Determinants of maternal mortality in a critical care unit: A prospective analysis

Background: Maternal sepsis is one of the leading causes of maternal mortality around the world. The aim of this study was to study the prevalence, clinical profile and fetomaternal outcome of maternal sepsis at a dedicated Obstetric critical care unit of a tertiary care centre of North India. It was retrospective study conducted in tertiary care centre in North IndiaMethods: Women diagnosed as sepsis or septic shock at any point in pregnancy and up to 6 weeks postpartum (irrespective of the source of infection) were included in the study. Demographic, clinical, microbiological and outcome data were recorded from the case sheets of all patients admitted in obstetrical critical care unit between January to December 2016. Outcome measures: Prevalence, bacterial organism, source of infection, mode of delivery, period of gestation, maternal and fetal outcome.Results: The prevalence of maternal sepsis was 16.5/10,000 live births. The number of maternal deaths attributable to sepsis were 35, making the maternal mortality ratio due to sepsis 128/100,000 live births. 87% of the cases were unbooked. 22% presented antenatally while 58% were postpartum and 20% were postabortal. Genital tract infection was most common source of infection. E. coli was the predominant organism in 28% followed by Methicillin resistant staphylococcus aureus in 12%. The mortality from sepsis was very high (78%). 54% of cases required mechanical ventilation and around 7% had to be shifted to intensive care unit for advanced life support and care. Sepsis was associated with preterm delivery and a high perinatal mortality rate.Conclusions: Early recognition of the severity of infection and prompt management by a multidisciplinary team of intensivists, anesthetists, neonatologists, obstetrician, midwives are the key to success. Vigilant infection control measures must be strictly practiced during all pregnancy events.

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Response Time in the Transport of Critically Ill Pediatric Patients to a Tertiary Critical Care Unit

10.1542/peds.140.1_meetingabstract.144 ◽

2017 ◽

Author(s):

Sindy Villacres ◽

Chhavi Katyal

Keyword(s):

Critical Care ◽

Response Time ◽

Critically Ill ◽

Critical Care Unit ◽

Pediatric Patients

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Case Report: When all claims that it is necrotizing fasciitis but Point of care ultrasound (POCUS) proves the opposite!

POCUS Journal ◽

10.24908/pocus.v3i1.13310 ◽

2018 ◽

Vol 3 (1) ◽

pp. 13-14

Author(s):

Hadiel Kaiyasah, MD, MRCS (Glasgow), ABHS-GS ◽

Maryam Al Ali, MBBS

Keyword(s):

Emergency Department ◽

Critical Care ◽

Case Report ◽

Soft Tissue ◽

Necrotizing Fasciitis ◽

Soft Tissue Infection ◽

Critical Care Unit ◽

Point Of Care ◽

Point Of Care Ultrasound ◽

Soft Tissue Infections

Soft tissue ultrasound (ST-USS) has been shown to be of utmost importance in assessing patients with soft tissue infections in the emergency department or critical care unit. It aids in guiding the management of soft tissue infection based on the sonographic findings.

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Aspects on Patient Safety in Critical Care Unit

Tanta Scientific Nursing Journal ◽

10.21608/tsnj.2018.69205 ◽

2018 ◽

Vol 14 (9) ◽

pp. 149-157

Author(s):

Hanan Mohammed

Keyword(s):

Critical Care ◽

Patient Safety ◽

Critical Care Unit

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SARS-CoV-2 in pregnancy: maternal and perinatal outcome data of 34 pregnant women hospitalised between May and October 2020

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0499 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Mirijam Hall ◽

David Endress ◽

Susanne Hölbfer ◽

Barbara Maier

Keyword(s):

Critical Care ◽

Pregnant Women ◽

Critical Care Unit ◽

Birth Rate ◽

Total Population ◽

Neonatal Outcome ◽

Mode Of Delivery ◽

Outcome Data ◽

High Risk Population ◽

Retrospective Data Collection

AbstractObjectivesTo report clinical data on maternal outcome, mode of delivery and immediate neonatal outcome in women infected with COVID-19.MethodsRetrospective data collection.ResultsA total of 8.6% of the total population of hospitalised SARS-CoV-2 positive pregnant women were admitted to a critical care unit. The premature birth rate for births before 34+0 weeks of gestation among pregnant women who tested positive for SARS-CoV-2 was 7.1%. One newborn (3.6%) tested positive for SARS-CoV-2 two days after birth and showed symptoms.ConclusionsPregnant women with COVID-19 seem to be at higher risk of invasive ventilation, admission to a critical care unit and preterm birth, and should therefore be considered a high-risk-population.

