scholarly journals The Relationship Between the Level of Inflammation Biomarkers at Admission to the Intensive Care Unit and the Duration of Acute Brain Dysfunction in Sepsis Patients

2019 ◽  
Vol 17 (3) ◽  
pp. 138-145
Author(s):  
Günseli Orhun ◽  
Achmet Ali ◽  
Gülçin Alay ◽  
Verda Tuna ◽  
Emre Çeliköz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Dysfunction ◽  
Acute Brain Dysfunction ◽  
The Relationship

Innovative ICU Solutions to Prevent and Reduce Delirium and Post–Intensive Care Unit Syndrome

2019 ◽  
Vol 40 (05) ◽  
pp. 673-686 ◽  
Author(s):  
Alawi Luetz ◽  
Julius J. Grunow ◽  
Rudolf Mörgeli ◽  
Max Rosenthal ◽  
Steffen Weber-Carstens ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Interior Design ◽  
Healing Process ◽  
Brain Dysfunction ◽  
Therapeutic Effects ◽  
Room Design ◽  
Sound Environment ◽  
Acute Brain Dysfunction ◽  
The Impact

AbstractDelirium, the most common form of acute brain dysfunction affecting up to 80% of intensive care unit (ICU) patients, has been shown to predict long-term cognitive impairment, one of the domains in “Post-ICU Syndrome” (PICS). The ICU environment affects several potentially modifiable risk factors for delirium, such as disorientation and disruption, of the sleep–wake cycle. Innovative solutions aim to transform standard concepts of ICU room design to limit potential stressors, and utilizing the patient care space as a treatment tool, exerting positive, therapeutic effects. The main areas affected by most architectural and interior design modifications are sound environment, light control, floor planning, and room arrangement. Implementation of corresponding solutions is challenging considering the significant medical and technical demands of ICUs. This article discusses innovative concepts and promising approaches in ICU design that may be used to prevent stress and to support the healing process of patients, potentially limiting the impact of delirium and PICS.

scholarly journals Lung ultrasound presentation of COVID-19 patients: phenotypes and correlations

2021 ◽  
Author(s):  
Gianmarco Secco ◽  
◽  
Marzia Delorenzo ◽  
Francesco Salinaro ◽  
Caterina Zattera ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Ultrasound ◽  
Structure And Function ◽  
General Ward ◽  
Prognostic Role ◽  
Interstitial Syndrome ◽  
Lung Structure ◽  
And Function ◽  
The Relationship

AbstractBedside lung ultrasound (LUS) can play a role in the setting of the SarsCoV2 pneumonia pandemic. To evaluate the clinical and LUS features of COVID-19 in the ED and their potential prognostic role, a cohort of laboratory-confirmed COVID-19 patients underwent LUS upon admission in the ED. LUS score was derived from 12 fields. A prevalent LUS pattern was assigned depending on the presence of interstitial syndrome only (Interstitial Pattern), or evidence of subpleural consolidations in at least two fields (Consolidation Pattern). The endpoint was 30-day mortality. The relationship between hemogasanalysis parameters and LUS score was also evaluated. Out of 312 patients, only 36 (11.5%) did not present lung involvment, as defined by LUS score < 1. The majority of patients were admitted either in a general ward (53.8%) or in intensive care unit (9.6%), whereas 106 patients (33.9%) were discharged from the ED. In-hospital mortality was 25.3%, and 30-day survival was 67.6%. A LUS score > 13 had a 77.2% sensitivity and a 71.5% specificity (AUC 0.814; p < 0.001) in predicting mortality. LUS alterations were more frequent (64%) in the posterior lower fields. LUS score was related with P/F (R2 0.68; p < 0.0001) and P/F at FiO2 = 21% (R2 0.59; p < 0.0001). The correlation between LUS score and P/F was not influenced by the prevalent ultrasound pattern. LUS represents an effective tool in both defining diagnosis and stratifying prognosis of COVID-19 pneumonia. The correlation between LUS and hemogasanalysis parameters underscores its role in evaluating lung structure and function.

