International Journal of Critical Care and Emergency Medicine最新文献

{"title":"Dexamethasone versus Methylprednisolone in Hospitalized COVID-19 Patients: A Systematic Review and Meta-Analysis","authors":"Bajaj Divyansh, Agrawal Ankit, Gupta Manasvi, Manek Gaurav, H. Kurt, Boregowda Umesha","doi":"10.23937/2474-3674/1510128","DOIUrl":"https://doi.org/10.23937/2474-3674/1510128","url":null,"abstract":"","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74088460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Delirium and Difficult Sedation Weaning in ICU Thiamine Deficiency Maybe a Possible not Uncommon Cause","authors":"Aly Magdy Khames","doi":"10.23937/2474-3674/1510131","DOIUrl":"https://doi.org/10.23937/2474-3674/1510131","url":null,"abstract":"","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85454724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Intensive Care Syndrome in Newborns from a Nutritional and Neuromotor Perspective","authors":"Drews Júnea Regina Pires, Campos Janaina Aparecida, Guimarães Polianna de Brito, Trandafilov Romilda Maria Vidigal, Lopes Natascha Severnini","doi":"10.23937/2474-3674/1510129","DOIUrl":"https://doi.org/10.23937/2474-3674/1510129","url":null,"abstract":"Premature newborns who need prolonged hospital stays may develop Post-Intensive Care Syndrome, which, as the term itself suggests, is characterized by post-hospital changes that manifest themselves in the physical, cognitive and/or nutritional fields. The advance of care in recent decades has provided greater survival for the newborns, thus allowing initial studies to characterize signs and symptoms which may indicate, in the future, the risk of developing PICS. Given the above, the aim of this study was to characterize and verify the prevalence of signs related to PICs in the neuro psychomotor and nutritional domains in children followed at a public hospital in Belo Horizonte, Minas Gerais, Brazil. To this end, an observational, cross-sectional, prospective study was carried out in the period from October 2016 to June 2017. The sample consisted of 26 children, 77% male, 58% of cesarean delivery and age from 1 to 12 months. The birth took place at 26 to 41 weeks of gestation and these newborns remained hospitalized in the NICU for 6 to 97 days. Birth weight was diagnosed as adequate for 92% of these newborns, considering their prematurity. After hospitalization, the prevalence of adequate weight for these children decreased to 81% and a new nutritional diagnosis of low weight was established. As expected, premature children and children with a nutritional diagnosis of low weight stayed longer in the ICU. Complementarily, our study observed that children with longer hospital stays tend to have an altered motor development. Noteworthy, this is one of the first studies on the subject and demonstrated that there is a tendency for changes in the motor and nutritional performance of children who remain hospitalized in the ICU, bringing the need for future studies with more robust samples and followed for more time.","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87073362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Tranexamic Acid Prevents Intubation in ACE Inhibitor-Induced Angioedema","authors":"Judge Ramzan, Kolaski Stephanie, Qadeer Farhan","doi":"10.23937/2474-3674/1510127","DOIUrl":"https://doi.org/10.23937/2474-3674/1510127","url":null,"abstract":"Angiotensin-converting enzyme inhibitors (ACE-I) are medications within the antihypertensive class that are used by nearly 108 million patients worldwide [1]. A rare but possibly life-threatening adverse effect of ACE-I is angioedema, which occurs due to elevated levels of bradykinin [2]. In this case report, we discuss a patient case where the use of tranexamic acid (TXA), an antifibrinolytic agent, prevented impending intubation due to ACE-I induced angioedema. CaSe RepoRt","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75632262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Lower Abdominal Compression a Possible Therapeutic Intervention in ARDS","authors":"C. Alexandru, Cohen Vladimir, Dudoignon Emmanuel, Dépret François","doi":"10.23937/2474-3674/1510124","DOIUrl":"https://doi.org/10.23937/2474-3674/1510124","url":null,"abstract":"Citation: Cupaciu A, Cohen V, Dudoignon E, Dépret F (2021) Continuous Lower Abdominal Compression a Possible Therapeutic Intervention in ARDS. Int J Crit Care Emerg Med 7:124. doi.org/10.23937/24743674/1510124 Accepted: June 28, 2021: Published: June 30, 2021 Copyright: © 2021 Cupaciu A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76160431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Obstetric Patient Transfers by Helicopter in Turkey","authors":"Uzun Asiye, Usul Eren, Işık Gülşah Çıkrıkçı, Korkut Semih","doi":"10.23937/2474-3674/1510119","DOIUrl":"https://doi.org/10.23937/2474-3674/1510119","url":null,"abstract":"Aims: Air ambulance services, which began in 2008 in our country, have become increasingly widespread. Today, there are command centers in 17 cities, and helicopter ambulances are preferably provided during the day, while air craft ambulances are used at night. The aim of the present study was to examine the characteristics of obstetric patient transfers by helicopter ambulance throughout Turkey in 2020. Materials and methods: This study was started after receiving permission from the Turkish Ministry of Health, and all obstetric cases transported by helicopter ambulance throughout the country between 01.01.2020 and 31.12.2020 were retrospectively examined and included in the study. Results: The mean age was 27.46 ± 5.98 (mean ± SD), and the three most common conditions were non-complicated pregnancy (n = 9), preeclampsia (n = 8), and early membrane rupture (n = 5). Regarding the flights, 13 (34.2%) took place in