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COVID-19 infection among international travellers: a prospective analysis

BMJ Open ◽

10.1136/bmjopen-2021-050667 ◽

2021 ◽

Vol 11 (6) ◽

pp. e050667

Author(s):

Meaghan Lunney ◽

Paul E Ronksley ◽

Robert G Weaver ◽

Lianne Barnieh ◽

Norman Blue ◽

...

Keyword(s):

Critical Care ◽

Outcome Measures ◽

Contact Tracing ◽

Prospective Analysis ◽

Pilot Programme ◽

Negative Test ◽

Secondary Transmission ◽

To Receive ◽

Test Result

ObjectivesThis report estimates the risk of COVID-19 importation and secondary transmission associated with a modified quarantine programme in Canada.Design and participantsProspective analysis of international asymptomatic travellers entering Alberta, Canada.InterventionsAll participants were required to receive a PCR COVID-19 test on arrival. If negative, participants could leave quarantine but were required to have a second test 6 or 7 days after arrival. If the arrival test was positive, participants were required to remain in quarantine for 14 days.Main outcome measuresProportion and rate of participants testing positive for COVID-19; number of cases of secondary transmission.ResultsThe analysis included 9535 international travellers entering Alberta by air (N=8398) or land (N=1137) that voluntarily enrolled in the Alberta Border Testing Pilot Programme (a subset of all travellers); most (83.1%) were Canadian citizens. Among the 9310 participants who received at least one test, 200 (21.5 per 1000, 95% CI 18.6 to 24.6) tested positive. Sixty-nine per cent (138/200) of positive tests were detected on arrival (14.8 per 1000 travellers, 95% CI 12.5 to 17.5). 62 cases (6.7 per 1000 travellers, 95% CI 5.1 to 8.5; 31.0% of positive cases) were identified among participants that had been released from quarantine following a negative test result on arrival. Of 192 participants who developed symptoms, 51 (26.6%) tested positive after arrival. Among participants with positive tests, four (2.0%) were hospitalised for COVID-19; none required critical care or died. Contact tracing among participants who tested positive identified 200 contacts; of 88 contacts tested, 22 were cases of secondary transmission (14 from those testing positive on arrival and 8 from those testing positive thereafter). SARS-CoV-2 B.1.1.7 lineage was not detected in any of the 200 positive cases.Conclusions21.5 per 1000 international travellers tested positive for COVID-19. Most (69%) tested positive on arrival and 31% tested positive during follow-up. These findings suggest the need for ongoing vigilance in travellers testing negative on arrival and highlight the value of follow-up testing and contact tracing to monitor and limit secondary transmission where possible.

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COVID-19: Nutrition and functional outcomes for critical care survivors in a 400- bedded district general hospital in North London

Journal of the Intensive Care Society ◽

10.1177/17511437211025420 ◽

2021 ◽

pp. 175114372110254

Author(s):

Rachel Catlow ◽

Charlotte Cheeseman ◽

Helen Newman

Keyword(s):

Critical Care ◽

General Hospital ◽

Health Professionals ◽

Functional Outcomes ◽

Critical Care Unit ◽

Workforce Planning ◽

District General Hospital ◽

Allied Health Professionals ◽

Novel Coronavirus ◽

Rehabilitation Needs

Novel coronavirus disease (COVID-19) has resulted in huge numbers of critically ill patients. This study describes the inpatient recovery and rehabilitation needs of patients admitted with COVID-19 to the critical care unit of a 400 bedded general hospital in London, United Kingdom. The rehabilitation needs of our sample were considerable. It is recommended that the increase demand on allied health professionals capacity demonstrated is considered in future COVID-19-related workforce-planning.

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