scholarly journals Platelet-Lymphocyte Ratio as a New Predictor of In-hospital Mortality in Cardiac Intensive Care Unit Patients

2021 ◽  
Author(s):  
Guangyao Zhai ◽  
Biyang Zhang ◽  
Jianlong Wang ◽  
Yuyang Liu ◽  
Yujie Zhou
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiovascular Diseases ◽  
Hospital Mortality ◽  
Subgroup Analysis ◽  
Cardiac Intensive Care Unit ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
Cardiac Intensive Care ◽  
The Relationship

Abstract Background: It has been discovered that both inflammation and platelet aggregation could cause crucial effect on the occurrence and development of cardiovascular diseases. As a combination of platelet and lymphocyte, platelet-lymphocyte ratio (PLR) was proved to be correlated with the severity as well as prognosis of cardiovascular diseases. Exploring the relationship between PLR and in-hospital mortality in cardiac intensive care unit (CICU) patients was the purpose of this study. Method: PLR was calculated by dividing platelet count by lymphocyte count. All patients were grouped by PLR quartiles and the primary outcome was in-hospital mortality. The independent effect of PLR was determined by binary logistic regression analysis. The curve in line with overall trend was drawn by local weighted regression (Lowess). Subgroup analysis was used to determine the relationship between PLR and in-hospital mortality in different subgroups. Result: We included 5577 CICU patients. As PLR quartiles increased, in-hospital mortality increased significantly (Quartile 4 vs Quartile 1: 13.9 vs 8.3, P <0.001). After adjusting for confounding variables, PLR was proved to be independently associated with increased risk of in-hospital mortality (Quartile 4 vs Quartile 1: OR, 95% CI: 1.99, 1.46-2.71, P<0.001, P for trend <0.001). The Lowess curves showed a positive relationship between PLR and in-hospital mortality. The subgroup analysis revealed that patients with low Acute Physiology and Chronic Health Evaluation IV (APACHE IV) or with less comorbidities had higher risk of mortality for PLR. Further, PLR quartiles had positive relation with length of CICU stay (Quartile 4 vs Quartile 1: 2.7, 1.6-5.2 vs 2.1, 1.3-3.9, P<0.001), and the length of hospital stay (Quartile 4 vs Quartile 1: 7.9, 4.6-13.1 vs 5.8, 3.3-9.8, P<0.001). Conclusion: PLR was independently associated with in-hospital mortality in CICU patients.

scholarly journals The relationship between magnesium levels and mortality in the respiratory intensive care unit

Medicine ◽  
2020 ◽  
Vol 99 (52) ◽  
pp. e23290
Author(s):  
Mustafa Özgür Cirik ◽  
Mukaddes Kilinç ◽  
Güler Eraslan Doğanay ◽  
Meriç Ünver ◽  
Murat Yildiz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Intensive Care Unit ◽  
The Relationship

Diurnal Sedative Changes During Intensive Care: Impact On Acute Brain Dysfunction And Liberation From Mechanical Ventilation

2011 ◽  
Author(s):  
Christopher W. Seymour ◽  
Renee E. Torres ◽  
Pratik P. Pandharipande ◽  
Tyler Koestner ◽  
Leonard D. Hudson ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Brain Dysfunction ◽  
Acute Brain Dysfunction

Abstract 339: Relationship Between Post-arrest Care Hemodynamics and Cerebral Oxygen Saturation in Comatose Survivors of Out-of-hospital Cardiac Arrest: Insights From the CAPITAL-RETURN Trial

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Juan J Russo ◽  
Paul Boland ◽  
Simon Parlow ◽  
Jordan Bernick ◽  
Rebecca Mathew ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Oxygen Delivery ◽  
Cerebral Oxygen ◽  
Shockable Rhythm ◽  
The Mean ◽  
The Relationship ◽  
Capital Return