the spring, 13 (34.2%) in the summer, 9 (23.7%) in the autumn, and 3 (7.9%) in the winter. The median flight time was 63 minutes (IQR: 52.50-78.75). If the same distances had been taken by road, the estimated transfer time would have been 96 minutes (IQR: 87.75-124.5). Discussion: Although the air transfer of high-risk obstetric patients has been carried out for more than four decades, there are still controversial headlines on this topic. Studies have shown that high-risk newborns are more likely to survive when they are born in a place with a perinatal care center compared to local births and subsequent transfers. This data is similar to the data in the present study. Meanwhile, a report on all existing studies in 2000 and beyond showed that, compared to land transfers, helicopter transfers generally led to better results in terms of survival rates and treatment termination, and patients reached their health care facilities faster and time interval up to final treatment improved. Conclusion: The medical transportation of high-risk obstetric patients can be performed safely by air. Furthermore, air transfers help reduce maternal mortality and morbidity by reducing the time until patients receive precise treatment.","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88230337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underdiagnosed Delirium on Elderly Patients in the Emergency Room Principal Author","authors":"Alondra Sánchez Martínez Fátima, Alberto Ruiz Mondragón, Jaime Marín Nieto, Sebastián Villaseñor Talavera Yael","doi":"10.23937/2474-3674/1510122","DOIUrl":"https://doi.org/10.23937/2474-3674/1510122","url":null,"abstract":"Introduction: Delirium is a fluctuant, transitional and acute affection of cognition and attention, with multifactorial aetiologies. It is a medical emergency and requires an integral evaluation to identify the underlying causes. In elderly people, over 65 years old, the incidence of Delirium oscillates greatly between 14% to 24% at the moment of hospitalization and 6% to 56% during the time of hospitalization. The prevalence of Delirium acquired in the community oscillates from 1% to 2%. However, this prevalence increases as high as 10% when entering the emergency department. The identification of Delirium in the emergency department usually is not realized, leading to a delay in the instauration of treatment, which increases morbidity and mortality, leading to prolonged permanency at the hospital. Material and methods: A prospective study with no probabilistic sample was evaluated through logistic regression analysis, central tendency measurements, standard deviation and comparison between means. This study included 118 patients over 65 years old who were admitted to the emergency service of the Hospital General de Zona #50 (HGZ #50) in San Luis Potosi, S.L.P. Mexico; between the months of March and May of the year 2016. We utilized the Confusion Assessment Method (CAM) scale to evaluate the presence or absence of Delirium and its clinical subtypes in these 188 patients. T-Test was utilized to recognize the existence of under diagnose of Delirium. Objective: To identify the frequency of underdiagnose cases of Delirium in elderly patients in the emergency service of the HGZ#50. Results: A total of 118 patients over 65 years old admitted to the emergency service were included in the study, having 51.7% males (n = 61) and 48.3% females (n = 57). From the total number of patients, in only 26 patients Delirium was diagnosed thought CAM scale. Nevertheless, in only 6 patients (5.1%) the diagnosis was recorded in their medical record. Utilizing T-Test, to compare the 26 patients with Delirium and the 6 patients with Delirium recorded in their medical record we obtained a p = 0.014 as a result meaning that diagnosis of Delirium is under diagnosed. Conclusions: In this study Delirium was present in 22% of the 118 patients analysed and only 5.1% had the diagnosis of Delirium recorded in the medical record. This result shows that underdiagnose of Delirium is not uncommon. We, therefore, recommend the use of CAM scale in patients over 65 years old to diagnose Delirium, during their stay in the emergency service, paying special attention to patients with metabolic affections, mixed syndromes and age over 76 years old. Identifying the presence of Delirium in patients admitted in the emergency room could improve the prognostic and also could decrease the time hospitalized by initiating treatment promptly.","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82846266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Bundle Approach in Venous Thromboembolism Prophylaxis in Patients with Non-Traumatic Subarachnoid Hemorrhage","authors":"P. Brian, Fagaragan Lolita, Alaraj Ali, S. KimKeri","doi":"10.23937/2474-3674/1510118","DOIUrl":"https://doi.org/10.23937/2474-3674/1510118","url":null,"abstract":"Background: The incidence of asymptomatic deep vein thrombosis (DVT) is reported to be up to 21% in patients with non-traumatic subarachnoid hemorrhage (SAH). A venous thromboembolism (VTE) bundle was launched in 2016 at the University of Illinois Hospital (UIH) aiming to reduce the rate of newly diagnosed VTE in the neurosurgical ICU. Two main elements of the bundle included prospective and daily audit on the correct use of intermittent pneumatic compression (IPC) and compliance of subcutaneous heparin (SQH). Methods: Patients with SAH were retrospectively identified from April 2014 until July 2018 (two years before and after the bundle implementation). VTE events were diagnosed using twice weekly lower-extremity venous Duplex ultrasound and chest computerized tomography when appropriate. Results: A total of 266 patients were included, with 133 of them in the post-bundle group. The incidence of VTE was not significantly