scholarly journals Post Anesthesia Care in Intensive Care Unit: A Review

2021 ◽  
pp. 253-261
Author(s):  
Tamer M. Kadry ◽  
Ali Adnan Al Khamis ◽  
Khalil Abdrabalnabi M. Ahmed ◽  
Ahmed Mohammed Al Hammad ◽  
A. Sakabomi, Duoaa Mohammad ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Inpatient Treatment ◽  
Postoperative Morbidity ◽  
Care Process ◽  
Anesthesia Care ◽  
Duration Of Stay ◽  
The World ◽  
Level Of Training ◽  
To Receive

The notion of inpatient treatment is possibly as ancient as medicine itself. It would have been sensible to place patients in such facilities such that those who were sicker were more visible to receive better care from the personnel. The first Intensive Care Units (ICUs) were established in Europe and around the world in the 1950, today intensive care units (ICUs) are a common sight in hospitals throughout the world. The PACU is designed to make some processes easier in order to provide better postoperative care. Invasive and noninvasive breathing, goal-directed hemodynamic control, invasive monitoring, and pain management are just a few of the options that can be provided. PACU helps reducing postoperative morbidity and consequently the duration of stay of patients.The costs of both establishing and operating a PACU are undeniable. however, by reducing postoperative morbidity and consequently the duration of stay of patients, overall expenses should be reduced. But with that being said many developing countries do not have the same luxury as developed ones when it come to having enough ICUs. That with other problems such as the differences in level of training and number of staff operating such units determine the overall result of health care process. In this article we will be discussingthe importance of PACU and various factors that affect it.

scholarly journals Factors influencing plasma transfusion practices in paediatric intensive care units around the world

Vox Sanguinis ◽  
2017 ◽  
Vol 112 (2) ◽  
pp. 140-149 ◽  
Author(s):  
O. Karam ◽  
P. Demaret ◽  
A. Duhamel ◽  
A. Shefler ◽  
P. C. Spinella ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Paediatric Intensive Care ◽  
Plasma Transfusion ◽  
Factors Influencing ◽  
The World ◽  
Paediatric Intensive Care Units

scholarly journals Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Alberto García-Salido ◽  
◽  
Juan Carlos de Carlos Vicente ◽  
Sylvia Belda Hofheinz ◽  
Joan Balcells Ramírez ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Gastrointestinal Symptoms ◽  
Pediatric Intensive Care ◽  
Critically Ill Children ◽  
Vasoactive Drugs ◽  
Pediatric Intensive Care Units ◽  
Neutrophil Lymphocyte Ratio ◽  
Inflammatory Syndrome ◽  
To Receive

Abstract Background Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. Methods A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. Results Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5–11.8) vs 3.4 years (IQR 0.4–9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5–8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. Conclusions MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients.

scholarly journals Surgical Critical Care at the Epicenter of the COVID-19 Pandemic

2020 ◽  
Vol 86 (7) ◽  
pp. 736-740
Author(s):  
Rifat Latifi
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Infected People ◽  
Care Specialist ◽  
Surgical Critical Care ◽  
The World ◽  
Surgery Resident ◽  
Back To Work

The number of deaths and infected people by Corona-19 virusin 2020 around the world is alarming and numbing at the same time. It almostdifficult to remember when the world was normal, although it just started fewmonths ago. Our world and everything around have changed, our surgical practicehas changed, our life has changed, but Intensive Care Units (ICU)in WestchesterMedical center in Valhalla, NY, continue to care for the sickest of thesickest. But this time, different disease with different prognosis. Everycritical care specialist, every surgery resident and surgical critical carefellow, are COVID-19 doctors. As I round in the ICU, I imagine myself in one ofthose beds that I could have been few weeks ago. Now, fully recovered fromCOVID-19, and coming back to work is a real treat. Yet, I still have morequestions than answers.

Ethics dilems care and die in intensive care units: vision nursing studentsConflitos éticos do cuidar e do morrer nas unidades de terapia intensiva: visão dos acadêmicos de enfermagem

2008 ◽  
Vol 2 (4) ◽  
pp. 338
Author(s):  
Júlio Cesar Santana ◽  
Ana Cristina de Sá ◽  
Vera Lúcia Zaher
Keyword(s):  
Intensive Care ◽  
Nursing Students ◽  
Intensive Care Units ◽  
Meaning Making ◽  
Phenomenological Approach ◽  
Family Influence ◽  
Care Process ◽  
Ethical Conflicts ◽  
Terapia Intensiva ◽  
Taking Care