Introduction: Comatose survivors of OHCA develop a post cardiac arrest syndrome (PCAS) characterized by myocardial dysfunction and cerebrovascular dysregulation. Hemodynamic derangements related to PCAS can jeopardize cerebral oxygen delivery and therefore impair neurologic recovery. However, optimal hemodynamic targets to ensure adequate cerebral oxygen delivery following OHCA remain undefined. Accordingly, we examined the relationship between cardiac index (CI), mean arterial pressure (MAP), and regional cerebral oxygen saturation (rO 2 %) following OHCA. Methods: CAPITAL-RETURN was a prospective, single-center observational study examining hemodynamics in comatose survivors of OHCA undergoing targeted temperature management after an initial shockable rhythm. Between August 2016 and December 2017, comatose survivors of OHCA underwent continuous, blinded, non-invasive monitoring of CI and rO 2 % using bioimpedance (Cheetah Medical, Portland, OR, USA) and near-infrared spectroscopy (Covidien, Boulder, CO, USA), respectively, for 96 hours after intensive care unit admission. In the present study, we examined the relationship between CI, MAP, and rO 2 % using multivariable linear regression. Results: In 56 patients in this analysis, the mean CI and MAP during the first 96 hours of intensive care unit admission were 3.2±0.5 L/min/m 2 and 76±6 mmHg, respectively (Figure). The mean rO 2 % was 63±9% and increased over time (+0.1% per hour; p<0.001). Higher CI was associated with improved rO 2 % (+3.2% per L/min/m2 increase in CI; p<0.0001). There was no association between MAP and rO 2 % (p=0.42). After adjustment for MAP, the association between CI and rO 2 % remained significant (+3.1% per L/min/m2 increase in CI; p<0.0001). Conclusion: In comatose survivors of OHCA with an initial shockable rhythm, a higher CI is associated with improved rO 2 %. Further studies are needed to determine whether CI targets improve rO2% and neurologic outcomes following OHCA.

Relationship between perceived organizational justice and moral distress in intensive care unit nurses

2017 ◽  
Vol 26 (2) ◽  
pp. 460-470 ◽  
Author(s):  
Ghazaleh Haghighinezhad ◽  
Foroozan Atashzadeh-Shoorideh ◽  
Tahereh Ashktorab ◽  
Jamileh Mohtashami ◽  
Maasoumeh Barkhordari-Sharifabad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Organizational Justice ◽  
Moral Distress ◽  
Interactional Justice ◽  
Significant Negative Correlation ◽  
Moral Decision Making ◽  
Informed Consent Form ◽  
Intensive Care Unit Nurses ◽  
The Relationship

Background: The nature of the nursing profession pays more attention to ethics of healthcare than its therapeutic dimension. One of the prevalent moral issues in this profession is moral distress. Moral distress appears more in intensive care units due to the widespread need for moral decision-making regarding treatment and care in emergency situations. In this connection, organizational justice is of high importance and, as a significant motivational tool, leaves important impacts upon attitude and behavior of personnel. Aim/objective: This study aimed at investigation of the relationship between perceived organizational justice and moral distress in intensive care unit nurses. Research design: This is a descriptive-correlational research which examined the relationship between perceived organizational justice and moral distress in intensive care unit nurses. Participants and research context: A total of 284 intensive care unit nurses were selected via census sampling. The data were collected through questionnaires and then were analyzed via SPSS-20 using Pearson and Spearman correlation tests. Ethical considerations: This study was approved by the Committee of Ethics in Medical Research. Completion of informed consent form, guarantee of the confidentiality of information, explanation on purposes of the research, and voluntary participation in the study were moral considerations observed in this study. Findings: There was a statistically significant negative correlation between the total perceived organizational justice and the total moral distress (p = 0.024, r = −0.137) and also between “procedural and interactional justice and errors” and “not respecting the ethics principles.” Meanwhile, no relationship was found by the findings between distributive justice and dimensions of moral distress. Conclusion: According to the results of the study, there was a reverse significant relationship between moral distress and perceived organizational justice; therefore, the head nurses are expected to contribute to reduce moral distress and to increase perceived organizational justice in nurses.

Sign in / Sign up

Export Citation Format

Share Document