different before and after the bundle (15% vs. 12%, p = 0.47). Out of all intended interventions within the bundle, only the compliance rate of IPC was significantly higher in the post-bundle group. No difference was found regarding new episode of intracranial hemorrhage secondary to SQH (1.5% vs. 2.1%, p = 0.65). Multivariate analysis demonstrated that longer ICU LOS, higher Caprini score, and presence of baseline lung diseases were associated with VTE development. Conclusions: With a median Caprini score of 9, our patient population was found to be at high risk for developing VTE. The implementation of the VTE bundle did not significantly reduce the rate of VTE in patients with non-traumatic SAH at UIH. ORigiNAL ReSeARCh","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"43 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91469626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge, Attitude and Practices of ICU Nurses on Catheter Related Bloodstream Infection (CRBSI)","authors":"Azlan Nur Aimi Safura Binti, Aung Khin Thandar","doi":"10.23937/2474-3674/1510125","DOIUrl":"https://doi.org/10.23937/2474-3674/1510125","url":null,"abstract":"Background: Bloodstream infections (BSIs) are associated with insertion and maintenance of central venous catheters (CVC). Catheter Related Bloodstream Infection (CRBSI) is the most frequent causes of healthcare-associated infections in intensive care units (ICUs) and is a major challenge for health care providers working in intensive care units. It gives the higher risk to the mortality rate of ICU patients and also increased length of ICU stay and additional healthcare costs for them. Most international institutions published the clinical practice for the prevention of (CRBSIs) and update annually that will guide specific actions to be implemented by health care personnel who insert and handle a CVC including nurses in ICU settings who also have the direct exposure and continuous perform CVC procedures. Therefore, they should be knowledgeable and compliant in the insertion assistance, care, and maintenance of central lines. To improve the appropriate use of CVCs, in-depth knowledge, attitude and practice of ICU nurses is essential to adherence the appropriate preventive measures for Catheter Related Bloodstream Infection (CRBSI) and reducing the CRBIs rate among the patients. Aim: The objective of this study was to assess the level of knowledge, attitude and practice of ICU nurses regarding on catheter related bloodstream infection (CRBSI). Moreover, this study was also done to investigate the association between knowledge and attitude of ICU nurses on catheter related bloodstream infection (CRBSI) and the association between knowledge and practices of ICU nurses regarding CRBSI. Methods/materials: A cross-sectional study conducted on 86 ICU nurses in two ICUs in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia. A purposive sampling method was used. The tool for data collection was a questionnaire consists of 4 parts such as sociodemographic data of participants, level of knowledge, attitude and practices of ICU nurses regarding CRBSI. The data were analyzed by using descriptive statistics and inferential statistics (Chi-square test) of IBM Statistical Package Social Science (SPSS) version 25. Result: 100% response rate was achieved and 94.2% of ICU nurses have a good level of knowledge, and 94.2% have a good attitude in handling patients with CVC at ICU. Moreover, 88.4% of participants had good practices based on evidence-based practice guidelines of CVC care. There was a significant association between knowledge and attitude of ICU nurses regarding CBRIs (p = 0.000) and also there was a significant association between knowledge and practices of ICU nurses regarding CBRIs (p = 0.001). Conclusion: In conclusion, the results of this study clearly indicated that the majority of ICU nurses had good knowledge, attitude and practice regarding CBRIs in patients with CVC at Kuantan, Malaysia. However, this study was conducted in only one hospital due to time constraint using self administered questionnaires. Hence, the researcher suggest","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79731935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-aortic Balloon Pump Induced Dynamic Left Ventricular Outflow Tract Obstruction and Cardiogenic Shock: A Case Report","authors":"Wong Shiun Woei, Ng Ke Xuan Jessica","doi":"10.23937/2474-3674/1510123","DOIUrl":"https://doi.org/10.23937/2474-3674/1510123","url":null,"abstract":"We present a complex case of a 50-year-old man who presented with inferior ST-elevation myocardial infarction and cardiogenic shock. Our patient presented with out-of-hospital ventricular fibrillation cardiac arrest. Cardiopulmonary resuscitation was promptly started and return of spontaneous circulation was achieved. The patient underwent urgent coronary angiography with implantation of drug-eluting stent in his right coronary artery. Intra-aortic balloon pump was inserted. However, this was complicated by worsening of left ventricular outflow tract obstruction and systolic anterior motion of mitral valve leaflet. He was successfully weaned off balloon pump, inotropes and liberated from mechanical ventilation. To our knowledge, this is the first case reported of balloon pump associated left ventricular outflow tract obstruction in a setting of inferior myocardial infarction. This case illustrates the importance of early removal of balloon pump and precise use vasopressor in instituting the stepwise treatment modalities leading to a favourable outcome. CaSe RePORt","PeriodicalId":13937,"journal":{"name":"International Journal of Critical Care and Emergency Medicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84772743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}