scholarly journals Epidemiology and Prognostic Significance of Rapid Response System Activation in Patients Undergoing Liver Transplantation

2021 ◽  
Vol 10 (23) ◽  
pp. 5680
Author(s):  
Marcus Robertson ◽  
Andy K. H. Lim ◽  
Ashley Bloom ◽  
William Chung ◽  
Andrew Tsoi ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Liver Transplant ◽  
Prognostic Significance ◽  
Clinical Deterioration ◽  
Rapid Response System ◽  
Post Transplantation ◽  
Response System ◽  
Transplant Patients

Patients undergoing liver transplantation have a high risk of perioperative clinical deterioration. The Rapid Response System is an intensive care unit-based approach for the early recognition and management of hospitalized patients identified as high-risk for clinical deterioration by a medical emergency team (MET). The etiology and prognostic significance of clinical deterioration events is poorly understood in liver transplant patients. We conducted a cohort study of 381 consecutive adult liver transplant recipients from a prospectively collected transplant database (2011–2017). Medical records identified patients who received MET activation pre- and post-transplantation. MET activation was recorded in 131 (34%) patients, with 266 MET activations in total. The commonest triggers for MET activation were tachypnea and hypotension pre-transplantation, and tachycardia post-transplantation. In multivariable analysis, female sex, increasing Model for End-Stage Liver Disease score and hepatorenal syndrome were independently associated with MET activation. The unplanned intensive care unit admission rate following MET activation was 24.1%. Inpatient mortality was 4.2% and did not differ by MET activation status; however, patients requiring MET activation had significantly longer intensive care unit and hospital length of stay and were more likely to require inpatient rehabilitation. In conclusion, liver transplant patients with perioperative complications requiring MET activation represent a high-risk group with increased morbidity and length of stay.

scholarly journals Evaluation of the SpO2/FiO2 ratio as a predictor of intensive care unit transfers in respiratory ward patients for whom the rapid response system has been activated

PLoS ONE ◽  
2018 ◽  
Vol 13 (7) ◽  
pp. e0201632 ◽  
Author(s):  
Won Gun Kwack ◽  
Dong Seon Lee ◽  
Hyunju Min ◽  
Yun Young Choi ◽  
Miae Yun ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Rapid Response ◽  
Rapid Response System ◽  
Response System

Liver transplant patients: their experience in the intensive care unit. A phenomenological study

2004 ◽  
Vol 13 (8) ◽  
pp. 967-976 ◽  
Author(s):  
Miriam del Barrio ◽  
Ma Mar Lacunza ◽  
Ana Carmen Armendariz ◽  
Ma Angeles Margall ◽  
Ma Carmen Asiain
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Phenomenological Study ◽  
Transplant Patients

Intensive Care Unit Management of Liver Transplant Patients: A Formidable Challenge for the Intensivist

2008 ◽  
Vol 40 (9) ◽  
pp. 3206-3208 ◽  
Author(s):  
F.H. Saner ◽  
G.C. Sotiropoulos ◽  
A. Radtke ◽  
I. Fouzas ◽  
E.P. Molmenti ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Transplant Patients ◽  
Unit Management ◽  
Formidable Challenge ◽  
Intensive Care Unit Management

scholarly journals Effect of Rapid Response System on Unplanned Intensive Care Unit Admission after Elective Surgery

2018 ◽  
Vol 02 (02) ◽  
Author(s):  
Masayuki Akatsuka ◽  
Hiroomi Tatsumi ◽  
Shinichiro Yoshida ◽  
Satoshi Kazuma ◽  
Yoichi Katayama ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Elective Surgery ◽  
Rapid Response ◽  
Rapid Response System ◽  
Response System

scholarly journals Lung ultrasound predicts clinical course but not outcome in COVID-19 ICU patients: a retrospective single-center analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stephanie-Susanne Stecher ◽  
Sofia Anton ◽  
Alessia Fraccaroli ◽  
Jeremias Götschke ◽  
Hans Joachim Stemmler ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Clinical Course ◽  
Point Of Care ◽  
Clinical Deterioration ◽  
Normal Lung ◽  
Icu Patients ◽  
Standardized Protocol ◽  
Ultrasound Score

Abstract Background Point-of-care lung ultrasound (LU) is an established tool in the first assessment of patients with coronavirus disease (COVID-19). Purpose of this study was to evaluate the value of lung ultrasound in COVID-19 intensive care unit (ICU) patients in predicting clinical course and outcome. Methods We analyzed lung ultrasound score (LUS) of all COVID-19 patients admitted from March 2020 to December 2020 to the Internal Intensive Care Unit, Ludwig-Maximilians-University (LMU) of Munich. LU was performed according to a standardized protocol at ICU admission and in case of clinical deterioration with the need for intubation. A normal lung scores 0 points, the worst LUS has 24 points. Patients were stratified in a low (0–12 points) and a high (13–24 points) lung ultrasound score group. Results The study included 42 patients, 69% of them male. The most common comorbidities were hypertension (81%) and obesity (57%). The values of pH (7.42 ± 0.09 vs 7.35 ± 0.1; p = 0.047) and paO2 (107 [80–130] vs 80 [66–93] mmHg; p = 0.034) were significantly reduced in patients of the high LUS group. Furthermore, the duration of ventilation (12.5 [8.3–25] vs 36.5 [9.8–70] days; p = 0.029) was significantly prolonged in this group. Patchy subpleural thickening (n = 38; 90.5%) and subpleural consolidations (n = 23; 54.8%) were present in most patients. Pleural effusion was rare (n = 4; 9.5%). The median total LUS was 11.9 ± 3.9 points. In case of clinical deterioration with the need for intubation, LUS worsened significantly compared to baseline LU. Twelve patients died during the ICU stay (29%). There was no difference in survival in both LUS groups (75% vs 66.7%, p = 0.559). Conclusions LU can be a useful monitoring tool to predict clinical course but not outcome of COVID-19 ICU patients and can early recognize possible deteriorations.

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