scholarly journals Impact of hospitalization in an intensive care unit on range of motion of critically ill patients: a pilot study

2014 ◽  
Vol 26 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Balbino Rivail Ventura Nepomuceno Júnior ◽  
Bruno Prata Martinez ◽  
Mansueto Gomes Neto
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Range Of Motion ◽  
Critically Ill ◽  
Critically Ill Patients

Surface Electrostimulation of Acupuncture Points for Sedation of Critically Ill Patients in the Intensive Care Unit – a Pilot Study

2008 ◽  
Vol 26 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Sandeep Nayak ◽  
Richard Wenstone ◽  
Andy Jones ◽  
Jill Nolan ◽  
Ann Strong ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Controlled Trial ◽  
Acupuncture Points ◽  
Current Frequency ◽  
Arterial Blood ◽  
Randomised Controlled

Background This is a pilot study to investigate the effects of electrostimulation of acupuncture points on sedation and the dose of sedatives in the Intensive Care Unit. Methods Electrostimulation of acupuncture points was performed on 12 critically ill patients requiring sedation for mechanical ventilation. Electrostimulation was applied by point surface electrodes at LI4, ST36, HT7 and LR3 points for 20 minutes every hour for 12 hours using dense dispersed mode with a current frequency of 10–100Hz and maximum intensity of 10mA. All patients were sedated with propofol and alfentanil as required. The dose of propofol was reduced by 10mg/hour provided the patient remained sedated according to our guidelines. Sedation and analgesia scores, dose of sedative and analgesics drugs, respiratory rate, heart rate, mean arterial blood pressure and compliance with the ventilator were recorded before electrostimulation of acupuncture points, and hourly thereafter for 12 hours. Results There was significant reduction in the median propofol consumption from 145mg/hour (range 30–250) to 15mg/hour (range 0–250) (P<0.05), without any significant change in sedation scores or analgesia scores. The haemodynamic and respiratory variables remained stable. All patients were compliant with the ventilator. Conclusion This pilot study showed significant reduction in the dose of propofol required for sedation in critically ill patients following surface electrostimulation of acupuncture points, without any adverse effects. A randomised controlled trial is warranted.

scholarly journals Avaliação dos níveis álgicos de pacientes críticos em terapia intensiva, antes, durante e após sessão de fisioterapia respiratória: um estudo piloto

2017 ◽  
Vol 27 (2) ◽  
pp. 26647
Author(s):  
Nathalya Tamara Costa Fermiano ◽  
Odete Mauad Cavenaghi ◽  
Juliana Rodrigues Correia ◽  
Marcus Vinicius Camargo De Brito ◽  
Lucas Lima Ferreira
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pilot Study ◽  
Physical Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Self Report ◽  
Mechanically Ventilated ◽  
Hemodynamic Variables ◽  
Chest Physical Therapy

*** Evaluation of pain levels of critically ill intensive care unit patients, before, during and after a session of chest physical therapy: a pilot study ***AIMS: To evaluate pain levels of critically ill patients before, during, and after a chest physical therapy intervention.METHODS: Pilot study conducted at the intensive care unit (ICU) of a teaching hospital. Sedated and mechanically ventilated adult patients aged 18 to 60 years were selected. Sociodemographic, clinical, and hemodynamic data were analyzed, and the Behavioral Pain Scale (BPS) scale was used to assess pain in patients unable to be evaluated by self-report questionnaires.The physical therapy protocol consisted of  manual vibrocompression maneuvers in both hemithoraces and of intratracheal aspiration. The hemodynamic variables and the BPS were analyzed in three periods: immediately before, in the fifth minute of intervention, and immediately after physical therapy. The Shapiro-Wilk test and ANOVA were used for the statistical analyses. The level of significance was p ≤0.05.RESULTS: The sample consisted of 22 patients, most of them male, aged 55±23.8 years. Nosocomial pneumonia the most prevalent pathology. There were no significant differences in hemodynamic variables and in pain assessment (p = 0.78) of the critically ill patients in any of the evaluated periods.CONCLUSIONS: In this sample of critically ill and mechanically ventilated ICU patients , no alterations in pain levels were detected during or after chest physical therapy.

