scholarly journals COVID-19 and Post-Acute COVID-19 Syndrome: From Pathophysiology to Novel Translational Applications

Biomedicines ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 47
Author(s):  
Pasquale Ambrosino ◽  
Anna Lanzillo ◽  
Mauro Maniscalco
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Molecular Mechanisms ◽  
Future Research ◽  
Special Issue ◽  
Lung Abnormalities ◽  
Insight Into ◽  
Rehabilitation Strategies

The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was responsible for a global emergency, with the declaration of a pandemic in March 2020. SARS-CoV-2 can determine coronavirus disease 2019 (COVID-19), ranging from a mild illness to a serious condition requiring hospitalization in an intensive care unit. Furthermore, reports of persistent lung abnormalities and residual disability after a negative swab test suggest the presence of a post-acute COVID-19 syndrome, with the need for multidisciplinary rehabilitation strategies in the majority of survivors. However, the pathophysiological mechanisms of the acute and post-acute manifestations of COVID-19 have not been fully elucidated. In this Special Issue, a number of review and original articles provided a stimulating insight into the pathophysiology and diagnostics of COVID-19 and post-acute COVID-19 syndrome. Moreover, some novel prognostic and therapeutic applications were analyzed, with potential repercussions in clinical practice and future research. The need for further laboratory and translational research seems to emerge from this collection of articles, with the aim of elucidating the molecular mechanisms of COVID-19 at different stages of the disease. This could enable personalized prevention, interventional and rehabilitation strategies aimed at reducing disease progression and long-term disability.

Survival after cardiac surgery and long-term intensive care unit stay

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
C Schimmer ◽  
K Hamouda ◽  
M Özkur ◽  
SP Sommer ◽  
I Aleksic ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay

Sportliche Leistung von Pferden, die als Fohlen intensivmedizinischer Behandlung bedurften

2019 ◽  
Vol 47 (06) ◽  
pp. 399-399
Author(s):  
Lukas Demattio
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sich Eine ◽  
Factors Associated ◽  
Intensivmedizinische Behandlung ◽  
Sportliche Leistung

Studies AC, Chidlow H, Ere SG et al. Factors associated with long-term athletic outcome in Thoroughbred neonates admitted to an intensive care unit. Equine Vet J 2019; 51: 716–719 Für viele Pferdezüchter stellt sich immer wieder die Frage, wie viel Geld in ein Fohlen investiert werden soll, wenn dieses tierärztlicher Behandlung bedarf. Lohnt sich eine intensivmedizinische Behandlung für ein Fohlen, das für eine sportliche Nutzung vorgesehen ist? Diese Frage versuchten die Autoren in der Studie zu beantworten.

scholarly journals Completeness of the operating room to intensive care unit handover: a matter of time?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fabian Dusse ◽  
Johanna Pütz ◽  
Andreas Böhmer ◽  
Mark Schieren ◽  
Robin Joppich ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Information Transfer ◽  
Time Pressure ◽  
Intraoperative Complications ◽  
Patient Characteristics ◽  
Information Loss ◽  
Ensure Patient Safety ◽  
Underlying Diseases

Abstract Background Handovers of post-anesthesia patients to the intensive care unit (ICU) are often unstructured and performed under time pressure. Hence, they bear a high risk of poor communication, loss of information and potential patient harm. The aim of this study was to investigate the completeness of information transfer and the quantity of information loss during post anesthesia handovers of critical care patients. Methods Using a self-developed checklist, including 55 peri-operative items, patient handovers from the operation room or post anesthesia care unit to the ICU staff were observed and documented in real time. Observations were analyzed for the amount of correct and completely transferred patient data in relation to the written documentation within the anesthesia record and the patient’s chart. Results During a ten-week study period, 97 handovers were included. The mean duration of a handover was 146 seconds, interruptions occurred in 34% of all cases. While some items were transferred frequently (basic patient characteristics [72%], surgical procedure [83%], intraoperative complications [93.8%]) others were commonly missed (underlying diseases [23%], long-term medication [6%]). The completeness of information transfer is associated with the handover’s duration [B coefficient (95% CI): 0.118 (0.084-0.152), p<0.001] and increases significantly in handovers exceeding a duration of 2 minutes (24% ± 11.7 vs. 40% ± 18.04, p<0.001). Conclusions Handover completeness is affected by time pressure, interruptions, and inappropriate surroundings, which increase the risk of information loss. To improve completeness and ensure patient safety, an adequate time span for handover, and the implementation of communication tools are required.

