scholarly journals Discomforts in Critically ill Patients: Our Experience in Intensive Care Unit of a Tertiary Care Hospital in India

2021 ◽  
Author(s):  
Reetu Verma ◽  
Sasmita Panda ◽  
Rajeev Kumar Nishad
Keyword(s):  
Intensive Care ◽  
Environmental Factors ◽  
Critically Ill ◽  
Nursing Care ◽  
Critically Ill Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Icu Patients ◽  
Common Cause

Introduction: Patients admitted in the Intensive Care Units (ICUs) experiences various discomforts which may be recognised or unrecognised. These discomforts may arise from the environment, may be related to the ICU care and discomfort related to the health status of the patient and critical care interventions. Aim: To identify the various discomforts in ICU patients, to classify them with respective causes, identify the most common cause among them and whether ICU sedation helps in reducing discomforts. Materials and Methods: This observational study was conducted from 15th July to 15th October 2018 on 120 mixed ICU patients in a Tertiary Care Hospital in India. Patients who were admitted to ICU for more than 24 hours, aged 18 years and above, those who gave written informed consent were observed and enquired for any discomfort. Discomforts have been identified and recorded by a fulltime intensivist by direct observation, by interacting with the patients and asking the family members and others (indirect approach). Through this study discomforts of critically ill patients were broadly classified into four categories 1. Due to existing illness, 2. Due to ICU interventions, 3. Due to improper nursing care and 4. Due to environmental factors. Results: Out of 120 patients studied, 84 patients (70%) reported some kind of discomfort during their ICU stay. Existing illness was the most common cause of discomfort, 80 patients (66.6%) suffered due to it. ICU interventions was the second most common cause, 71 patients (59.1%) had discomfort due to interventions. Thirty five patients (29.1%) suffered due to improper nursing care and 25 patients (20.8%) suffered due to the environmental factors. In this study, it was observed that sedation reduces all kind of discomforts. conclusion: In this study 70% of patients, who were admitted to ICU due to various illness reported some kind of discomfort. The most common cause of ICU discomforts was existing illness followed by ICU interventions. In this study it was observed that sedation reduces all kind of discomforts. Sedated patients tolerate the endotracheal tube better and they had less environmental and procedure related discomforts. With the present study observation it can be suggested that ICU charts of nurses and doctors can carry a separate column for mentioning discomforts in different duty shifts. However, with the use of appropriate analgesia and sedation discomfort can be reduced.

scholarly journals The Predictive Power of Low T3 Levels among ICU Patients in a Tertiary Care Hospital of Kerala

2020 ◽  
Vol 11 (4) ◽  
pp. 7464-7467
Author(s):  
Nandu Baby P ◽  
Ramesh V
Keyword(s):  
Mortality Rate ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Care Hospital ◽  
Icu Patients ◽  
Low T3 ◽  
Study Results

Just a few studies recorded that low thyroid hormones are independent mortality predictors in ICU-admitted patients, indicating the use of thyroid profile in mortality prediction scoring systems. A spectrum of improvements occurs in ICU patients, beginning with low triiodothyronine (T3) accompanied by low thyroxine (T4) and low thyroid-stimulating hormone (TSH) levels. To evaluate whether low T3 levels were responsible for increased mortality among ICU patients in a tertiary care hospital. This is a prospective, observational and interventional study carried on 200 ICU admitted patients aged 30-70 years. The study subjects were categorized into two groups- survivors and non-survivors. Our study results revealed that non-survivors had less T3, less T4, less TSH, more HbA1c indicating that low thyroid levels are playing one of the crucial roles in determining the mortality rate in critically ill patients. Further, we found that the treatment with T4 alone was ineffective while replacement therapy, including T3, proved effective leading to significant clinical improvement. Low T3 syndrome has a significant effect on the mortality rate of critically ill patients. However, a further larger sample of patients should be evaluated to draw more reliable conclusions on Low T3 levels among ICU patients.

Pharmacoepidemiology of metaraminol in critically ill patients with shock in a tertiary care hospital

2021 ◽  
Author(s):  
Arwa Abu Sardaneh ◽  
Jonathan Penm ◽  
Matthew Oliver ◽  
David Gattas ◽  
Andrew J. McLachlan ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

Monitoring therapeutic colistin concentrations in critically ill patients admitted to a tertiary care hospital

2018 ◽  
Vol 34 (11) ◽  
pp. 534-538
Author(s):  
Sriramulu Manivannan Vithunes ◽  
Sathiyanathan Priyanka ◽  
Johncy Jose ◽  
Nitha Thankam Sajeev ◽  
Ranganathan Hariprasad ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

scholarly journals Characteristics and Outcomes of Critically Ill Patients with Raised Cardiac Troponins Admitted in the Intensive Care Unit

2021 ◽  
Author(s):  
Sunil K. Nadar ◽  
Muhammad M. Shaikh ◽  
Muhammad A. Khatri ◽  
Wael A. Abdelmottaleb ◽  
Sheeraz Ahmed ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Myocardial Injury ◽  
Tertiary Care ◽  
Hospital Length Of Stay ◽  
Care Hospital ◽  
Coronary Syndrome

Objectives: Critically ill patients have been shown to have raised troponins.  The aim of our study was to assess the incidence of myocardial injury in the intensive care unit (ICU) a tertiary care hospital in Oman and assess their management and prognosis. Methods: This was a retrospective study involving adult patients admitted to the ICU of our institution between 1st January and 31st December 2019 who had a high sensitive cardiac troponin (Hs-CTn) assay performed. We excluded patients who were admitted with a primary diagnosis of myocardial infarction. Results: A total of 264 patients had a Hs-cTn measured during this period. Of these 128 patients (64.3+17.1 years; 58.5% male) had elevated levels giving an incidence of around 48.4%. Those with raised troponin were older and had more co-morbidities. These patients were also more critical with lower blood pressure, higher heart rates, hypotensive episodes. Of the 128 patients, 47 were treated as acute coronary syndrome and 32 underwent coronary angiography. Of these only 3 patients required stenting. Patients with raised troponin had a poor outcome with only 45 (35.1%) surviving to discharge as compared to 73.5% where troponin was normal. They had a shorter hospital length of stay as compared to those with normal troponin (16(8-25) vs 19(13-28) p=0.017). Conclusion: A high proportion of critically ill patients have evidence of myocardial injury without significant coronary artery disease. It is associated with poor prognosis. Further prospective studies are required to ascertain the best mode of treatment in these patients. Keywords: Troponin; Biomarkers; Intensive Care; Myocardial Infarction.

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