scholarly journals The Comparison Between Hemodynamic Status on 15 0and 300 Head Up Elevation Patient With Risk For Increased Intracranial Pressure in Intensive Care Unit

Author(s):  
Eirene Gaghauna ◽  
Bagus Santoso
2019 ◽  
Vol 5 (2) ◽  
pp. 66
Author(s):  
Anna Christakou ◽  
Maria Alimatiri ◽  
Eirini Patsaki ◽  
Alexandros Kouvarakos ◽  
Emmanouel Papadopoulos ◽  
...  

Background: Heterotopic ossification is a musculoskeletal complication in patients in intensive care unit which expects to impair their mobility and quality of life after discharge. The aim of the study was to examine the incidence and the risk factors of heterotopic ossification in critically ill patients. Methods: One hundred-ninety seven consecutive patients evaluated through clinical and laboratory screenings for heterotopic ossification upon admission and discharge and 123 of them were eligible for the study. Symptomatic heterotopic ossification was confirmed to 9 patients (7.31%) by means of ultrasonography and radiography. Many risk factors examined by logistic regression such as age, admission of Glasgow Coma Scale score, length of stay in intensive care unit, duration of mechanical ventilation, duration in Venturi mask and in mask tracheostomy, days in coma, traumatic and non-traumatic brain injury, increased intracranial pressure monitoring, autonomic dysregulation and days in respiratory alkalosis. Results: The risk factors that predict heterotopic ossification were: age, duration of mechanical ventilation, respiratory alkalosis, days in coma, admission of Glasgow Coma Scale score, increased intracranial pressure monitoring, autonomic dysregulation, and non–traumatic brain injury. In multivariate analysis were found significant the autonomic dysregulation, the respiratory alkalosis, the increased intracranial pressure monitoring and the duration of mechanical ventilation (F=17.44, p<0.00).Conclusions: The incidence of symptomatic heterotopic ossification appears to be significant in a general intensive care unit. A few factors seem to predict the occurrence of it, confirming previous studies. Larger studies are needed to be done for better prevention and early identification of this frequent musculoskeletal complication in critical ill patients. 


Author(s):  
Cesar A. Keller

Shigeto Ikeda in Japan developed fiberoptic bronchoscopy (FOB), beginning a revolution in the diagnosis and treatment of diverse pulmonary conditions. FOB evolved with additional diagnostic and interventional tools. FOB has become an essential bedside tool for diagnosis and management in critically ill patients. FOB is safe, even in patients with respiratory failure and, if done cautiously, in patients with increased intracranial pressure.


2013 ◽  
pp. 363-378
Author(s):  
Brian M. Cummings ◽  
Phoebe H. Yager ◽  
Sarah A. Murphy ◽  
Brian Kalish ◽  
Chetan Bhupali ◽  
...  

PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 39-43
Author(s):  
Frank C. Chaten ◽  
Steven E. Lucking ◽  
Edwin S. Young ◽  
John J. Mickell

During an 18-month period in a pediatric intensive care unit, nine patients with vocal cord paralysis were identified using flexible bronchoscopy. When tracheally extubated, each child was found to have stridor. The children ranged in age from 17 days to 5½ years. Two patients had unilateral paralysis, but neither required tracheostomy. Seven patients displayed bilateral abductor vocal cord paralysis. Of these, six patients required tracheostomy. Surgical injury to the recurrent laryngeal nerve was the probable cause in two patients. The other seven patients had neurologic disorders with documented or suspected increases of intracranial pressure. Four of the seven patients with bilateral abductor vocal cord paralysis regained cord mobility within 4 months. Both children with unilateral cord paralysis have no stridor and vocalize well 1 year later. Cord paralysis in the setting of intracranial hypertension probably results from compression or ischemia of the vagus nerve before it exits the skull. Early visualization of the larynx should be done in patients who become stridulous when extubated, especially those with prior thoracic procedures or with neurologic disorders associated with intracranial hypertension.


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