Profile of Sepsis Patients Treated in Intensive Care Unit of Sanglah Hospital Denpasar

BACKGROUND: Primary data regarding sepsis patients in Indonesia, especially in Denpasar, are still limited in number in reporting. The lack of information about sepsis made the authors interested in conducting this study. AIM: The aim of the study was to obtain more in-depth information about the profile of sepsis patients treated in Sanglah Hospital, Denpasar. MATERIALS AND METHODS: This was a cross-sectional descriptive research. Target population in this study are data on patient registers that are included in the inclusion criteria from June 1, 2019 to June 30, 2021, at intensive care unit Sanglah Hospital, Denpasar. The variables in this study included: Demographic conditions such as age, gender, and address, qSOFA score, comorbidities, ventilator, and patient’s outcome (survival or non-survival). RESULTS: A total samples were 173 patients. The average age of patients in this study was 54 years old with 56.6% male and 32.9% lived in Denpasar. Patients suspected of having early sepsis had a qSOFA 0 score of 35.3%, qSOFA 1 was 33.5%, qSOFA 2 was 23.7%, and qSOFA 3 was 7.5%. Patients with sepsis and suspected sepsis with comorbidities were 96% and 79.8% of patients were on a ventilator. The mortality rate in this study was 67.1%. CONCLUSION: These primary data hopefully become references for the future research.

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Sepsis Criteria and Revision in Toxicological Intensive Care Unit

International Journal of Medical Toxicology and Forensic Medicine ◽

10.32598/ijmtfm.v10i4.31452 ◽

2020 ◽

Vol 10 (4) ◽

pp. 31452.1-31452.10

Author(s):

Haleh Talaie ◽

◽

Maryam Nazari ◽

Habib Emami ◽

◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Blood Culture ◽

Positive Blood Culture ◽

Coagulase Negative Staphylococci ◽

International Consensus ◽

Suspected Sepsis ◽

Cross Sectional ◽

Arterial Blood ◽

Study Results

Background: Sepsis is one of the significant causes of mortality in hospitalized patients. This cross-sectional study was performed to determine the frequency of positive blood culture and assess sepsis criteria based on Third International Consensus Definitions (related to Sequential Organ Failure Assessment score) and clinical and paraclinical findings (i.e., on-admission leukocytosis, increased lactate level, and fever) in poisoned patients admitted to the Toxicological Intensive Care Unit (TICU). Methods: Medical records of a total of 2000 poisoned patients admitted to the TICU of Loghman Hakim Hospital from 2016 to 2018 were assessed. Among them, 189 cases (9.45%) with suspected sepsis were considered eligible to be enrolled in the study. Results: Of 189 cases, 146 (77.24%) had possible signs and symptoms of sepsis as well as SOFA score higher than two with positive blood culture in 81 cases (55%). The Mean±SD serum level of lactate was 25.97±16.32 on admission. The most common pathogen detected in blood culture was coagulase-negative Staphylococci in 35 (24.0%) out of 146 cases. Glasgow Coma Scale (GCS) less than 12, age older than 50 years, and bilirubin more than 1.2 mg/dL were found as independent predictors of sepsis on multivariate analysis. Conclusion: Based on our findings, it is proposed that the sepsis definition should not be restricted to the guidelines. The patients’ poisoning background and presence of many confounding factors, including poisoning-induced on-admission increased lactate levels, leukocytosis, and disturbed arterial blood gas provide a critical decision-making situation to confirm sepsis according to guidelines.

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FREQUENCY OF GUILLIAN-BARRE SYNDROME AND ITS VARIANTS AT MILITARY HOSPITAL RAWALPINDI

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i2.2784 ◽

2021 ◽

Vol 71 (2) ◽

pp. 377-81

Author(s):

Marriam Hussain Awan ◽

Imran Fazal ◽

Muhammad Wajahat Alam Lodhi ◽

Ayesha Anwer ◽

Rimsha Azhar ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Tertiary Care ◽

