International Journal of Critical Illness and Injury Science最新文献

{"title":"What's New in Critical Illness and Injury Science? Evidence and limitations for using S100β to diagnose and risk stratify critically ill patients with delirium","authors":"AndrewC Miller","doi":"10.4103/ijciis.ijciis_51_23","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_51_23","url":null,"abstract":"Delirium is a transient fluctuating global disorder of cognition associated with increased morbidity and mortality and has a prevalence of up to 80% among intensive care unit (ICU) patients.[1–3] ICU delirium may be a predictor of increased complications, prolonged ICU and non-ICU hospital length of stay (LOS), increased hospital costs, long-term disability, long-term cognitive impairment, decreased odds of discharge home, and increased hospital mortality.[1] Moreover, ICU delirium has been associated with the development of incident neuropsychiatric disorders, including depression, anxiety, trauma, stress-related disorders, and neurocognitive disorders.[4] However, clinical management has been limited by the lack of an effective, reliable, and readily available biomarker to aid in the diagnosis, severity, and prognosis, and to aid clinical management. S100b protein is a calcium-binding protein that is mainly found in astrocytes and oligodendrocytes of the central nervous system and Schwann cells of the peripheral nervous system.[5] As such, S100β has been investigated as a biomarker for injury to the blood–brain barrier and/or astrocyte injury and has been reported to correlate with the degree of blood–brain barrier destruction and the severity and scope of brain injury.[5–7] Previously, S100β has been correlated with the development of delirium and cognitive changes after surgery in patients who are not critically ill.[6,8–11] Similarly, others have reported that delirium and neurologic outcomes may correlate with S100β in critically ill patients.[6,7,12–14] However, there are significant limitations and gaps in the available literature. The current studies display a predominance of male subjects (up to 65%), advanced age, and low levels of racial diversity among the study groups.[6,7,12–17] All current studies among critically ill populations have all been performed in China (n = 3),[5,12,13] the United States (n = 2),[6,7] Belgium (n = 2),[14,15] the Netherlands (n = 1),[17] or Brazil (n = 1).[16] Furthermore, limitations in study design limit the generalizability of the reported findings, including small sample sizes, differences in the study group populations (trauma vs. medical), differences in illness severity as evidenced by wide ranges on validated illness severity indices, and an absence of randomized studies (e.g. only observational and case–control studies).[5–7,12–17] In addition, the comparability of the preillness baseline health of the study populations across studies is unclear as only the US studies have reported a validated index for this (e.g. the Charlson Comorbidity Index).[5–7,12–17] Among the ICU populations, S100β levels have been reported to positively correlate with ICU LOS and readmission (trauma populations),[5,13] and adverse outcomes (mixed medical/surgical, trauma populations).[13,14] In addition, S100B was negatively correlated with global cognition up to 12 months after hospital discharge in a mixed medical/surg","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596436","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":"A comparison of the range of motion and dynamic stability of the ankle joint of athletes with an ankle sprain as compared to healthy controls: A cross-sectional study","authors":"Mohammad Ahsan, AhmedI Alomar, Shibili Nuhmani, QassimI Muaidi","doi":"10.4103/ijciis.ijciis_2_23","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_2_23","url":null,"abstract":"Background: Ankle sprains are the most common lower-leg musculoskeletal injuries, frequently occurring among athletes and other physical activity individuals. The objective of this study was to compare the ankle range of motion and dynamic stability of healthy and injured athletes for their dominant and nondominant legs. Methods: A cross-sectional study design was selected to investigate this study with 32 male soccer players with average age: 22.6 ± 3.3 years, weight: 69.6 ± 5.7 kg, height: 176.8 ± 5.32 cm, with a history of a lateral ankle sprain on the dominant leg for the past 2 