Faculty Opinions recommendation of Duration of withdrawal of life support in the intensive care unit and association with family satisfaction.

2008 ◽  
Author(s):  
Imre Noth
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Family Satisfaction

Code Blue Events in the Neonatal and Pediatric Intensive Care Units at a Tertiary Care Children's Hospital

2020 ◽  
Author(s):  
Catherine M. Groden ◽  
Erwin T. Cabacungan ◽  
Ruby Gupta
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Life Support ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Neonatal Resuscitation ◽  
Advanced Life Support ◽  
Pediatric Intensive Care ◽  
Code Blue ◽  
Neonatal Resuscitation Program

Objective The authors aim to compare all code blue events, regardless of the need for chest compressions, in the neonatal intensive care unit (NICU) versus the pediatric intensive care unit (PICU). We hypothesize that code events in the two units differ, reflecting different disease processes. Study Design This is a retrospective analysis of 107 code events using the code narrator, which is an electronic medical record of real-time code documentation, from April 2018 to March 2019. Events were divided into two groups, NICU and PICU. Neonatal resuscitation program algorithm was used for NICU events and a pediatric advanced life-support algorithm was used for PICU events. Events and outcomes were compared using univariate analysis. The Mann–Whitney test and linear regressions were done to compare the total code duration, time from the start of code to airway insertion, and time from airway insertion to end of code event. Results In the PICU, there were almost four times more code blue events per month and more likely to involve patients with seizures and no chronic condition. NICU events more often involved ventilated patients and those under 2 months of age. The median code duration for NICU events was 2.5 times shorter than for PICU events (11.5 vs. 29 minutes), even when adjusted for patient characteristics. Survival to discharge was not different in the two groups. Conclusion Our study suggests that NICU code events as compared with PICU code events are more likely to be driven by airway problems, involve patients <2 months of age, and resolve quickly once airway is taken care of. This supports the use of a ventilation-focused neonatal resuscitation program for patients in the NICU. Key Points

Resuscitation and Withdrawal of Therapy in Pediatric Intensive Care

PEDIATRICS ◽  
1992 ◽  
Vol 89 (5) ◽  
pp. 961-963
Author(s):  
RICHARD B. MINK ◽  
MURRAY M. POLLACK
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Life Support ◽  
Pediatric Intensive Care ◽  
New Haven ◽  
Hammersmith Hospital ◽  
Hospital Deaths ◽  
Withdrawal Of Therapy ◽  
Haven Hospital

Although issues concerning withdrawal and limitation of life support are commonly discussed,1-6 actual practices in pediatrics are largely unknown and are limited to neonatal intensive care unit (ICU) studies. In the neonatal ICUs at Yale-New Haven Hospital and at Hammersmith Hospital, 14% and 30%, respectively, of all deaths followed withdrawal of care.7,8 In adult ICUs, limitation and/or withdrawal of therapy is common,9 and in one investigation, resuscitation was not attempted immediately before ICU death in nearly two-thirds of cases.10 Nonetheless, many physicians believe that most hospital deaths occur only after all resuscitative attempts have failed,6,11,12 and others believe that resuscitative efforts neither are indicated nor desirable in many cases.1,13

scholarly journals Experiences of the Intensive Care Unit of Hospital Raja PerempuanZainab II in handling the Massive Evacuation of Critically-Ill Patients during Flood Disaster.

2018 ◽  
Vol 2 (4) ◽  
pp. 224
Author(s):  
WI Wan Nasruddin ◽  
ZA Nor Hidayah ◽  
A Nazri ◽  
WI Wan Azzlan ◽  
I Ruwaida ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Life Support ◽  
The State ◽  
Flood Disaster ◽  
Water Levels ◽  
Tertiary Centre ◽  
Set Up

In December 2014, Malaysia had suffered nationwide floods after unprecedented monsoon rains overwhelmed several parts of the country. The East Coast areas of Malaysia were especially badly affected, specifically for the state of Kelantan, whereby a total of 170,000 victims were evacuated to the evacuation centres. This was the worst flood in the last 40 years and has been referred to by the locals as ‘Bah Kuning’. As a tertiary centre for the state of Kelantan with a total number of hospital beds of 937, HRPZ II was also badly compromised during this time. The electricity supply to the main hospital building was shut-down during this period and the hospital had managed to maintain its operations hUP_(ÛT_e power from a generator which had faced the risk of being shut down if the water levels had increased further. These issues might have caused a worse impact viaa possible loss of electrical and oxygen supply and non-functional life support systems. In relation to this flood disaster, the Anaesthesiology and Intensive Care Unit of HRPZ II would like to share the experiences of handling ventilated and critically ill-patients for evacuation during the massive floods in 2014 from the ICU of Hospital Raja Perempuan Zainab II to “an open stage with no facilities”. During this time, we had a total of 19 patients in our 21-bedded Intensive Care Unit. The challenge was the need to evacuate all the critically ill patients and to set-up a new ICU in a safer place immediately at the time.International Journal of Human and Health Sciences Vol. 02 No. 04 October’18. Page : 224-227