Final Analysis ◽

Target Population ◽

Neurological Complications ◽

Motor Deficit ◽

Military Hospital ◽

Limb Weakness ◽

Cross Sectional

Objective: To assess the frequency, variants, clinical profile and outcome of patients admitted with the diagnosis of GuillianBarre Syndrome at neurology unit of a tertiary care teaching hospital of Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Neurology department, Pak Emirates Military Hospital Rawalpindi, from Jan to Dec 2018. Methodology: This study was conducted on 42 patients of Guillian-Barre Syndrome admitted in hospital. Demographic profile included age, gender, and the symptoms with which the patient presented. Medical and neurological complications were also documented among the target population. Outcomes included recovery, shifting to intensive care unit and death. Results: Out of 42 patients included in the final analysis 25 were male and 17 were female. Most of the patients presented with lower limb weakness followed by numbness. Acute inflammatory demyelinating polyneuropathy was the commonest while cranial nerve variant was least reported. Motor deficit were the commonest complication faced by the patients followed by respiratory involvement. Out of 42 patients, 34 (80.9%) recovered, 4 (9.5%) were shifted to the intensive care unit and 4 (9.5%) died. Conclusion: This study gives an insight into the pattern of a fairly common neurological illness which if diagnosed and managed in time has a good outcome in our set up. Management of critically ill Guillian-Barre Syndrome patients involves a multidisciplinary team with a need of intensive care unit during the course of management. Variety of types and presentations should be part of training of neurology doctors as well as internal medicine doctors.

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Role of Sildenafil in the Treatment of Persistent Pulmonary Hypertension of Newborn (PPHN) - Should it Be Withdrawn from Market of Bangladesh due to Threat of being Misuses

Dhaka Shishu (Children) Hospital Journal ◽

10.3329/dshj.v35i2.49688 ◽

2020 ◽

Vol 35 (2) ◽

pp. 100-104

Author(s):

Maksudur Rahman ◽

Mohammad Abdullah Al Mamun ◽

MAK Azad Chowdhury ◽

Abu Sayeed Munsi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cardiac Intensive Care Unit ◽

Cross Sectional ◽

Cardiac Intensive Care ◽

Hospital Protocol

Background: Recently it has been apprehended that sildenafil, a drug which has been successfully using in the treatment of PPHN and erectile dysfunction in adult, is going to be withdrawn from the market of Bangladesh due to threat of its misuses. Objective: The aim of this study was to see the extent of uses of sildenafil in the treatment of PPHN and importance of availability of this drugs in the market inspite of its probable misuses. Methods: This cross sectional study was conducted in neonatal intensive care unit (NICU), special baby care unit (SCABU) and cardiac intensive care unit (CICU) of Dhaka Shishu (Children) Hospital from June, 2017 to May 2018. Neonates with PPHN were enrolled in the study. All cases were treated with oral sildenefil for PPHN along with others management according to hospital protocol. Data along with other parameters were collected and analyzed. Results: Total 320 patients with suspected PPHN were admitted during the study period. Among them 92 (29%) cases had PPHN. Male were 49(53 %) cases and female were 43(47%) cases. Mean age at hospital admission was 29.7±13.4 hours. Based on echocardiography,13(14%) cases had mild, 38 (41%) cases moderate and 41(45%) cases severe PPHN. Mean duration of sildenafil therapy was 11.9±7.1 days. Improved from PPHN were 83 (90%) cases. Mortality was 10% (9). Conclusion: In this study it was found that the incidence of PPHN is 29% among the suspected newborns. Sildenafil is successfull in improving the oxygenation of PPHN and to decrease the mortality of neonates. DS (Child) H J 2019; 35(2) : 100-104

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Assessment of knowledge about oral cancer: study with students of public education

RSBO ◽

10.21726/rsbo.v12i1.172 ◽

2016 ◽

Vol 12 (1) ◽

pp. 41 ◽

Cited By ~ 1

Author(s):

Elisabete Rabaldo Bottan ◽

Iara Fiorentin Comunello ◽

Constanza Marín ◽

Eduardo Mazzetti Subtil

Keyword(s):

Public Schools ◽

Oral Cancer ◽

Target Population ◽

Cross Sectional Study ◽

Primary Data ◽

First Year ◽

Research Subjects ◽

Cross Sectional ◽

Adequate Knowledge ◽

Level Of Knowledge

Introduction and Objective: To evaluate the level of knowledge about oral cancer of students attending public school in one city of Santa Catarina (Brasil). Material and methods: A descriptive cross-sectional study, using primary data collection. Students of last year of elementary school and first year of high school, enrolled in public schools in the city of Itajaí (SC), in 2012, were the target population. The non-probability sample was obtained by convenience. Data were collected through a self-administered questionnaire structured with 13 questions divided into three fields. The level of knowledge was made based on pre-established scores. Results: 1149 instruments were analyzed (80.8% of the target population). The average age of the group was 15.5 years and 54.5% were female. The majority (78%) never had received information about oral cancer. Only 27.9% had cognizance about self-examination of the oral cavity. With regard to knowledge, 87.5% classified as unsatisfactory. For most issues the cognitive field did not identify a significant correlation between knowledge and the variables gender and education. When asked if they would like to participate in educational and preventive activitiesabout oral cancer and other issues related to health, 72.6% expressed interest. Conclusion: The group did not have adequate knowledge on the subject of oral cancer. Facing this reality, and the positive attitude of respondents, the researchers designed and offered an educational program to the research subjects.