years. Ankle range of motion was determined using dorsiflexion and plantar flexion by a goniometer. The dynamic stability was determined using the SWAY medical system. An independent t-test was used to study the differences between healthy and injured groups and between dominant and nondominant legs for dynamic stability, dorsiflexion, and plantar flexion range. Results: There were higher significant differences for dynamic stability in healthy participants than in injured participants for their dominant (P = 0.001) and nondominant (P = 0.001) legs. There were significant differences in dynamic stability in the dominant and nondominant leg (healthy [P = 0.033] and injured [P = 0.000] participants). The dominant leg shows higher dynamic stability in healthy group, whereas nondominant leg shows higher dynamic stability in the injured group. Conclusion: The study found significant differences between the injured and sound legs. The injured dominant and nondominant leg revealed a striking disparity in the ankle range of motion. Therefore, the study demonstrated that ankle sprain causes due to less stability of the ankle joint, which limits ankle movements.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596440","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":"Cardiac arrest in an emergency department in Colombia during 2011–2020: A descriptive study","authors":"JaimeAndres Quintero, JhonnyAlexander Medina, DavidAndres de Paz, DiegoFernando Scarpetta, CristianAndres Castro, NegirethAngell Paker, SandraMilena Carvajal","doi":"10.4103/ijciis.ijciis_87_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_87_22","url":null,"abstract":"Background: Cardiac arrest is a public health problem related to high morbidity and mortality. In Colombia, objective data characterize in our population has been not available. The aim of this study has been to determined the epidemiological characteristics of patients with cardiorespiratory arrest treated in an emergency room. Methods: A retrospective observational cross-sectional cohort study was performed. We included adult patients admitted with a diagnostic of out-of-hospital cardiac arrest (OHCA) or who presented with in-hospital cardiac arrest while in the emergency department (ED). Results: A total of 415 patients were included 232 were men, and the median age was 67 years. OHCA was presented in 383 patients. In this group, 80.2% required orotracheal intubation, 90.1% received Epinephrine, and and 52.6% received immediate resuscitation. Survival after discharge was 43.1% in patients with non-shockable rhythm registered. Return of spontaneous circulation was achieved in 49.6%. The survival after hospital discharge was 22.2%. Cerebral performance category score <=2 was 20.4%. Conclusion: In our study, the epidemiological characteristics and outcomes of patients seen in the ED with cardiac arrest are similar to those described in the literature.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596676","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":"Relationship between the rate of fluid resuscitation and acute kidney injury: A retrospective cohort study","authors":"Kianoush Kashani, Swetha Reddy, Bo Hu","doi":"10.4103/ijciis.ijciis_7_23","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_7_23","url":null,"abstract":"Background: Septic shock is the leading cause of acute kidney injury (AKI) in critically ill patients. The foundation of early septic shock management includes early fluid resuscitation, but the association between fluid resuscitation rates and kidney outcomes remains unclear. This investigation examines the association between fluid resuscitation rate and AKI recovery. Methods: In the medical intensive care unit of Mayo Clinic Rochester, adult patients with AKI and septic shock were retrospectively studied from January 1, 2006 to May 31, 2018. The surviving sepsis campaign recommends an initial fluid bolus of 30 ml/kg for sepsis resuscitation. The cohort of patients was divided into three groups based on the average fluid resuscitation time (<1 h, 1.1–3 h, >3 h) and the corresponding fluid rate ≥0.5, 0.17–0.49, and <0.17 ml/kg/min, respectively. The primary outcome was the recovery of AKI on day 7. To account for potential confounders, multivariable regression analyses were conducted. Results: After meeting the eligibility, 597 patients were included in the analysis. The AKI recovery was considerably different among the groups (P = 0.006). Patients in group 1 who received fluid resuscitation faster had a higher rate of AKI recovery (53%) compared to group 2 and group 3 (50% and 37.8%). Conclusion: In septic shock patients with AKI, a higher fluid resuscitation rate of 30 ml/kg IV fluids within the 1st-h sepsis diagnosis (i.e., >0.50 ml/kg/min) lead to higher AKI recovery compared with slower infusion rates.