Application of MEWS Score Combined with Blood Routine Index Observation in Potentially Critical Patients in Hematology Department

2021 ◽  
Keyword(s):  
Critical Patients ◽  
Blood Routine

PENGARUH TINDAKAN MOBILISASI DINI TERHADAP DENYUT JANTUNG DAN FREKUENSI PERNAPASAN PADA PASIEN KRITIS DI ICU RSUD SLEMAN YOGYAKARTA

2019 ◽  
Vol 5 (3) ◽  
pp. 213-223
Author(s):  
Muhamat Nofiyanto ◽  
Tetra Saktika Adhinugraha
Keyword(s):  
Heart Rate ◽  
Respiratory Rate ◽  
Early Mobilization ◽  
Critical Conditions ◽  
P Value ◽  
Cardiorespiratory Function ◽  
Arterial Blood ◽  
Post Test ◽  
Critical Patients ◽  
Security Standards

Background: Patients with critical conditions in the ICU depend on a variety of tools to support their lifes. Patients’ conditions and and their unstable hemodynamic are challenges for nurses to perform mobilization. Less mobilization in critical patients can cause a variety of physical problems, one of them is cardiorespiratory function disorder. Objective: to investigate differences in heart rate (HR) and respiratory rate (RR) before, during, and immediately after early mobilization. Methods: This study employed quasi experiment with one group pre and post test design. Twenty four respondents were selected based on the criteria HR <110 / min at rest, Mean Arterial Blood Pressure between 60 to 110 mmHg, and the fraction of inspired oxygen <0.6. Early mobilization was performed to the respondents, and followed by assessments on the changes of respiratory rate and heart rate before, during, and immediately after the mobilization. Analysis of differences in this study used ANNOVA. Results: Before the early mobilization, mean RR was 22.54 and mean HR was 78.58. Immediately after the mobilization,  mean RR was 23.21 and mean HR was 80.75. There was no differences in the value of RR and HR, before and immediately after the early mobilization with the p-value of 0.540 and 0.314, respectively. Conclusions: Early mobilization of critical patients is relatively safe. Nurses are expected to perform early mobilization for critical patients. However, it should be with regard to security standards and rigorous assessment of the patient's conditions. Keywords: Early mobilization, critical patients, ICU

Aspergillus But Not Candida: Fatal Fungus Infection in COVID-19 Critical Patients

2020 ◽  
Author(s):  
Aifang Zhong ◽  
Yang Yang ◽  
Jiang Wu ◽  
Lei Xiong ◽  
Jian Wu ◽  
...  
Keyword(s):  
Fungus Infection ◽  
Critical Patients

SUN-PO024: Evaluation of Noradrenaline Effect on Energy Deficitand Mortality of Critical Patients in Enteral Nutritional Therapy

2019 ◽  
Vol 38 ◽  
pp. S66-S67
Author(s):  
A.G.C. Custódio ◽  
A.B.M. de Oliveira ◽  
M.B. de Lima ◽  
R.D.S.F. Pequeno ◽  
V.S. Mendonça ◽  
...  
Keyword(s):  
Nutritional Therapy ◽  
Critical Patients

scholarly journals 4CPS-379 Parenteral nutrition management in coronavirus critical patients: case report

2021 ◽  
Author(s):  
T Palanques Pastor ◽  
A Vázquez Polo ◽  
L Lorente Fernández ◽  
E López Briz ◽  
I Beltrán García ◽  
...  
Keyword(s):  
Case Report ◽  
Parenteral Nutrition ◽  
Nutrition Management ◽  
Critical Patients

scholarly journals Managing admission and discharge processes in intensive care units

2021 ◽  
Author(s):  
Jie Bai ◽  
Andreas Fügener ◽  
Jochen Gönsch ◽  
Jens O. Brunner ◽  
Manfred Blobner
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Numerical Study ◽  
Early Discharge ◽  
Fixed Costs ◽  
Real World Data ◽  
Trade Off ◽  
Markov Decision ◽  
Critical Patients ◽  
Expected Mortality

AbstractThe intensive care unit (ICU) is one of the most crucial and expensive resources in a health care system. While high fixed costs usually lead to tight capacities, shortages have severe consequences. Thus, various challenging issues exist: When should an ICU admit or reject arriving patients in general? Should ICUs always be able to admit critical patients or rather focus on high utilization? On an operational level, both admission control of arriving patients and demand-driven early discharge of currently residing patients are decision variables and should be considered simultaneously. This paper discusses the trade-off between medical and monetary goals when managing intensive care units by modeling the problem as a Markov decision process. Intuitive, myopic rule mimicking decision-making in practice is applied as a benchmark. In a numerical study based on real-world data, we demonstrate that the medical results deteriorate dramatically when focusing on monetary goals only, and vice versa. Using our model, we illustrate the trade-off along an efficiency frontier that accounts for all combinations of medical and monetary goals. Coming from a solution that optimizes monetary costs, a significant reduction of expected mortality can be achieved at little additional monetary cost.

