scholarly journals COVID-19-Associated Pulmonary Aspergillosis in a Series of Complete Autopsies from the Brazilian Amazon

2022 ◽  
Author(s):  
Maria Eduarda Farias ◽  
Monique Freire Santana ◽  
Luiz Ferreira ◽  
Mayla Borba ◽  
João Silva-Neto ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Gene Sequencing ◽  
Brazilian Amazon ◽  
Mortality Rates ◽  
Pulmonary Aspergillosis ◽  
Prolonged Length ◽  
Autopsy Series ◽  
Individualized Approach

Between April and July 2020, and, therefore, prior to the broad recommendation of corticosteroids for severe COVID-19, a total of 50 full autopsies were performed in Manaus. We confirmed two invasive cases of aspergillosis through histopathology and gene sequencing (4%) in our autopsy series. The confirmed invasive aspergillosis incidence seems much lower than expected based on the “probable and possible” definitions, and an individualized approach should be considered for each country scenario. Interestingly, a prolonged length of stay in the intensive care unit was not observed in any of the cases. Timely diagnosis and treatment of fungal infection can reduce mortality rates.

Survival After Prolonged Length of Stay in a Trauma Intensive Care Unit

2007 ◽  
Vol 62 (1) ◽  
pp. 147-150 ◽  
Author(s):  
Vincent Trottier ◽  
Mark G. McKenney ◽  
Michael Beninati ◽  
Ronald Manning ◽  
Carl I. Schulman
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Prolonged Length

scholarly journals Factors Associated with Prolonged Length of Stay in Intensive Care Unit: Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (1) ◽  
pp. 30
Author(s):  
Nashwa M. Radwan ◽  
Nagla E. Mahmoud ◽  
Amal H. Alfaifi ◽  
Khaled I. Alabdulkareem
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
English Language ◽  
Medical Condition ◽  
Severity Of Illness ◽  
Risk Of Bias ◽  
Prolonged Length ◽  
Factors Associated

Background: Prolonged length of Stay (PLOS) increases the risk of hospital-acquired infections and disrupts patient flowand access to care due to bed shortages. The extent to which PLOS is attributable to complications, patient characteristics, illness, or inefficienpractice style is unclear. Objectives: To determine risk factors associated with prolonged length of stay (PLOS) in intensive care unit. (ICU). Search methods: We searched the COCHRANE, MEDLINE, TRIP and EMBASE from 2010 till now. Selection criteria: We included all the studies published in English language from 2010 till now and investigated the PLOS in ICU after any medical condition. Data collection and analysis: Two authors independently assessed trials eligibility and risk of bias and extracted data. Review Manager 5.3 was utilized to manage the data. Main results: The review included 84719 participants from fourteen observational studies that had some degree of risk of bias and substantial heterogeneity. Post-operative sepsis/ septic shock and the severity of illness of the patients at hospital admission were the most common risk factors for PLOS (OR= 5.65, CI= 1.98, 16.08 and OR=3.95, CI= 1.67, 9.34 respectively), followed by emergency operation (OR= 2.68, CI= 1.56, 4.62), and comorbidities including renal failure and coronary heart disease (OR= 2.64, CI=1.26, 5.51 and OR=2.57, CI= 1.61, 4.10 respectively). Other variables associated with PLOS were respectively; pre-operative condition (OR=2.36, CI=1.28, 4.34), long term use of corticosteroids (OR= 2.03, CI= 1.81, 2.29 ), age >70 years (OR=1.89, CI=0.54, 2.32), operation duration >180 minutes (OR=1.86, CI=1.46, 2.38), most deprived condition (OR= 1.82, CI= 1.15, 2.89), diabetes (OR= 1.36, CI=1.18, 1.56), hypertension (OR=1.32, CI= 1.09, 1.62), smoking (OR=1.25, CI= 1.13, 1.39) and male sex (OR= 1.11, CI=1.06, 1.17). Authors conclusion: Identificationof risk factors associated with PLOS provides the opportunity for intervention to reduce the LOS and support efficient/optimause of hospital resources.

scholarly journals 1412. The utility of respiratory viral panel testing for nosocomial fever in the neonatal intensive care unit

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S713-S713
Author(s):  
Carlo Fopiano Palacios ◽  
Eric Lemmon ◽  
James Campbell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Linear Regression ◽  
Length Of Stay ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
P Value ◽  
Fisher Exact Test ◽  
The Mean ◽  
Pcr Test

Abstract Background Patients in the neonatal intensive care unit (NICU) often develop fevers during their inpatient stay. Many neonates are empirically started on antibiotics due to their fragile clinical status. We sought to evaluate whether the respiratory viral panel (RVP) PCR test is associated with use of antibiotics in patients who develop a fever in the NICU. Methods We conducted a retrospective chart review on patients admitted to the Level 4 NICU of the University of Maryland Medical Center from November 2015 to June 2018. We included all neonates who developed a fever 48 hours into their admission. We collected demographic information and data on length of stay, fever work-up and diagnostics (including labs, cultures, RVP), and antibiotic use. Descriptive statistics, Fisher exact test, linear regression, and Welch’s ANOVA were performed. Results Among 347 fever episodes, the mean age of neonates was 72.8 ± 21.6 days, and 45.2% were female. Out of 30 total RVP samples analyzed, 2 were positive (6.7%). The most common causes of fever were post-procedural (5.7%), pneumonia (4.8%), urinary tract infection (3.5%), meningitis (2.6%), bacteremia (2.3%), or due to a viral infection (2.0%). Antibiotics were started in 208 patients (60%), while 61 neonates (17.6%) were already on antibiotics. The mean length of antibiotics was 7.5 ± 0.5 days. Neonates were more likely to get started on antibiotics if they had a negative RVP compared to those without a negative RVP (89% vs. 11%, p-value < 0.0001). Patients with a positive RVP had a decreased length of stay compared to those without a positive RVP (30.3 ± 8.7 vs. 96.8 ± 71.3, p-value 0.01). On multivariate linear regression, a positive RVP was not associated with length of stay. Conclusion Neonates with a negative respiratory viral PCR test were more likely to be started on antibiotics for fevers. Respiratory viral PCR testing can be used as a tool to promote antibiotic stewardship in the NICU. Disclosures All Authors: No reported disclosures

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