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596690","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":"Incorporation of plasma Vitamin C levels to modified nutritional risk in critically ill score as the novel Vitamin C nutritional risk in critically ill score in sepsis subjects as an early predictor of multidrug-resistant bacteria: A prospective observational study.","authors":"Shwethapriya Rao,&nbsp;Ravindra Maradi,&nbsp;Nitin Gupta,&nbsp;Arjun Asok,&nbsp;Souvik Chaudhuri,&nbsp;Margiben Tusharbhai Bhatt,&nbsp;Sagar Shanmukhappa Maddani","doi":"10.4103/ijciis.ijciis_54_22","DOIUrl":"10.4103/ijciis.ijciis_54_22","url":null,"abstract":"<p><strong>Background: </strong>On intensive care unit (ICU) admission, it is difficult to predict which patient may harbor multidrug-resistant (MDR) bacteria. MDR is the nonsusceptibility of bacteria to at least one antibiotic in three or more antimicrobial categories. Vitamin C inhibits bacterial biofilms, and its incorporation into the modified nutritional risk in critically ill (mNUTRIC) scores may help predict MDR bacterial sepsis early.</p><p><strong>Methods: </strong>A prospective observational study was conducted on adult subjects with sepsis. Plasma Vitamin C level was estimated within 24 h of ICU admission, and it was incorporated into the mNUTRIC score (designated as Vitamin C nutritional risk in critically ill [vNUTRIC]). Multivariable logistic regression was performed to determine if vNUTRIC was an independent predictor of MDR bacterial culture in sepsis subjects. The receiver operating characteristic curve was plotted to determine the vNUTRIC cutoff score for predicting MDR bacterial culture.</p><p><strong>Results: </strong>A total of 103 patients were recruited. The bacterial culture-positive sepsis subjects were 58/103, with 49/58 culture-positive subjects having MDR. The vNUTRIC score on ICU admission in the MDR bacteria group was 6.71 ± 1.92 versus 5.42 ± 2.2 in the non-MDR bacteria group (<i>P</i> = 0.003, Independent Student's <i>t</i>-test). High vNUTRIC score ≥6 on admission is associated with MDR bacteria (<i>P</i> = 0.042 Chi-Square test), and is a predictor of MDR bacteria (<i>P</i> = 0.003, AUC 0.671, 95% confidence interval [0.568-0.775], sensitivity 71%, specificity 48%). Logistic regression showed that the vNUTRIC score is an independent predictor of MDR bacteria.</p><p><strong>Conclusion: </strong>High vNUTRIC score (≥6) on ICU admission in sepsis subjects is associated with MDR bacteria.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"13 1","pages":"32-37"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9461400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Early Warning Score 2 is superior to quick Sequential Organ Failure Assessment in predicting mortality in sepsis patients presenting to the emergency department in India: A prospective observational study.","authors":"Ankur Verma,&nbsp;Aasiya Farooq,&nbsp;Sanjay Jaiswal,&nbsp;Meghna Haldar,&nbsp;Wasil Rasool Sheikh,&nbsp;Palak Khanna,&nbsp;Amit Vishen,&nbsp;Rinkey Ahuja,&nbsp;Abbas Ali Khatai,&nbsp;Nilesh Prasad","doi":"10.4103/ijciis.ijciis_41_22","DOIUrl":"10.4103/ijciis.ijciis_41_22","url":null,"abstract":"<p><strong>Background: </strong>High in-hospital mortality in sepsis patients remains challenging for clinicians worldwide. Early recognition, prognostication, and aggressive management are essential for treating septic patients. Many scores have been formulated to guide clinicians to predict the early deterioration of such patients. Our objective was to compare predictive values of quick Sequential Organ Failure Assessment (qSOFA) and National Early Warning Score 2 (NEWS2) with respect to in-hospital mortality.</p><p><strong>Methods: </strong>This prospective observational study was conducted in a tertiary care center in India. Adults with suspected infection with at least two Systemic Inflammatory Response Syndrome criteria presenting to the emergency department (ED) were enrolled. NEWS2 and qSOFA scores were calculated, and patients were followed until their primary outcome of mortality or hospital discharge. The diagnostic accuracy of qSOFA and NEWS2 for predicting mortality was analyzed.