scholarly journals Prognostic biomarkers in predicting mortality in respiratory patients with ventilator-associated pneumonia

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Nermeen A. Abdelaleem ◽  
Hoda A. Makhlouf ◽  
Eman M. Nagiub ◽  
Hassan A. Bayoumi
Keyword(s):  
Sofa Score ◽  
Diagnostic Performance ◽  
Mortality Prediction ◽  
Ventilator Associated Pneumonia ◽  
Distribution Width ◽  
Mechanically Ventilated ◽  
Neutrophil Lymphocyte Ratio ◽  
Prognostic Accuracy ◽  
Severity Scores ◽  
Critical Patients

Abstract Background Ventilator-associated pneumonia (VAP) is the most common nosocomial infection. Red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) are prognostic factors to mortality in different diseases. The aim of this study is to evaluate prognostic efficiency RDW, NLR, and the Sequential Organ Failure Assessment (SOFA) score for mortality prediction in respiratory patients with VAP. Results One hundred thirty-six patients mechanically ventilated and developed VAP were included. Clinical characteristics and SOFA score on the day of admission and at diagnosis of VAP, RDW, and NLR were assessed and correlated to mortality. The average age of patients was 58.80 ± 10.53. These variables had a good diagnostic performance for mortality prediction AUC 0.811 for SOFA at diagnosis of VAP, 0.777 for RDW, 0.728 for NLR, and 0.840 for combined of NLR and RDW. The combination of the three parameters demonstrated excellent diagnostic performance (AUC 0.889). A positive correlation was found between SOFA at diagnosis of VAP and RDW (r = 0.446, P < 0.000) and with NLR (r = 0.220, P < 0.010). Conclusions NLR and RDW are non-specific inflammatory markers that could be calculated quickly and easily via routine hemogram examination. These markers have comparable prognostic accuracy to severity scores. Consequently, RDW and NLR are simple, yet promising markers for ICU physicians in monitoring the clinical course, assessment of organ dysfunction, and predicting mortality in mechanically ventilated patients. Therefore, this study recommends the use of blood biomarkers with the one of the simplest ICU score (SOFA score) in the rapid diagnosis of critical patients as a daily works in ICU.

scholarly journals Preparedness for transplantation during COVID-19 outbreak: how to manage?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Valdi ◽  
G Varadi ◽  
A Panzera ◽  
M Parpinel ◽  
R Peressutti
Keyword(s):  
Organ Transplantation ◽  
Task Force ◽  
Emergency Situation ◽  
Donor Pool ◽  
Surge Capacity ◽  
Emergency Procedures ◽  
Life Saving ◽  
Critical Patients ◽  
End Stage ◽  
Assessment Procedures

Abstract Problem When WHO declared COVID-19 “international”, it was important not to damage some critical patients who need emergency procedures like organ transplantation, due to end stage organ disease. In 2003 SARS outbreak demonstrated the vulnerability of organ transplantation services o network. Descritption If transplantation is required as a life-saving procedure, it can be conducted with appropriate risk infection assessment. It is crucial during these emergencies to assess donor pool, as it is expected to decrease. A crucial point is to organize and evaluate the surge capacity, in terms of understaffing and lack of supplies, especially in ICU. The research methods were literature review using Pub Med, CDC, ECDC, WHO, TTS, searching as key words “SARS-CoV-2”, “COVID-19”, “transplantation”, “preparedness”. The analysis has been conducted between Feb 26th 2020 and March 5th 2020. Results As happened during SARS breakout in 2003, it is essential to establish a task force for crisis, currently updated and skilled for this particular management. Preparedness should regard especially the adoption of donor safety assessment procedures, ICU capability, the availability of covid-19 test for all the donors, and the adoption of specific post-transplant care. It is essential in this case establish preparedness in several points: education and training of the staff, practice drills, inspection of supplies, evaluation of surge capacity, relocation of patients. Lessons SARS-CoV-2 imposed in public health to establish new protocols and guidelines, which should be regularly updated to be useful in other epidemics outbreaks or other emergency situation. These protocols should focus on donor pool and ICU capability in order to carry on transplantation activities. Key messages This outbreak has tested the resilience of the whole system by day-by-day updating for transplantation teams and preparedness of the staff involved in transplantation management. During outbreak, seems to be useful a task force for crisis in order to support organ transplantation services.

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