scholarly journals Clinical Outcomes and Independent Risk Factors for 90-Day Mortality in Critically Ill Patients with Respiratory Failure Infected with SARS-CoV-2: A Multicenter Study in Turkish Intensive Care Units

Author(s):  
Kursat Gundogan ◽  
◽  
Ismail Hakki Akbudak ◽  
Pervin Hanci ◽  
Burcin Halacli ◽  
...  
2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Diana K. Sarkisian ◽  
Natalia V. Chebotareva ◽  
Valerie McDonnell ◽  
Armen V. Oganesyan ◽  
Tatyana N. Krasnova ◽  
...  

Background — Acute kidney injury (AKI) reaches 29% in the intensive care unit (ICU). Our study aimed to determine the prevalence, features, and the main AKI factors in critically ill patients with coronavirus disease 2019 (COVID-19). Material and Methods — The study included 37 patients with COVID-19. We analyzed the total blood count test results, biochemical profile panel, coagulation tests, and urine samples. We finally estimated the markers of kidney damage and mortality. Result — All patients in ICU had proteinuria, and 80.5% of patients had hematuria. AKI was observed in 45.9% of patients. Independent risk factors were age more than 60 years, increased C-reactive protein (CRP) level, and decreased platelet count. Conclusion — Kidney damage was observed in most critically ill patients with COVID-19. The independent risk factors for AKI in critically ill patients were elderly age, a cytokine response with a high CRP level.


2016 ◽  
Vol 49 (2) ◽  
pp. 153-154 ◽  
Author(s):  
Carlo Tascini ◽  
Emanuela Sozio ◽  
Nicola Salini ◽  
Francesco Sbrana ◽  
Andrea Ripoli ◽  
...  

2009 ◽  
Vol 10 (2) ◽  
pp. 83-92
Author(s):  
Maurizio Muscaritoli ◽  
Lorenzo Pradelli ◽  
Orietta Zaniolo ◽  
Sergio Iannazzo ◽  
Mario Eandi

Introduction: the supplementation of alanyl-glutamine dipeptide in critically ill patients necessitating total parenteral nutrition (TPN) improves clinical outcomes, reducing mortality, infection rate, and shortening ICU hospital lengths of stay (LOS), as compared to standard TPN regimens. Here we present a pharmacoeconomic evaluation of alanyl-glutamine dipeptide in critically ill patients admitted to Italian Intensive Care Units (ICUs). Methods: a Discrete Event Simulation model that incorporates outcomes rates from 200 Italian ICUs for over 60,000 patients, alanyl-glutamine dipeptide efficacy data synthesized by means of a Bayesian Random-Effects meta-analysis, and national cost data has been developed to evaluated the alternatives from the point of view of the hospital. Simulated clinical outcomes are death and infection rates in ICU, death rate in general ward, and hospital LOSs. One-way and probabilistic sensitivity analyses are performed by varying all uncertain parameter values in a plausible range. Results: alanyl-glutamine dipeptide results more effective and less costly than standard TPN: reduced mortality rate (23.55% ± 15.2% vs 34.50% ± 2.06%), infection rate (15.91% ± 3.95% vs 18.97% ± 3.94%), and hospital LOS (25.47 ± 0.26 vs 26.00 ± 0.27 days) come at a lower total cost per patient (23,922 ± 3,249 vs 24,145 ± 3,361 Euro). Treatment cost is completely offset by savings on ICU and antibiotic costs. The cost/effectiveness acceptability curve indicates an estimated 78% probability of alanyl-glutamine dipeptide resulting dominant and a 90% probability of resulting cost/effective for a willingness to pay up to 1,500 Euro for one patient death avoided. Conclusions: alanyl-glutamine dipeptide is expected to improve clinical outcomes and to do so with a concurrent saving for the hospital.


2020 ◽  
Vol 13 (9) ◽  
pp. 550-556
Author(s):  
Minal Karavadra ◽  
Ricky Bell

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.


