Measuring Height in Recumbent Critical Care Patients

2015 ◽  
Vol 24 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Diane M. Dennis ◽  
Emily E. Hunt ◽  
Charley A. Budgeon
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Gold Standard ◽  
Ventilatory Support ◽  
Whole Body ◽  
Standing Height ◽  
Preadmission Clinic ◽  
Practice Methods ◽  
Critical Care Patients

Background Estimates of the height of patients in the intensive care unit are required to adhere to clinical guidelines for drug dosages, ventilatory support, and nutrition. The gold standard of standing height cannot be used because these patients are often unconscious and recumbent. The ability of physiotherapists or dietitians to measure height in unconscious, recumbent patients has not been evaluated. Objectives To compare the accuracy of physicians, physiotherapists, and dietitians in estimating the height of recumbent critical care patients by using existing practice methods. Methods A total of 35 patients were recruited from the cardiothoracic preadmission clinic, where standing height is routinely measured by a physiotherapist. After surgery, in the intensive care unit, 1 physician, 2 physiotherapists, and 2 dietitians measured each recumbent patient’s height. Three methods were used: observation, whole-body measurement, and height estimated by using length of the forearm and the British Association for Parenteral and Enteral Nutrition normative chart. Difference from standing height was measured from zero and was compared across professions and methods, with zero indicating no difference. Results Overall, 17 physicians, 4 dietitians, and 9 physiotherapists consented to measure patients. After adjustments for method, measurements by physiotherapists did not differ significantly from the gold standard (P = .59), whereas those of physicians (P = .02) and dietitians (P < .001) did. Conclusions Physiotherapists’ measurements of supine height of recumbent critical care patients, obtained by using a nonrigid measuring tape, are more accurate than measurements obtained by physicians and dietitians.

scholarly journals Venous Thromboembolism in Intensive Care Unit

1970 ◽  
Vol 5 (2) ◽  
pp. 84-88 ◽  
Author(s):  
RJ Tamanna
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Preventive Measures ◽  
Common Complication ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
The Past ◽  
Deep Vein ◽  
Critical Care Patients

Venous thromoboembolism (VTE) represents a spectrum of disease which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), a common complication in critically ill patients. VTE is difficult to diagnose, expensive to treat and occasionally lethal despite therapy. Therefore preventive measures are paramount. DVT and PE contribute significantly to morbidity and mortality associated with critical illness. But VTE remains an underestimated problem in ICU patients, despite the findings of many randomized controlled trials performed in the fields of DVT prophylaxis during the past few decades This article reviews the risk of VTE in critical care patients, thromboprophylaxis and suggests strategies to reduce the burden of thrombo-embloic disease in critical care unit. Key words: Venous thromoboembolism; Intensive Care Unit. DOI: 10.3329/uhj.v5i2.4562 University Heart Journal Vol.5(2) July 2009 pp.84-88

scholarly journals DYSNATREMIAS;

2017 ◽  
Vol 24 (07) ◽  
pp. 1076-1080
Author(s):  
Riffat Omer ◽  
Muhammad Khalid Masood ◽  
Saima Asghar ◽  
Muhammad Jawad ◽  
Amir Afzal ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Serum Sodium ◽  
Prospective Observational Study ◽  
Pediatric Intensive Care ◽  
Pediatric Critical Care ◽  
Life Threatening ◽  
Study Setting ◽  
Critical Care Patients

Dysnatremias (hyponatremia and hypernatremia) are common electrolytedisorders encountered in pediatric critical care patients. The spectrum of both hypo- andhypernatremia varies from mild to severe, being life threatening occasionally. We carried outa study to determine the etiology, epidemiology and effect of dysnatremias on outcomes ofpediatric critical care patients. Objectives: To determine the etiology, epidemiology and effectof dysnatremias on outcomes of pediatric critical care patients. Study Design: Prospective,observational study. Setting: Paediatric Intensive Care Unit (PICU) Services Hospital Lahore.Period: October 2014 to March 2015. Results: 185 patients were included. 19 (10.3%) patientshad hyponatremia and 22 (11.9%) patients had hypernatremia. A weak but significant inverserelationship between presentation serum sodium and mortality was observed (r = - 0.39,n=185, p= <0.001, two-tailed). Conclusions: Presentation serum sodium may influence theoutcomes of the patients admitted to the pediatric intensive care unit.

