scholarly journals Characteristics and outcome of tertiary care critically ill COVID-19 patients with multiple comorbidities admitted to the intensive care unit

2022 ◽  
Vol 17 (1) ◽  
pp. 59
Author(s):  
Imran Khalid ◽  
AbeerN Alshukairi ◽  
TabindehJabeen Khalid ◽  
Maryam Imran ◽  
Manahil Imran ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Tertiary Care

scholarly journals A study on symptoms of children mechanically ventilated in a paediatric intensive care unit of a minimum resource setting in tertiary care centre

2019 ◽  
Vol 6 (2) ◽  
pp. 574
Author(s):  
Korisipati Ankireddy ◽  
Aruna Jyothi K.
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Critically Ill ◽  
Tertiary Care ◽  
Limited Resource ◽  
Critically Ill Children ◽  
Invasive Ventilation ◽  
Ventilator Support ◽  
Mechanically Ventilated

Background: Mechanical ventilation, a lifesaving intervention in a critical care unit is under continuous evolution in modern era. Despite this, the management of children with invasive ventilation in developing countries with limited resources is challenging. The study analyses the clinical profile, indications, complications and duration of ventilator care in limited resource settings. Methods: A retrospective study of critically ill children mechanically ventilated in an intensive care unit of a tertiary care government hospital.   Results: A total of 120 children required invasive ventilation during the study period of 1 year. Infants constituted the majority (70%), and males (65%) were marginally more than female children (35%). Respiratory failure was the most common indication for invasive ventilation (55%). The major underlying etiology for invasive ventilation was bronchopneumonia associated with septic shock (30%); and the same also required a prolonged duration of ventilation of >72 hours (35%). Prolonged ventilator support of >72 hours predisposed to more complications as well as a prolonged hospital stay of >2 weeks and above, which was statistically significant. Upper lobe atelectasis (50%) and ventilator associated pneumonia (25%) were the major complications. The mortality rate of present study population was 40% as opposed to the overall mortality of 10%.   Conclusions: Present study highlights that critically ill children can be managed with mechanical ventilation even in limited resource settings. The child should be assessed clinically regarding the tolerance to extubation every day, to minimise the complications associated with prolonged ventilator support.

scholarly journals Characteristics and Outcomes of Critically Ill Patients with Raised Cardiac Troponins Admitted in the Intensive Care Unit

2021 ◽  
Author(s):  
Sunil K. Nadar ◽  
Muhammad M. Shaikh ◽  
Muhammad A. Khatri ◽  
Wael A. Abdelmottaleb ◽  
Sheeraz Ahmed ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Myocardial Injury ◽  
Tertiary Care ◽  
Hospital Length Of Stay ◽  
Care Hospital ◽  
Coronary Syndrome

Objectives: Critically ill patients have been shown to have raised troponins.  The aim of our study was to assess the incidence of myocardial injury in the intensive care unit (ICU) a tertiary care hospital in Oman and assess their management and prognosis. Methods: This was a retrospective study involving adult patients admitted to the ICU of our institution between 1st January and 31st December 2019 who had a high sensitive cardiac troponin (Hs-CTn) assay performed. We excluded patients who were admitted with a primary diagnosis of myocardial infarction. Results: A total of 264 patients had a Hs-cTn measured during this period. Of these 128 patients (64.3+17.1 years; 58.5% male) had elevated levels giving an incidence of around 48.4%. Those with raised troponin were older and had more co-morbidities. These patients were also more critical with lower blood pressure, higher heart rates, hypotensive episodes. Of the 128 patients, 47 were treated as acute coronary syndrome and 32 underwent coronary angiography. Of these only 3 patients required stenting. Patients with raised troponin had a poor outcome with only 45 (35.1%) surviving to discharge as compared to 73.5% where troponin was normal. They had a shorter hospital length of stay as compared to those with normal troponin (16(8-25) vs 19(13-28) p=0.017). Conclusion: A high proportion of critically ill patients have evidence of myocardial injury without significant coronary artery disease. It is associated with poor prognosis. Further prospective studies are required to ascertain the best mode of treatment in these patients. Keywords: Troponin; Biomarkers; Intensive Care; Myocardial Infarction.

