scholarly journals Noninvasive ventilation versus conventional oxygen therapy after extubation failure in high-risk patients in an intensive care unit: a pragmatic clinical trial

2021 ◽  
Vol 33 (3) ◽  
Author(s):  
Alberto Belenguer-Muncharaz ◽  
Maria-Lidón Mateu-Campos ◽  
Bárbara Vidal-Tegedor ◽  
María- Desamparados Ferrándiz-Sellés ◽  
Maria-Luisa Micó-Gómez ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Noninvasive Ventilation ◽  
Oxygen Therapy ◽  
Extubation Failure ◽  
Pragmatic Clinical Trial ◽  
High Risk Patients ◽  
Risk Patients

Readiness Assessment for Extubation Planning in the Intensive Care Unit: A Quality Improvement Initiative

2021 ◽  
Vol 41 (3) ◽  
pp. 42-48
Author(s):  
Jace D. Johnny
Keyword(s):  
High Risk ◽  
Failure Rate ◽  
Noninvasive Ventilation ◽  
Extubation Failure ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Prophylactic Measure ◽  
High Risk Patients ◽  
Risk Patients

Background Extubation failure is the reintubation of patients meeting criteria for weaning from mechanical ventilation. Extubation failure is correlated with mortality, prolonged mechanical ventilation, and longer hospital stays. Noninvasive ventilation or high-flow nasal cannula oxygen therapy after extubation is recommended to prevent extubation failure in high-risk patients. Local Problem The extubation failure rate is unknown. Prophylactic measures (noninvasive ventilation or high-flow nasal cannula) after extubation are not commonly used and vary among clinicians. The objective was to assess extubation planning readiness by determining extubation failure rate, identifying high-risk patients, and determining prophylactic measure compliance. Methods A quality improvement initiative included an evidence-based extubation failure risk assessment that identified high-risk patients and determined prophylactic measure compliance. A 2-year retrospective medical record review was used to determine baseline patient characteristics and extubation failure rate. Results Extubation failure rate within the retrospective cohort was 13 of 146 patients (8.9%). Extubation failure did not correlate with previously identified risk factors; however, 150 identified patients were excluded from analysis. During risk assessment integration, the extubation failure rate was 3 of 37 patients (8.1%) despite identifying 24 high-risk patients (65%). Few high-risk patients received prophylactic measures (noninvasive ventilation, 17%; high-flow nasal cannula, 12%). Conclusions Extubation failure should be routinely measured because of its effects on patient outcomes. This project reveals the multifactorial nature of extubation failure. Further research is needed to assess patients’ risk and account for acute conditions. This project used best practice guidelines for routine patient care and added transparency to a previously unmeasured event.

Inpatient Goals-of-Care Conversations Reduce Intensive Care Unit Transfers in High-Risk Patients

2019 ◽  
Vol 36 (7) ◽  
pp. 583-586 ◽  
Author(s):  
Amber Zimmer Deptola ◽  
Jessica Riggs
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Goals Of Care ◽  
High Risk Patients ◽  
Risk Patients

Proactive palliative care in the medical intensive care unit: Effects on length of stay for selected high-risk patients

2007 ◽  
Vol 35 (6) ◽  
pp. 1530-1535 ◽  
Author(s):  
Sally A. Norton ◽  
Laura A. Hogan ◽  
Robert G. Holloway ◽  
Helena Temkin-Greener ◽  
Marcia J. Buckley ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Palliative Care ◽  
Intensive Care ◽  
High Risk ◽  
Length Of Stay ◽  
Medical Intensive Care Unit ◽  
High Risk Patients ◽  
Risk Patients ◽  
Medical Intensive Care

scholarly journals Effects of the proportion of high-risk patients and control strategies on the prevalence of methicillin-resistant Staphylococcus aureus in an intensive care unit

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Farida Chamchod ◽  
Prasit Palittapongarnpim
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Risk Group ◽  
Control Strategies ◽  
High Risk Group ◽  
High Risk Patients ◽  
Risk Patients ◽  
Mrsa Infection ◽  
And Control

Abstract Background The presence of nosocomial pathogens in many intensive care units poses a threat to patients and public health worldwide. Methicillin-resistant Staphylococcus aureus (MRSA) is an important pathogen endemic in many hospital settings. Patients who are colonized with MRSA may develop an infection that can complicate their prior illness. Methods A mathematical model to describe transmission dynamics of MRSA among high-risk and low-risk patients in an intensive care unit (ICU) via hands of health care workers is developed. We aim to explore the effects of the proportion of high-risk patients, the admission proportions of colonized and infected patients, the probability of developing an MRSA infection, and control strategies on MRSA prevalence among patients. Results The increasing proportion of colonized and infected patients at admission, along with the higher proportion of high-risk patients in an ICU, may significantly increase MRSA prevalence. In addition, the prevalence becomes higher if patients in the high-risk group are more likely to develop an MRSA infection. Our results also suggest that additional infection prevention and control measures targeting high-risk patients may considerably help reduce MRSA prevalence as compared to those targeting low-risk patients. Conclusions The proportion of high-risk patients and the proportion of colonized and infected patients in the high-risk group at admission may play an important role on MRSA prevalence. Control strategies targeting high-risk patients may help reduce MRSA prevalence.

Specialty Linens and Pressure Injuries in High-Risk Patients in the Intensive Care Unit

2017 ◽  
Vol 26 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Regi Freeman ◽  
Andrew Smith ◽  
Sharon Dickinson ◽  
Dana Tschannen ◽  
Shandra James ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
High Risk Patients ◽  
Risk Patients

Scoring system for the selection of high-risk patients in the intensive care unit

2006 ◽  
Vol 34 (4) ◽  
pp. 1039-1043 ◽  
Author(s):  
Gaetano Iapichino ◽  
Giovanni Mistraletti ◽  
Davide Corbella ◽  
Gabriele Bassi ◽  
Erika Borotto ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
High Risk ◽  
Scoring System ◽  
High Risk Patients ◽  
Risk Patients ◽  
Selection Of

Postoperative Outcome of High Risk Patients in the Intensive Care Unit: A Retrospective Study

2017 ◽  
Vol 4 (2 (Part-1)) ◽  
pp. 209-214
Author(s):  
K.K. Mubarak ◽  
◽  
James Chacko ◽  
Dhanesh S. ◽  
Sruthi Unni ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
High Risk ◽  
Postoperative Outcome ◽  
High Risk Patients ◽  
Risk Patients
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