Troponin in critical care patients and outcomes

2020 ◽  
Vol 81 (5) ◽  
pp. 1-8
Author(s):  
Elizabeth M Cole ◽  
Annemarie B Docherty
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Intensive Care Unit ◽  
At Risk ◽  
Critical Care ◽  
Intensive Care ◽  
Oxygen Supply ◽  
Critical Care Patients ◽  
Overall Mortality

Myocardial infarction is common in the critically unwell population with pre-existing cardiovascular disease and is associated with a greater overall mortality. This article explores guidelines for diagnosing myocardial infarction, and research into the use of troponin as both a diagnostic and prognostic tool. Currently, the majority of patients in the intensive care unit with acute myocardial infarction go unrecognised. The underlying cause is predominantly oxygen supply–demand imbalance, therefore identifying those at risk is important as there is the potential to modify elements of their care and reduce their overall mortality.

scholarly journals Development and Evaluation of a Guideline for Monitoring Propylene Glycol Toxicity in Pediatric Intensive Care Unit Patients Receiving Continuous Infusion Lorazepam

2015 ◽  
Vol 20 (5) ◽  
pp. 367-372
Author(s):  
Lizbeth Hansen ◽  
Rebecca Lange ◽  
Sameer Gupta
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Continuous Infusion ◽  
Propylene Glycol ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Pediatric Critical Care ◽  
Clinical Toxicity ◽  
Critical Care Patients

OBJECTIVES: To develop and determine the safety of a guideline, by using osmol gap as an indicator of propylene glycol toxicity for pediatric patients receiving continuous infusion lorazepam. METHODS: From existing adult data, a guideline was developed for the use of continuous infusion lorazepam in pediatric critical care patients with recommendations for using osmol gap as an indicator of propylene glycol toxicity. A retrospective medical chart review was performed of patients receiving continuous infusion lorazepam from February 2012 to September 2012 for whom the guideline was used. RESULTS: Twenty-one patients received continuous infusion lorazepam for sedation in the pediatric intensive care unit during the 9-month study period for a total of 23 infusions. Eight patients (34.8%) had an osmol gap of ≥ 12 mOsm/kg during lorazepam infusion, and 7 patients (30.4%) did not have an elevated osmol gap at any point during the infusion. Two patients (8.6%) had clinical toxicity as indicated by elevated anion gap or lactate in addition to an osmol gap ≥ 12 mOsm/kg, while no patients experienced clinical toxicity with an osmol gap &lt; 12 mOsm/kg. CONCLUSIONS: A guideline for the use of lorazepam infusion in pediatric critical care patients was developed and evaluated for safety. Lorazepam continuous infusions appeared to be associated with minimal toxicity in pediatric intensive care unit patients when the osmol gap monitoring guideline was used.

Complex Oncologic Surgeries and Implications for the Intensive Care Unit Nurse

2021 ◽  
Vol 32 (3) ◽  
pp. 297-305
Author(s):  
Michele L. Weber ◽  
Roberta Kaplow
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Length Of Stay ◽  
Patient Population ◽  
Ventilatory Support ◽  
Critical Care Nurses ◽  
Intensive Care Unit Care ◽  
Intensive Care Unit Nurse ◽  
Mechanical Ventilatory Support

There are many challenges in caring for the postsurgical patient in the intensive care unit. When the postsurgical patient has an active malignancy, this can make the intensive care unit care more challenging. Nutrition, infection, and the need for postoperative mechanical ventilatory support for the patient with cancer present challenges that may increase the patient’s length of stay in the intensive care unit. Critical care nurses must be aware of these challenges as they provide care to this patient population.