ABSTRACTObjective: to understand the ethical conflicts meaning in the taking care process and perception of the nursing academics of dying in Intensive Care Units (ICUs). Method: research with phenomenological approach, according to the following scheming question: which had been the ethical conflicts lived deeply by you during the training period on ICUs. For such question, it was looked to refer the bioethical questions that contemplate the science of life. They had gotten the deposition of nine nursing academics, of which they had excited the units of meaning, making possible to investigate the citizens everyday and its expression in the world-life. Results: it had been attributed units of meanings in a perspective that emerged the ethical conflicts of academics nursing in the taking care and dying process:  holistic care  X  technique; care centered in the illness; family influence and the communication in taking care of; ICUs limits: until when investing? Conclusion: the reflections revealed that the nursing academics face complex situations, that go, since the routines techniques learning process to diverse situations that involves the human suffering and revealing ethical conflicts of our fragility, waking up its proper human being dimension, the existential direction, sensitizing them for a taking care reflection, becoming vulnerable to the suffering and questioning the limits where they are placed in. Descriptors: ethics; nursing; students; intensive care units; bioethics.RESUMOObjetivo: compreender o significado dos conflitos éticos no processo do cuidar e do morrer em Unidades de Terapia Intensiva (UTIs) na visão dos acadêmicos de enfermagem. Métodos: pesquisa com abordagem fenomenológica, direcionada pela seguinte questão norteadora: quais os conflitos éticos vivenciados por você durante o período de estágio em UTIs? Para tal, procurou-se referenciar as questões da bioética que contemplam a ciência da vida. Resultados: foram atribuídas unidades de significado na medida em que emergiam os conflitos éticos dos acadêmicos no processo do cuidar e morrer: cuidado holístico X tecnicismo; cuidado centrado na doença; limites na UTI: até quando investir? Conclusão: as reflexões desvelaram que os acadêmicos de enfermagem enfrentam situações complexas, que vão desde o processo de aprendizagem das rotinas técnicas a situações diversas que envolvem o sofrimento humano e conflitos éticos reveladores de nossa fragilidade, despertando a sua própria dimensão humana, o sentido existencial, sensibilizando-os para uma reflexão do cuidar, tornando-os vulneráveis ao sofrimento e questionando os limites em que são colocados. Descritores: ética; enfermagem; estudantes; unidades de terapia intensiva; bioética.RESUMENObjetivo: El  comprender el significado de los conflictos éticos en el proceso de cuidar y morir en Unidades de Terapia Intensiva (UTIs), dentro de la percepción de los académicos de enfermeria. Metodos: pesquisa con embasamiento  fenomenológico, direccionada por la siguiente cuestión norteadora: ¿cuales fueron los conflictos  éticos vivenciados por usted durante el periodo de estagio en UTIs?” Para tal, se buscó referenciar las cuestiones da bioética que contempla la ciencia de la vida. Resultados: el final de la pesquisa fueron atribuidas unidades de significados en una perspectiva que emergían los conflictos éticos de los académicos en el proceso de cuidar y morir: cuidado holístico X  tecnicismo; cuidado centrado en enfermedad; límites en UTI: ¿hasta cuando invertir? Conclusion: las reflexiones desvelaron que los académicos de enfermeria enfrentan situaciones complejas, que van, desde el proceso de aprendizaje de rutinas técnicas hasta situaciones diversas que envuelven el sufrimiento humano y conflictos éticos reveladores de nuestra fragilidad, despertando su propria dimensión humana, el sentido existencial, sensibilizándolos para una reflexión del cuidar, volviéndose vulnerables al sufrimiento y cuestionando los límites que son colocados. Descriptores: ética; enfermería; estudiantes; unidades de terapia intensiva; boética. 

Assessment of the intensity of procedural pain in newborns treated in the intensive care unit measured by the Neonatal Infant Pain Scale (NIPS)

2018 ◽  
Vol 8 (2) ◽  
pp. 33-39
Author(s):  
A. Bomersbach ◽  
L. Sochocka
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Pain Perception ◽  
Pain Scale ◽  
Full Term ◽  
Care Process ◽  
Procedural Pain ◽  
Medical Procedure ◽  
Medical Procedures ◽  
Infant Pain

