE) was the most frequent diagnosis (144, 43.2%); 44 patients (13.2%) showed depression and 32 (9.6%) anxiety. The variables associated with depression were all the pandemic concern items, body mass index, anxiety, and a higher COVID-19 symptom score. Anxiety was associated with depression, all pandemic concern items, and a higher COVID-19 symptom score. Women presented higher scores in all concern items. The SLE group presented higher scores in concern questions and difficulty finding medication. Conclusion During the COVID-19 outbreak, rheumatic patients are vulnerable to psychiatric conditions, which makes it imperative for physicians who treat these patients to pay careful attention in order to detect them promptly and to settle coping strategies.

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