STUDY THE ISOLATION RATE AND ANTIBIOTIC RESISTANCE OF ACINETOBACTER SPP IN THE INTENSIVE CARE DEPARTMENT THANH NHAN HOSPITAL

Objectives: To describe the isolation rate and antibiotic status of Acinetobacter ssp hospital-acquired bacteria in the intensive care unit. Methods: 1434 patient samples isolated patient samples, cultured, performed antibiogram, described cross-section. Results: 109/331 strains of Acinetobacter spp were isolated (32.9%) and mainly from respiratory specimens, catheters (76.1% and 14.7%). Acinetobacter spp has a high degree of antibiotic resistance to most of the antibiotics Ceftazidime: 91.7%, Cefepime 91.7%, gentamycine 91.7%, Amikacin 83.3%, Imipenem and Meropenem 75%, still sensitive 100 % with antibiotics Polimycin B and Colistin.

Tobramycin: efficacy of intensive therapy

One of the leading cause of the decrease of treatment efficacy in patient with community-acquired infections in the intensive care department is a spread of antibiotic resistance in main causative agents. Among Gram-negative microorganisms Pseudomonas aeruginosa is one of the leading causative agents, that is related to health service. A review of foreign and domestic literature concerning tobramycin – systemic form use in the current medical practice in the conditions of increasing resistance of microorganisms to the most broad-spectrum antibiotics is presented in the article. Pharmacokinetic and pharmacodynamic characteristics of tobramycin are described, results of clinical trials, that demonstrate an efficacy of its use in the combination with other antibiotics in the life-threatening infections caused by Gram-negative microorganisms are presented in the article.

EVALUATION OF THE OXYGEN-HELIUM THERAPY EFFICIENCY FOR PATIENTS WITH COVID-19 ASSOCIATED PNEUMONIA

Evidence from patients in the intensive care department of a multifield hospital treated for COVID-19 associated pneumonia with or without the use of a heated heliox mixture points to the beneficial effect of the mixture in the complex therapy of the disease. Comparative analysis of the clinical symptoms and laboratory data of the patients who received the heliox therapy and who did not (controls) testifies that heliox improves blood oxygenation, returns acid-base balance to normal, maintains dynamics of key pamaters positive and, therefore, increases effectiveness and shortens time of treatment.

ICU admissions: Consequences after discharge

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

Use of the expanded Apgar score for the assessment of intraventricular and intraparenchymal haemorrhage risk in neonates

Background Preterm birth is a key factor contributing to haemorrhage incidence in neonates. This study focused on defining relevant parameters for the assessment of intraventricular and intraparenchymal haemorrhage risks in neonates. Methods Chi-square automatic interaction detection was used to analyse the Apgar score (AS), the Apgar max score, and the course of resuscitation documented according to the expanded AS in 696 infants born between 2009 and 2011 in the Neonatal and Intensive Care Department of the Medical University of Warsaw. Results Gestational age was the most relevant discriminating variable for the prediction of intraventricular and intraparenchymal haemorrhage incidences. Infants born before the 31st week of pregnancy made up 80% of the intraventricular or intraparenchymal haemorrhage cases. Additionally, a fraction of inspired oxygen > 0.8 at ten minutes after birth was a better discriminating variable in the youngest neonates than an Apgar max score ≤ 5, identifying 31.6% and 20.6% of infants with intraventricular and intraparenchymal haemorrhage, respectively. Conclusions Consideration of the oxygen concentration supplied during resuscitation significantly improves the prognosis of intraventricular and intraparenchymal haemorrhages in preemies compared to the use of the classical AS.