2020 ◽  
Vol 10 (4) ◽  
pp. 72
Author(s):  
Mohamed E. Abdelgawad ◽  
Nadia T. Ahmed ◽  
Ahmed M. Elmenshawy

Background and objective: Electrolyte disturbances remain a common lifesaving issue in the intensive care units. They are associated with increased morbidity and mortality. They are mostly resulted secondary to critical illness itself or associated treatment modalities. Therefore, electrolytes repletion should be done effectively and timely. This could be ensured using nurse driven protocols rather than traditional methods of repletion. These protocols are nurse initiated and collaboratively developed. They have been shown to improve patient care outcomes through the provision of high quality care. They are increasingly being used in the critical care setting. Objective: Determine the effect of applying nurses driven electrolytes repletion protocol on electrolytes disturbance control among critically ill patients.Methods: Quasi experimental research design was used. Sixty two critically ill patients with electrolytes loss were enrolled in the study at Alexandria Main University Hospital intensive care units, Egypt. All episodes of electrolyte loss were evaluated. Repletion of electrolyte loss was done according to unit routine for the control group and nurses driven electrolytes repletion protocol for the study group. Episodes of electrolyte disturbances, adverse events and timing of repletion were evaluated.Results: Neurological disorders represent the most encountered diagnosis. The most common cause of electrolyte loss in was the use of diuretics. Furthermore, there was a highly statistical difference between the two groups as regard electrolytes levels, effectiveness and timing of replacement.Conclusions: Application of nurses driven electrolyte repletion protocol resulted in improvements in the effectiveness and timeliness of electrolyte replacement.


2009 ◽  
Vol 16 (10) ◽  
pp. 1527-1528 ◽  
Author(s):  
Rafael Zaragoza ◽  
Javier Pemán ◽  
Guillermo Quindós ◽  
Jose R. Iruretagoyena ◽  
María S. Cuétara ◽  
...  

ABSTRACT The influence of kinetic patterns of Candida albicans germ tube antibodies (CAGTA) on mortality was analyzed in six intensive care units. Statistically significant lower mortality rates were found in patients with patterns of increasing CAGTA titers who had been treated with antifungal agents. Thus, antifungal treatment should be considered when CAGTA titers are increasing in critically ill patients.


2006 ◽  
Vol 124 (5) ◽  
pp. 257-263 ◽  
Author(s):  
Geraldo Bezerra da Silva Júnior ◽  
Elizabeth De Francesco Daher ◽  
Rosa Maria Salani Mota ◽  
Francisco Albano Menezes

CONTEXT AND OBJECTIVE: Acute renal failure is a common medical problem, with a high mortality rate. The aim of this work was to investigate the risk factors for death among critically ill patients with acute renal failure. DESIGN AND SETTING: Retrospective cohort at the intensive care unit of Hospital Universitário Walter Cantídio, Fortaleza. METHODS: Survivors and non-survivors were compared. Univariate and multivariate analyses were performed to establish risk factors for death. RESULTS: Acute renal failure occurred in 128 patients (33.5%), with mean age of 49 ± 20 years (79 males; 62%). Death occurred in 80 (62.5%). The risk factors most frequently associated with death were hypotension, sepsis, nephrotoxic drug use, respiratory insufficiency, liver failure, hypovolemia, septic shock, multiple organ dysfunction, need for vasoactive drugs, need for mechanical ventilation, oliguria, hypoalbuminemia, metabolic acidosis and anemia. There were negative correlations between death and: prothrombin time, hematocrit, hemoglobin, systolic blood pressure, diastolic blood pressure, arterial pH, arterial bicarbonate and urine volume. From multivariate analysis, the independent risk factors for death were: need for mechanical ventilation (OR = 3.15; p = 0.03), hypotension (OR = 3.48; p = 0.02), liver failure (OR = 5.37; p = 0.02), low arterial bicarbonate (OR = 0.85; p = 0.005), oliguria (OR = 3.36; p = 0.009), vasopressor use (OR = 4.83; p = 0.004) and sepsis (OR = 6.14; p = 0.003). CONCLUSIONS: There are significant risk factors for death among patients with acute renal failure in intensive care units, which need to be identified at an early stage for early treatment.


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