Predictors of Pressure Ulcers in Adult Critical Care Patients

2011 ◽  
Vol 20 (5) ◽  
pp. 364-375 ◽  
Author(s):  
Jill Cox
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Length Of Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pressure Ulcers ◽  
Critical Care Patients

BackgroundPressure ulcers are one of the most underrated conditions in critically ill patients. Despite the introduction of clinical practice guidelines and advances in medical technology, the prevalence of pressure ulcers in hospitalized patients continues to escalate. Currently, consensus is lacking on the most important risk factors for pressure ulcers in critically ill patients, and no risk assessment scale exclusively for pressure ulcers in these patients is available.ObjectiveTo determine which risk factors are most predictive of pressure ulcers in adult critical care patients. Risk factors investigated included total score on the Braden Scale, mobility, activity, sensory perception, moisture, friction/shear, nutrition, age, blood pressure, length of stay in the intensive care unit, score on the Acute Physiology and Chronic Health Evaluation II, vasopressor administration, and comorbid conditions.MethodsA retrospective, correlational design was used to examine 347 patients admitted to a medical-surgical intensive care unit from October 2008 through May 2009.ResultsAccording to direct logistic regression analyses, age, length of stay, mobility, friction/shear, norepinephrine infusion, and cardiovascular disease explained a major part of the variance in pressure ulcers.ConclusionCurrent risk assessment scales for development of pressure ulcers may not include risk factors common in critically ill adults. Development of a risk assessment model for pressure ulcers in these patients is warranted and could be the foundation for development of a risk assessment tool.

The Going Home Initiative: Getting Critical Care Patients Home With Hospice

2011 ◽  
Vol 31 (5) ◽  
pp. 46-57 ◽  
Author(s):  
Paula Lusardi ◽  
Paul Jodka ◽  
Mark Stambovsky ◽  
Beth Stadnicki ◽  
Betty Babb ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Critical Care ◽  
Intensive Care ◽  
Hospice Care ◽  
Good Death ◽  
Small Scale ◽  
Considerable Effort ◽  
The Past ◽  
Critical Care Patients

Although considerable effort is being directed at providing patients and their families with a “good death,” most patients in intensive care units, if given the choice, would prefer to die at home. With little guidance from the literature, the palliative care committee of an intensive care unit developed guidelines to get patients home from the intensive care unit to die. In the past few years, the unit has transferred many patients home with hospice care, much to the delight of their families. Although several obstacles to achieving this goal exist, the unit has achieved success in a small-scale implementation of its Going Home Initiative.

scholarly journals Top 10 publications of Intensive Care Medicine journal 2020

2020 ◽  
Vol 5 (4) ◽  
pp. 89-96
Author(s):  
Е. V. Grigoriev ◽  
O. N. Ivanova ◽  
V. V. Krasnov ◽  
V. V. Zhdanov
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Ventilatory Support ◽  
Kidney Injury ◽  
Multiple Organ ◽  
Evidence Based ◽  
Medicine Journal ◽  
Number Of Patients ◽  
Evidence Based Guidelines ◽  
Critical Care Patients

COVID-19 pandemic provoked an increasing interest in recent advances in diagnosis and treatment of critical care patients. Among the main problems are the lack of evidence-based guidelines and a growing number of patients with multiple organ dysfunction syndrome. Therefore, indications for the use of previously uncommon intensive care approaches are expanding. These reasons, along with a large pool of non-systematic literature, dictate the need in the narrative review of top 10 recent publications which provide a snapshot of the most relevant research in critical care. These papers overview evidence-based information on the control of acute kidney injury, ventilator-associated pneumonia and sepsis in critically ill patients including those with COVID-19, principles of proper haemodynamic and ventilatory support, timely cessation of antimicrobial therapy, efficient prevention of gastrointestinal bleeding, and the use of the prone position in patients with acute respiratory distress syndrome.

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