scholarly journals Incidence, risk factors, and outcomes of unplanned extubation in adult patients in a resource-limited teaching hospital in the Philippines: a cohort study

2019 ◽  
Vol 31 (1) ◽  
Author(s):  
Angelique Bea C Uy ◽  
Everly Faith P Ramos ◽  
Adovich S Rivera ◽  
Norman L Maghuyop ◽  
Cezar Thomas R Suratos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Teaching Hospital ◽  
The Philippines ◽  
Adult Patients ◽  
Unplanned Extubation ◽  
Resource Limited ◽  
Incidence Risk

scholarly journals Incidence and Determinants of Health Care Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

2018 ◽  
Author(s):  
Mamta Dhaneria ◽  
Sachin Jain ◽  
Poonam Singh ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Preterm Neonates ◽  
Resource Limited Settings ◽  
Resource Limited ◽  
Incidence Risk

Very little is known about laboratory confirmed blood stream infections (LCBIs) in neonatal intensive care units (NICUs) in resource-limited settings. The aim of this cohort study was to determine the incidence, risk factors, and causative agents of LCBIs in a level-2 NICU in India. The diagnosis of LCBIs was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with LCBIs was filled-in. A total of 150 neonates (43% preterm) were included in the study. The overall incidence of LCBIs was 31%. The independent risk factors for LCBIs were: preterm neonates (relative risk (RR) 2.23), duration of NICU stay more than 14 days (RR 1.75), chorioamnionitis in the mother (RR 3.18), premature rupture of membrane in mothers (RR 2.32), neonate born through meconium-stained amniotic fluid (RR 2.32), malpresentation (RR 3.05), endotracheal intubation (RR 3.41), umbilical catheterization (RR 4.18), and ventilator-associated pneumonia (RR 3.17). The initiation of minimal enteral nutrition was protective from LCBIs (RR 0.22). The predominant causative organisms were gram-negative pathogens (58%). The results of the present study can be used to design antibiotic interventions to reduce LCBIs in resource-limited settings.

scholarly journals Incidence, risk factors and prognostic effect of imaging right ventricular involvement in patients with COVID-19: a dose–response analysis protocol for systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049866
Author(s):  
Chenghui Zhou ◽  
Baohui Lou ◽  
Hui Li ◽  
Xin Wang ◽  
Hushan Ao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Right Ventricular ◽  
Dose Response ◽  
Meta Analysis ◽  
Adult Patients ◽  
Sensitivity Analyses ◽  
Prognostic Effect ◽  
All Cause Mortality ◽  
Incidence Risk

IntroductionEmerging evidence has shown that COVID-19 infection may result in right ventricular (RV) disturbance and be associated with adverse clinical outcomes. The aim of this meta-analysis is to summarise the incidence, risk factors and the prognostic effect of imaging RV involvement in adult patients with COVID-19.MethodsA systematical search will be performed in PubMed, EMBase, ISI Knowledge via Web of Science and preprint databases (MedRxiv and BioRxiv) (until October 2021) to identify all cohort studies in adult patients with COVID-19. The primary outcome will be the incidence of RV involvement (dysfunction and/or dilation) assessed by echocardiography, CT or MRI. Secondary outcomes will include the risk factors for RV involvement and their association with all-cause mortality during hospitalisation. Additional outcomes will include the RV global or free wall longitudinal strain (RV-GLS or RV-FWLS), tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and RV diameter. Univariable or multivariable meta-regression and subgroup analyses will be performed for the study design and patient characteristics (especially acute or chronic pulmonary embolism and pulmonary hypertension). Sensitivity analyses will be used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of RV involvement incidence and related risk factors, association with all-cause mortality, and other RV parameters (RV-GLS or RV-FWLS, TAPSE, S’, FAC and RV diameter). Both linear and cubic spline regression models will be used to explore the dose–response relationship between different categories (>2) of RV involvement and the risk of mortality (OR or HR).Ethics and disseminationThere was no need for ethics approval for the systematic review protocol according to the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication.PROSPERO registration numberCRD42021231689.

Predicting Reintubation After Unplanned Extubations in Children: Art or Science?

2016 ◽  
Vol 33 (8) ◽  
pp. 467-474
Author(s):  
Paulo Sérgio Lucas da Silva ◽  
Maria Eunice Reis ◽  
Thais Suelotto Machado Fonseca ◽  
Marcelo Cunio Machado Fonseca
Keyword(s):  
Risk Factors ◽  
Odds Ratio ◽  
Univariate Analysis ◽  
Length Of Hospital Stay ◽  
Pediatric Intensive Care ◽  
Unplanned Extubation ◽  
Ventilator Support ◽  
Unplanned Extubations ◽  
Mechanical Ventilation Support ◽  
Incidence Risk

Purpose: Reintubation following unplanned extubation (UE) is often required and associated with increased morbidity; however, knowledge of risk factors leading to reintubation and subsequent outcomes in children is still lacking. We sought to determine the incidence, risk factors, and outcomes related to reintubation after UEs. Methods: All mechanically ventilated children were prospectively tracked for UEs over a 7-year period in a pediatric intensive care unit. For each UE event, data associated with reintubation within 24 hours and outcomes were collected. Results: Of 757 intubated patients, 87 UE occurred out of 11 335 intubation days (0.76 UE/100 intubation days), with 57 (65%) requiring reintubation. Most of the UEs that did not require reintubation were already weaning ventilator settings prior to UE (73%). Univariate analysis showed that younger children (<1 year) required reintubation more frequently after an UE. Patients experiencing UE during weaning experienced significantly fewer reintubations, whereas 90% of patients with full mechanical ventilation support required reintubation. Logistic regression revealed that requirement of full ventilator support (odds ratio: 37.5) and a COMFORT score <26 (odds ratio: 5.5) were associated with UE failure. There were no differences between reintubated and nonreintubated patients regarding the length of hospital stay, ventilator-associated pneumonia rate, need for tracheostomy, and mortality. Cardiovascular and respiratory complications were seen in 33% of the reintubations. Conclusion: The rate of reintubation is high in children experiencing UE. Requirement of full ventilator support and a COMFORT score <26 are associated with reintubation. Prospective research is required to better understand the reintubation decisions and needs.

scholarly journals 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study

The Lancet ◽  
2015 ◽  
Vol 386 (9989) ◽  
pp. 154-162 ◽  
Author(s):  
Renate B Schnabel ◽  
Xiaoyan Yin ◽  
Philimon Gona ◽  
Martin G Larson ◽  
Alexa S Beiser ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cohort Study ◽  
Framingham Heart Study ◽  
Heart Study ◽  
Incidence Risk
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