Study of incidence of acute renal failure and its associated factors and complications amongst patients admitted in intensive care unit of a tertiary care teaching hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 108-111
Author(s):  
Rameshwar A Warkad ◽  
Keyword(s):  
Intensive Care Unit ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Critically Ill ◽  
Teaching Hospital ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Tertiary Care Teaching Hospital

Background: Impairment of renal function is a serious complication in critically ill patients. Mortality of acute renal failure remains high ranging from 35% to 86% despite haemodialysis therapy and substantial improvement of dialysis techniques. Therefore attention must be paid to the conditions favouring deterioration of renal function in order to prevent acute renal failure or to intervene in an early phase when less invasive therapies might be even more promising. Methods: This prospective study was conducted in a tertiary care teaching hospital in Mumbai from 1st January 2006 to 31st December 2006. All patients consecutively admitted in intensive care unit were studied. Results: Total number of patients admitted during the said period to the Intensive care Unit was 406, of which 50 had evidence of acute renal failure. The incidence of acute renal failure in the critically ill patients included in our study was 12.31%. There was a statistically significant difference in the incidence of fluid overload, oliguria and hyperkalemia between the pre-renal and renal failure groups. Conclusion: The incidence of acute renal failure in the critically ill patients was 12.31% and commonest predisposing factors associated with acute renal failure were acute insults like hypotension, sepsis and risk factors like age >50 years and pre-existing renal disease.

Mobilization Therapy in the Pediatric Intensive Care Unit: A Multidisciplinary Quality Improvement Initiative

2018 ◽  
Vol 27 (3) ◽  
pp. 194-203 ◽  
Author(s):  
Blair R. L. Colwell ◽  
Cydni N. Williams ◽  
Serena P. Kelly ◽  
Laura M. Ibsen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Critically Ill ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Severity Of Illness ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Improvement Project

Background Mobilization is safe and associated with improved outcomes in critically ill adults, but little is known about mobilization of critically ill children. Objective To implement a standardized mobilization therapy protocol in a pediatric intensive care unit and improve mobilization of patients. Methods A goal-directed mobilization protocol was instituted as a quality improvement project in a 20-bed cardiac and medical-surgical pediatric intensive care unit within an academic tertiary care center. The mobilization goal was based on age and severity of illness. Data on severity of illness, ordered activity limitations, baseline functioning, mobilization level, complications of mobilization, and mobilization barriers were collected. Goal mobilization was defined as a ratio of mobilization level to severity of illness of 1 or greater. Results In 9 months, 567 patient encounters were analyzed, 294 (52%) of which achieved goal mobilization. The mean ratio of mobilization level to severity of illness improved slightly but nonsignificantly. Encounters that met mobilization goals were in younger (P = .04) and more ill (P < .001) patients and were less likely to have barriers (P < .001) than encounters not meeting the goals. Complication rate was 2.5%, with no difference between groups (P = .18). No serious adverse events occurred. Conclusions A multidisciplinary, multiprofessional, goal-directed mobilization protocol achieved goal mobilization in more than 50% of patients in this pediatric intensive care unit. Undermobilized patients were older, less ill, and more likely to have mobilization barriers at the patient and provider level.