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Impact of sound levels and patient-related factors on sleep of patients in the intensive care unit: a cross-sectional cohort study

Scientific Reports ◽

10.1038/s41598-020-76314-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Piotr F. Czempik ◽

Agnieszka Jarosińska ◽

Krystyna Machlowska ◽

Michał P. Pluta

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Sleep Quality ◽

Sleep Duration ◽

Smartphone Application ◽

Sound Level ◽

Related Factors ◽

Cross Sectional ◽

Sound Levels ◽

The Impact

Abstract Sleep disruption is common in patients in the intensive care unit (ICU). The aim of the study was to measure sound levels during sleep-protected time in the ICU, determine sources of sound, assess the impact of sound levels and patient-related factors on duration and quality of patients' sleep. The study was performed between 2018 and 2019. A commercially available smartphone application was used to measure ambient sound levels. Sleep duration was measured using the Patient's Sleep Behaviour Observational Tool. Sleep quality was assessed using the Richards-Campbell Sleep Questionnaire (RCSQ). The study population comprised 18 (58%) men and 13 (42%) women. There were numerous sources of sound. The median duration of sleep was 5 (IQR 3.5–5.7) hours. The median score on the RCSQ was 49 (IQR 28–71) out of 100 points. Sound levels were negatively correlated with sleep duration. The cut-off peak sound level, above which sleep duration was shorter than mean sleep duration in the cohort, was 57.9 dB. Simple smartphone applications can be useful to estimate sound levels in the ICU. There are numerous sources of sound in the ICU. Individual units should identify and eliminate their own sources of sound. Sources of sound producing peak sound levels above 57.9 dB may lead to shorter sleep and should be eliminated from the ICU environment. The sound levels had no effect on sleep quality.

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Comparison between near miss criteria in a maternal intensive care unit

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2017038703404 ◽

2018 ◽

Vol 52 (0) ◽

Author(s):

Alana Santos Monte ◽

Liana Mara Rocha Teles ◽

Mônica Oliveira Batista Oriá ◽

Francisco Herlânio Costa Carvalho ◽

Helen Brown ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Maternal Death ◽

High Sensitivity ◽

High Specificity ◽

Near Miss ◽

World Health ◽

Maternal Near Miss ◽

Chi Square ◽

Cross Sectional

ABSTRACT Objective: The aim of this study was to compare the incidence of different criteria of maternal near miss in women admitted to an obstetric intensive care unit and their sensitivity and specificity in identifying cases that have evolved to morbidity. Method: A cross-sectional analytical epidemiological study was conducted with women admitted to the intensive care unit of the Maternity School Assis Chateaubriand in Ceará, Brazil. The Chi-square test and odds ratio were used. Results: 560 records were analyzed. The incidence of maternal near miss ranged from 20.7 in the Waterstone criteria to 12.4 in the Geller criteria. The maternal near-miss mortality ratio varied from 4.6:1 to 7.1:1, showing better index in the Waterstone criteria, which encompasses a greater spectrum of severity. The Geller and Mantel criteria, however, presented high sensitivity and low specificity. Except for the Waterstone criteria, there was an association between the three other criteria and maternal death. Conclusion: The high specificity of Geller and Mantel criteria in identifying maternal near miss considering the World Health Organization criteria as a gold standard and a lack of association between the criteria of Waterstone with maternal death.

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Level and Noise Sources in the Neonatal Intensive Care Unit of a Reference Hospital

Investigación y Educación en Enfermería ◽

10.17533/udea.iee.v38n3e13 ◽

2020 ◽

Vol 38 (3) ◽

Author(s):

Alma Damaris Hernández-Salazar ◽

Josefina Gallegos-Martínez ◽

Jaime Reyes-Hernández

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Neonatal Intensive Care Unit ◽

Neonatal Intensive Care ◽

Environmental Noise ◽

Sound Level ◽

Noise Sources ◽

Cross Sectional ◽

Reference Hospital ◽

And Shifts

Objective. Determine the level of environmental and periauricular noise in preterm babies and identify the sources generating noise in the Neonatal Intensive Care Unit -NICU- of a reference hospital in San Luis Potosí, Mexico. Methods. Cross-sectional and analytic study of the measurement of the level of environmental noise in five critical areas of the NICU, according with the method of measurement of noise from fixed sources by the Mexican Official Norm and periauricular at 20 cm from the preterm patient’s pinna. The measurements were carried out during three representative days of a week,morning, evening and nocturnal shifts. A STEREN 400 sound level meter was used with 30 to 130 dB range of measurement and a rate of 0.5 s. Results. The average level of periauricular noise (64.5±1.91dB) was higher than the environmental noise (63.3±1.74 dB) during the days and shifts evaluated. The principal noise sources were activities carried out by the staff, like the nursing change of shift and conversations by the staff, which raised the level continuously or intermittently, operation of vital support equipment (alarms) and incidences (clashing of baby bottles and moving furnishings) producedsudden rises of noise. Conclusions. Environmental and periauricular noise in NICU exceeds by two and almost three times the 45 dB during the day and 35 dB at night from the norm in hospitals. It is necessary to implement permanent noise reduction programs to prevent sequelae in the preterm infant and professional burnout in the nursing staff.