<b>Introduction:</b> Newborns born prematurely and treated in intensive care units are at greater risk of experiencing pain than patients treated in other units. <b>Purpose:</b> To evaluate the severity of pain perceived by children during the performance of medical procedures related to the treatment and care process. <b>Materials and methods:</b> The study was conducted at one of the Intensive Care Units in Opole. The study group consisted of 100 newborns, 60% of the subjects were prematurely born newborns, and 40% - were full-term. The degree of procedural pain associated with blood collection, peripheral puncture insertion, upper respiratory tract suction, gastric tube insertion and ophthalmic examination was assessed by an observation method using the standard Neonatal Infant Pain Scale Form (NIPS). <b>Results:</b> Out of the analysed medical procedures, 100% of children experienced acute, severe pain over the course of suction and ophthalmological examination. The highest perception of pain was experienced by 88.3% of premature newborns and 71.8% of full-term newborns. Over the course of medical procedures, 84% of male and 79.6% female newborns experienced acute pain. It was shown that the degree of pain perception was determined by the type of performed medical procedure (p=0.001) and the gestational age of the newborn (p=0.037). On the other hand, there was no correlation between the sex of the newborn child and the degree of pain perception (p=0.758). <b>Conclusions:</b> Based on the foregoing study result, bearing in mind the need to minimise the effects of pain stimulation, it seems important to use standardised tools to assess the severity of pain in newborns treated in Intensive Care Units on a larger scale.

scholarly journals The world knows the real heroes after the outbreak of COVID-19 pandemic!

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
M. Kashif Iqbal
Keyword(s):  
Intensive Care ◽  
Emergency Room ◽  
Key Words ◽  
Intensive Care Units ◽  
Human Life ◽  
Operating Rooms ◽  
The Real ◽  
Corona Virus ◽  
The World ◽  
Positive Effect

Over the previous few months, COVID-19 and the corona virus have become the key words in every medium of the world. Our TV screens show the ever-riding number of fresh cases and the latest mortality figures. The pandemic has affected every aspect of the human life, but it has had one positive effect; it dragged the specialty of anesthesiology and its practitioners into limelight as never before. This editorial highlights the diverse nature of the anesthesiologists’ role in confronting COVID-19 and management of the patients from emergency room (ER), to intensive care units (ICUs) to operating rooms (ORs). Key words: Anesthesiologist; Perioperative physician; Pain managers; Intensivists; COVID-19; Pandemic Citation: Iqbal MK. The world knows the real heroes after the outbreak of COVID-19 pandemic! Anaesth. pain intensive care 2020;24(5):484-486 Received: 2 September 2020, Reviewed: 4 September 2020, Accepted: 30 September 2020

scholarly journals A scaling approach to estimate the COVID-19 infection fatality ratio from incomplete data

2020 ◽  
Author(s):  
Beatriz Seoane
Keyword(s):  
Intensive Care ◽  
Mortality Rate ◽  
Intensive Care Units ◽  
Exponential Growth ◽  
Incomplete Data ◽  
Death Certificates ◽  
Antibody Prevalence ◽  
The World ◽  
Official Records ◽  
Similar Growth

AbstractSARS-CoV-2 has disrupted the life of billions of people around the world since the first outbreak was officially declared in China at the beginning of 2020. Yet, important questions such as how deadly it is or its degree of spread within different countries remain unanswered. In this work, we exploit the ‘universal’ growth of the mortality rate with age observed in different countries since the beginning of their respective outbreaks, combined with the results of the antibody prevalence tests in the population of Spain, to unveil both unknowns. We validate these results with an analogous antibody rate survey in the canton of Geneva, Switzerland. We also argue that the official number of deaths over 70 years old is importantly underestimated in most of the countries, and we use the comparison between the official records with the number of deaths mentioning COVID-19 in the death certificates to quantify by how much. Using this information, we estimate the fatality infection ratio (IFR) for the different age segments and the fraction of the population infected in different countries assuming a uniform exposure to the virus in all age segments. We also give estimations for the non-uniform IFR using the sero-epidemiological results of Spain, showing a very similar growth of the fatality ratio with age. Only for Spain, we estimate the probability (if infected) of being identified as a case, being hospitalized or admitted in the intensive care units as function of age. In general, we observe a nearly exponential growth of the fatality ratio with age, which anticipates large differences in total IFR in countries with different demographic distributions, with numbers that range from 1.82% in Italy, to 0.62% in China or even 0.14% in middle Africa.

scholarly journals COVID-19 Treatment Experiences in the ICU

2020 ◽  
pp. 33-38
Author(s):  
George Mychaskiw II ◽  
Harish Siddaiah ◽  
Shilpadevi S. Patil
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medical Center ◽  
Academic Medical Center ◽  
Disease Process ◽  
Global Crisis ◽  
Disease Symptoms ◽  
Academic Medical ◽  
The World ◽  
The U.S

The COVID-19 pandemic has been a global crisis at an unprecedented level. More than 4.75 million cases and 157,000 deaths have been reported in the U.S. as of August 3, 2020. The whole disease process, from symptoms and diagnosis to medications and treatment, has been a challenge, as COVID-19 is a novel disease that the world has never before encountered. In this article, the authors discuss the disease symptoms, pathophysiology and treatments based on their experience treating COVID-19 positive patients in the intensive care units of a major Louisiana academic medical center.

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