Morbidity Pattern and Outcome of Patients Admitted into a Pediatric Intensive Care Unit in India

2014 ◽  
Vol 5 ◽  
pp. IJCM.S13902 ◽  
Author(s):  
Blessing I. Abhulimhen-Iyoha ◽  
Suneel Kumar Pooboni ◽  
Nanda Kishore Kumar Vuppali
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Pediatric Intensive Care Unit ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Common Disease ◽  
Duration Of Stay ◽  
Desirable Outcome

Background Intensive care has become very important in the management of critically ill children who require advanced airway, respiratory, and hemodynamic supports and are usually admitted into the pediatric intensive care unit (PICU) with the aim of achieving an outcome better than if the patients were admitted into other parts of the hospital. It becomes important to audit admissions and their outcome, which may help to modify practices if necessary following thorough introspection, leading to better patient outcomes. Objective To evaluate the morbidity pattern and outcome of admissions into the PICU of a tertiary care center in India. Methods A retrospective study in which records of admissions (from August 2012 to June 2013) were obtained from the PICU records. Information retrieved included age, sex, diagnosis, duration of stay in the unit, and outcome. Results Mean age of the studied 341 patients was 40.01 ± 45.79 months; 50.7% were infants and 59.8% were males. The three most common disease categories admitted were cardiovascular disease (41.1%), neurological disorders (12.0%), and respiratory disease (10.0%). The mean duration of stay in PICU was 3.2 ± 4.5 days. The overall mortality rate was 2.1%. Conclusion Mortality is low in our PICU. We conclude that a well-equipped intensive care unit with modern and innovative intensive care greatly facilitates the care of critically ill patients giving desirable outcome. An expansion of the pediatric wards is advocated to enhance cost–-effective management of patients and avoid unnecessary stretch of the PICU facilities.

scholarly journals Demographic and clinical profile with early outcome of critically ill COVID-19 patients admitted in an ICU of a tertiary care hospital in Dhaka, Bangladesh

2020 ◽  
pp. 51-55
Author(s):  
ASM Areef Ahsan ◽  
Rozina Sultana ◽  
Kaniz Fatema ◽  
Fatema Ahmed ◽  
Debasish Kumar Saha ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Rt Pcr ◽  
Demographic Profile ◽  
Icu Stay ◽  
Length Of Icu Stay

Background: First outbreak of corona virus disease (COVID-19) started in Wuhan, China at December 2019 and since then, it spread globally but information about critically ill patients with COVID-19 is still limited. So, it is important to know the demographic profile and overall outcome of COVID-19 patients. We aimed to describe the clinic-demographic characteristics and outcome of critically ill COVID-19 patients admitted in our intensive care unit. Methods: This prospective observational study was carried out in the intensive care unit of department of Critical Care Medicine of BIRDEM General Hospital, Dhaka, Bangladesh from 11th June to 31st October, 2020. Out of 382 suspected cases, 86 patients were found to be RT-PCR for COVID-19 positive and were included in this study. After admission in ICU, all patients were resuscitated according to ICU protocol. Length of ICU stay were recorded and patient outcomes were mentioned as survival (transferred or discharged) or death. Results: A total of 86 patients (male 53, female 33, mean age 63.6 ± 12.8 years) with RT-PCR for COVID-19 positive were enrolled in this study. Regarding COVID related symptoms, Ninety six percent(83) had respiratory distress, 93.02 % (n=80) had cough, 84.9% (n=73) had history of fever,11.6 % (n=10) had loose motion and 7% (n=6), had anosmia. Diabetes mellitus (DM) was the most common co morbidity (91.9%).For improvement of oxygenation of COVID patient, we treated 7% of patients (n=6) by nasal Cannula, 24.4% (n=21) by Face Mask, 20.9% (n=18) by Non Rebreather Mask, 22.1% (n= 19) by High Flow Nasal Cannula (HFNC) and 25.6% (n= 22) by Mechanical Ventilation. Mean length of ICU stay were 6.9 ± 3.6 days and range of icu stay were 1-20 days. Among 86 COVID patient, 51.16% (n=44) were transferred to the isolation ward or discharged at home and 48.8% (n=42) were died. Conclusion: This study showed the overall demographic and clinical features of critically ill COVID-19 patients, admitted in an icu of a tertiary care hospital. As it is a single centered study, we need more study with multi center approach to know the detail demographic profile and outcome of COVID-19 patients. Birdem Med J 2020; 10, COVID Supplement: 51-55

Sign in / Sign up

Export Citation Format

Share Document