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Changes in muscle ultrasound for the diagnosis of intensive care unit acquired weakness in critically ill patients

Scientific Reports ◽

10.1038/s41598-021-97680-y ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Weiqing Zhang ◽

Jun Wu ◽

Qiuying Gu ◽

Yanting Gu ◽

Yujin Zhao ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Diagnostic Accuracy ◽

Biceps Brachii ◽

Rectus Femoris ◽

Apache Ii ◽

Cross Sectional ◽

Icu Admission ◽

The Right ◽

Muscle Ultrasound

AbstractTo test diagnostic accuracy of changes in thickness (TH) and cross-sectional area (CSA) of muscle ultrasound for diagnosis of intensive care unit acquired weakness (ICU-AW). Fully conscious patients were subjected to muscle ultrasonography including measuring the changes in TH and CSA of biceps brachii (BB) muscle, vastus intermedius (VI) muscle, and rectus femoris (RF) muscles over time. 37 patients underwent muscle ultrasonography on admission day, day 4, day 7, and day 10 after ICU admission, Among them, 24 were found to have ICW-AW. Changes in muscle TH and CSA of RF muscle on the right side showed remarkably higher ROC-AUC and the range was from 0.734 to 0.888. Changes in the TH of VI muscle had fair ROC-AUC values which were 0.785 on the left side and 0.779 on the right side on the 10th day after ICU admission. Additionally, Sequential Organ Failure Assessment (SOFA), Acute Physiology, and Chronic Health Evaluation II (APACHE II) scores also showed good discriminative power on the day of admission (ROC-AUC 0.886 and 0.767, respectively). Ultrasonography of changes in muscles, especially in the TH of VI muscle on both sides and CSA of RF muscle on the right side, presented good diagnostic accuracy. However, SOFA and APACHE II scores are better options for early ICU-AW prediction due to their simplicity and time efficiency.

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Nosocomial infections in a pediatric surgical intensive care unit: An unicentric cross-sectional study

Medicinski pregled ◽

10.2298/mpns2104112p ◽

2021 ◽

Vol 74 (3-4) ◽

pp. 112-116

Author(s):

Marina Pandurov ◽

Izabella Fabri-Galambos ◽

Andjela Opancina ◽

Anna Uram-Benka ◽

Goran Rakic ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Nosocomial Infections ◽

Hospital Length Of Stay ◽

Surgical Intensive Care Unit ◽

Negative Consequences ◽

Surgical Intensive Care ◽

Acinetobacter Baumanii ◽

Cross Sectional ◽

The Impact

Introduction. Nosocomial infections are a common complication in patients hospitalized in intensive care units. The aims of this research were to examine the incidence of nosocomial infections in patients admitted to the pediatric surgical intensive care unit, the impact of hospital length of stay and type of surgical disease on the incidence of nosocomial infections, the frequency of microorganisms causing nosocomial infections and their antibiotic susceptibility profile. Material and Methods. Data on 50 subjects were extracted from the database. The following data were taken from the medical histories of the examinees: age, sex, diagnosis, number of days at the hospital before admission to the intensive care unit, number of days in the intensive care unit, levels of C-reactive protein, applied antimicrobial drugs, isolated microorganisms and their susceptibility to antibiotics. Results. The incidence of nosocomial infections in the study period was 52%. Patients who developed nosocomial infection remained longer in the intensive care unit than those who did not develop it (p = 0.003). Patients with the diagnosis of acute abdomen had a statistically significantly higher incidence of nosocomial infections compared to other patients (p = 0.001). Gram-negative bacteria were the most commonly isolated pathogens (46.8%). Acinetobacter baumanii proved to be the most resistant species in this study, since 80% of the strains did not show sensitivity to any of the tested antibiotics. Conclusion. Nosocomial infections are present in slightly more than half of the patients treated at the pediatric surgical intensive care unit. Patients who developed nosocomial infections stayed longer in the pediatric surgical intensive care unit, which had negative consequences for their health and treatment costs.

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