Shortening the Application Time of Alcohol-Based Hand Rubs to 15 Seconds May Improve the Frequency of Hand Antisepsis Actions in a Neonatal Intensive Care Unit

2017 ◽  
Vol 38 (12) ◽  
pp. 1430-1434 ◽  
Author(s):  
Axel Kramer ◽  
Didier Pittet ◽  
Romana Klasinc ◽  
Stefan Krebs ◽  
Torsten Koburger ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Application Time ◽  
Improve Hand Hygiene ◽  
Independent Observer ◽  
Hand Antisepsis

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434

The Impact of Implementing a “Pain, Agitation, and Delirium Bundle” in a Pediatric Intensive Care Unit: Improved Delirium Diagnosis

2021 ◽  
Author(s):  
Lise D. Cloedt ◽  
Kenza Benbouzid ◽  
Annie Lavoie ◽  
Marie-Élaine Metras ◽  
Marie-Christine Lavoie ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Post Intervention ◽  
Number Of Patients ◽  
Implementation Period ◽  
Short And Long Term ◽  
The Impact

AbstractDelirium is associated with significant negative outcomes, yet it remains underdiagnosed in children. We describe the impact of implementing a pain, agitation, and delirium (PAD) bundle on the rate of delirium detection in a pediatric intensive care unit (PICU). This represents a single-center, pre-/post-intervention retrospective and prospective cohort study. The study was conducted at a PICU in a quaternary university-affiliated pediatric hospital. All patients consecutively admitted to the PICU in October and November 2017 and 2018. Purpose of the study was describe the impact of the implementation of a PAD bundle. The rate of delirium detection and the utilization of sedative and analgesics in the pre- and post-implementation phases were measured. A total of 176 and 138 patients were admitted during the pre- and post-implementation phases, respectively. Of them, 7 (4%) and 44 (31.9%) were diagnosed with delirium (p < 0.001). Delirium was diagnosed in the first 48 hours of PICU admission and lasted for a median of 2 days (interquartile range [IQR]: 2–4). Delirium diagnosis was higher in patients receiving invasive ventilation (p < 0.001). Compliance with the PAD bundle scoring was 79% for the delirium scale. Score results were discussed during medical rounds for 68% of the patients in the post-implementation period. The number of patients who received opioids and benzodiazepines and the cumulative doses were not statistically different between the two cohorts. More patients received dexmedetomidine and the cumulative daily dose was higher in the post-implementation period (p < 0.001). The implementation of a PAD bundle in a PICU was associated with an increased recognition of delirium diagnosis. Further studies are needed to evaluate the impact of this increased diagnostic rate on short- and long-term outcomes.

Adapting the Six-Part Storymaking Method for use with siblings of infants on the neonatal intensive care unit

2020 ◽  
Vol 7 (2) ◽  
pp. 223-242
Author(s):  
Rebecca Ann Versaci
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Emotional Expression ◽  
Neonatal Intensive Care ◽  
Well Being ◽  
Hospital Staff ◽  
Case Vignette ◽  
Profound Influence ◽  
Insight Into

When an infant is hospitalized on the neonatal intensive care unit (NICU) it can have a profound influence on the psychosocial well-being of the infant and their older sibling(s). This article presents a case vignette of the use of the Six-Part Storymaking Method with the sibling of an infant hospitalized on the NICU. The article reviews the therapeutic aims and benefits of the intervention, including: supporting emotional expression, providing opportunity for the sibling to be deeply witnessed by caregivers, therapist and hospital staff, empowering the sibling to inhabit the big sibling role and fostering insight into the sibling’s thoughts, feelings and behaviours as related to their infant’s hospitalization. Considerations for facilitation and assessment are also discussed.

scholarly journals Paediatric nonbronchoscopic bronchoalveolar lavage overview and recommendations for clinical practice

2006 ◽  
Vol 62 (1) ◽  
Author(s):  
B. M. Morrow ◽  
M. J. Futter ◽  
A. C. Argent
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Respiratory Tract ◽  
Bronchoalveolar Lavage ◽  
Pulmonary Disease ◽  
Paediatric Intensive Care Unit ◽  
Lower Respiratory Tract ◽  
Paediatric Intensive Care ◽  
Coagulation Defects

NB-BAL is an effective procedure for the diagnosis of pulmonary disease processes in ventilated infants and children. This procedure is, however, not without risks to both patients and staff. Numerous complications of NB-BAL exist, with hypoxia being themost common. As a result, care should be taken in performing NB-BAL on haemodynamically unstable patients; patients with coagulation defects; and patients with cardiac or brain abnormalities.This paper presents an overview of paediatric nonbronchoscopic bronchoalveolar lavage (NB-BAL) including: the rationale for NB-BAL; the complications associated with the procedure; indications and contraindications. It also recommends an evidence-basedclinical guideline for performing the procedure in the paediatric intensive care unit. By following the NB-BAL guidelines presented in this paper, one can ensure that an effective specimen is obtained from the lower respiratory tract, whilst minimising the risk to the patient.

Management of long-term hypothyroidism: a potential marker of quality of medicines reconciliation in the intensive care unit

2012 ◽  
Vol 20 (5) ◽  
pp. 303-306 ◽  
Author(s):  
Nicholas A. Barrett ◽  
Andrew Jones ◽  
Craig Whiteley ◽  
Sarah Yassin ◽  
Cathrine A. McKenzie
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Potential Marker ◽  
Medicines Reconciliation
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