scholarly journals Treatment of a Critically Ill COVID-19 Patient with the Seraph 100 Microbind Affinity Filter

TH Open ◽  
2021 ◽  
Vol 05 (02) ◽  
pp. e134-e138
Author(s):  
Anke Pape ◽  
Jan T. Kielstein ◽  
Tillman Krüger ◽  
Thomas Fühner ◽  
Reinhard Brunkhorst
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Randomized Trials ◽  
Clinical Course ◽  
Pharmacological Therapy ◽  
The European Union ◽  
Positive Effects ◽  
Special Patient

AbstractThe coronavirus disease 2019 (COVID-19) pandemic has a serious impact on health and economics worldwide. Even though the majority of patients present with moderate and mild symptoms, yet a considerable portion of patients need to be treated in the intensive care unit. Aside from dexamethasone, there is no established pharmacological therapy. Moreover, some of the currently tested drugs are contraindicated for special patient populations like remdesivir for patients with severely impaired renal function. On this background, several extracorporeal treatments are currently explored concerning their potential to improve the clinical course and outcome of critically ill patients with COVID-19. Here, we report the use of the Seraph 100 Microbind Affinity filter, which is licensed in the European Union for the removal of pathogens. Authorization for emergency use in patients with COVID-19 admitted to the intensive care unit with confirmed or imminent respiratory failure was granted by the U.S. Food and Drug Administration on April 17, 2020.A 53-year-old Caucasian male with a severe COVID-19 infection was treated with a Seraph Microbind Affinity filter hemoperfusion after clinical deterioration and commencement of mechanical ventilation. The 70-minute treatment at a blood flow of 200 mL/minute was well tolerated, and the patient was hemodynamically stable. The hemoperfusion reduced D-dimers dramatically.This case report suggests that the use of Seraph 100 Microbind Affinity filter hemoperfusion might have positive effects on the clinical course of critically ill patients with COVID-19. However, future prospective collection of data ideally in randomized trials will have to confirm whether the use of Seraph 100 Microbind Affinity filter hemoperfusion is an option of the treatment for COVID-19.

scholarly journals Bereavement interventions to support informal caregivers in the intensive care unit: a systematic review

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Stephana J. Moss ◽  
Krista Wollny ◽  
Therese G. Poulin ◽  
Deborah J. Cook ◽  
Henry T. Stelfox ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Traumatic Stress ◽  
Critically Ill Patients ◽  
Informal Caregivers ◽  
Post Traumatic Stress ◽  
Bereavement Support ◽  
Complex Needs ◽  
Post Traumatic

Abstract Background Informal caregivers of critically ill patients in intensive care unit (ICUs) experience negative psychological sequelae that worsen after death. We synthesized outcomes reported from ICU bereavement interventions intended to improve informal caregivers’ ability to cope with grief. Data sources MEDLINE, EMBASE, CINAHL and PsycINFO from inception to October 2020. Study selection Randomized controlled trials (RCTs) of bereavement interventions to support informal caregivers of adult patients who died in ICU. Data extraction Two reviewers independently extracted data in duplicate. Narrative synthesis was conducted. Data synthesis Bereavement interventions were categorized according to the UK National Institute for Health and Clinical Excellence three-tiered model of bereavement support according to the level of need: (1) Universal information provided to all those bereaved; (2) Selected or targeted non-specialist support provided to those who are at-risk of developing complex needs; and/or (3) Professional specialist interventions provided to those with a high level of complex needs. Outcome measures were synthesized according to core outcomes established for evaluating bereavement support for adults who have lost other adults to illness. Results Three studies of ICU bereavement interventions from 31 ICUs across 26 hospitals were included. One trial examining the effect of family presence at brain death assessment integrated all three categories of support but did not report significant improvement in emotional or psychological distress. Two other trials assessed a condolence letter intervention, which did not decrease grief symptoms and may have increased symptoms of depression and post-traumatic stress disorder, and a storytelling intervention that found no significant improvements in anxiety, depression, post-traumatic stress, or complicated grief. Four of nine core bereavement outcomes were not assessed anytime in follow-up. Conclusions Currently available trial evidence is sparse and does not support the use of bereavement interventions for informal caregivers of critically ill patients who die in the ICU.

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