scholarly journals Extracorporeal Membrane Oxygenation: The First 10 Years Experience of a Portuguese Pediatric Intensive Care Unit

2021 ◽  
Vol 34 (6) ◽  
pp. 435
Author(s):  
Daniel Meireles ◽  
Francisco Abecasis ◽  
Leonor Boto ◽  
Cristina Camilo ◽  
Miguel Abecasis ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Overall Survival ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Patients ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Pediatric Intensive Care ◽  
Overall Survival Rate ◽  
Clinical Complications

Introduction: In Portugal, extracorporeal membrane oxygenation (ECMO) is used in pediatric patients since 2010. The aim of this study was to describe the clinical characteristics of patients, indications, complications and mortality associated with the use of ECMO during the first 10-years of experience in the Pediatric Intensive Care Unit located in Centro Hospitalar Universitário Lisboa Norte.Material and Methods: Retrospective observational cohort study of all patients supported with ECMO in a Pediatric Intensive Care Unit, from the 1st of May 2010 up to 31st December 2019.Results: Sixty-five patients were included: 37 neonatal (≤ 28 days of age) and 28 pediatric patients (> 28 days). In neonatal cases, congenital diaphragmatic hernia was the main reason for ECMO (40% of neonatal patients and 23% of total). Among pediatric patients, respiratory distress was the leading indication for ECMO (47% of total). The median length of ECMO support was 12 days. Clinical complications were more frequent than mechanical complications (65% vs 35%). Among clinical complications, access site bleeding was the most prevalent with 38% of cases. The overall patient survival was 68% at the time of discharge (65% for neonatal and 71% for pediatric cases), while the overall survival rate in Extracorporeal Life Support Organization registry was 61%. The number of ECMO runs has been increasing since 2011, even though in a non-linear way (three cases in 2010 to 11 cases in 2019).Discussion: In the first 10 years we received patients from all over the country. Despite continuous technological developments, circuitrelated complications have a significant impact. The overall survival rate in the Pediatric Intensive Care Unit was not inferior to the one reported by the Extracorporeal Life Support Organization.Conclusion: The overall survival of our Pediatric Intensive Care Unit is not inferior to one reported by other international centers. Our experience showed the efficacy of the ECMO technique in a Portuguese centre.

Timely Family Feedback to Guide Family Engagement in the Intensive Care Unit

2020 ◽  
Vol 40 (6) ◽  
pp. 42-51
Author(s):  
Natalie S. McAndrew ◽  
Laura Mark ◽  
Mary Butler
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Patient Care ◽  
Care Delivery ◽  
Family Engagement ◽  
Family Satisfaction ◽  
Family Experience ◽  
Improvement Project ◽  
The Family

Background Organizations motivated to provide high-quality care in the intensive care unit are exploring strategies to engage families in patient care. Such initiatives are based on emerging evidence that family engagement improves quality and safety of care. Objective To gather family feedback to guide future nurse-led quality improvement efforts to engage families in the intensive care unit setting. Methods The Critical Care Family Satisfaction Survey, which consists of 20 items rated from 1 (very dissatisfied) to 5 (very satisfied), was paired with open-ended questions and administered to families during the intensive care unit stay from March through December 2017. Content analysis was used to identify themes regarding the family experience. Results Responses were collected from 178 family members. The mean (SD) score on the survey was 4.65 (0.33). Five themes emerged regarding the delivery of family care in the intensive care unit: family interactions with the interdisciplinary team, information sharing and effective communication, family navigation of the intensive care unit environment, family engagement in the intensive care unit, and quality of patient care. Conclusions This quality improvement project provided foundational information to guide family engagement efforts in the intensive care unit. Real-time solicitation of feedback is essential to improving the family experience and guiding family-centered care delivery in this practice environment.

Sign in / Sign up

Export Citation Format

Share Document