</p><p><strong>Results: </strong>Three hundred and seventy-three patients were enrolled. Overall mortality was 35.12%. A majority of patients had LOS between 2 and 6 days (43.70%). NEWS2 had higher area under curve at 0.781 (95% confidence interval [CI] (0.59, 0.97)) than qSOFA at 0.729 (95% CI [0.51, 0.94]), with <i>P</i> < 0.001. Sensitivity, specificity, and diagnostic efficiency to predict mortality by NEWS2 were 83.21% (95% CI [83.17%, 83.24%]); 57.44% (95% CI [57.39%, 57.49%]); and 66.48% (95% CI [66.43%, 66.53%]), respectively. qSOFA score had sensitivity, specificity, and diagnostic efficiency to predict mortality of 77.10% (95% CI [77.06%, 77.14%]); 42.98% (95% CI [42.92%, 43.03%]); and 54.95% (95% CI [54.90%, 55.00%]), respectively.</p><p><strong>Conclusion: </strong>NEWS2 is superior to qSOFA in predicting in-hospital mortality for sepsis patients presenting to the ED in India.</p>","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"13 1","pages":"26-31"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10167809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9468066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute physiology and chronic health evaluation score and mortality of patients admitted to intermediate care units of a hospital in a low- and middle-income country: A cross-sectional study from Pakistan","authors":"Aysha Almas, SherMuhammad Sethi, AmberSabeen Ahmed, Madiha Iqbal, Mehmood Riaz, MuhammadZain Mushtaq","doi":"10.4103/ijciis.ijciis_83_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_83_22","url":null,"abstract":"Background: Intermediate care units (IMCUs) serve as a bridge between general wards and intensive care units by providing close monitoring and rapid response to medical emergencies. We aim to identify the common acute medical conditions in patients admitted to IMCU and compare the predicted mortality of these conditions by acute physiology and chronic health evaluation-II (APACHE-II) score with actual mortality. Methods: A cross-sectional study was conducted at a tertiary care hospital from 2017 to 2019. All adult internal medicine patients admitted to IMCUs were included. Acute conditions were defined as those of short duration (<3 weeks) that require hospitalization. The APACHE-II score was used to determine the severity of these patients’ illnesses. Results: Mean (standard deviation [SD]) age was 62 (16.5) years, and 493 (49.2%) patients were male. The top three acute medical conditions were acute and chronic kidney disease in 399 (39.8%), pneumonia in 303 (30.2%), and urinary tract infections (UTIs) in 211 (21.1%). The mean (SD) APACHE-II score of these patients was 12.5 (5.4). The highest mean APACHE-II (SD) score was for acute kidney injury (14.7 ± 4.8), followed by sepsis/septic shock (13.6 ± 5.1) and UTI (13.4 ± 5.1). Sepsis/septic shock was associated with the greatest mortality (odds ratio [OR]: 6.9 [95% CI (confidence interval): 4.5–10.6]), followed by stroke (OR: 3.9 [95% CI: 1.9–8.3]) and pneumonia (OR: 3.0 [95% CI: 2.0–4.5]). Conclusions: Sepsis/septic shock, stroke, and pneumonia are the leading causes of death in our IMCUs. The APACHE-II score predicted mortality for most acute medical conditions but underestimated the risk for sepsis and stroke.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596437","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":"Successful treatment of intermediate syndrome in a COVID-19 patient with severe organophosphate toxicity","authors":"MarwaMohammed Fouad, NerminHamdy Zawilla, DoaaAtef Moubarez","doi":"10.4103/ijciis.ijciis_84_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_84_22","url":null,"abstract":"Organophosphate (OP) poisoning is one of the most common causes of poisoning in the world, due to its easy availability, low cost, and wide occupational exposure. It has a significant death and morbidity rate. Cholinergic syndrome, intermediate syndrome (IMS), and syndrome of delayed polyneuropathy are the three primary syndromes that define OP poisoning. We report the case of a 44-year-old male patient who had a history of OP poisoning by inhalation and later developed altered mental status (AMS). The patient transiently improved and regained consciousness following treatment with atropine and obidoxime. He deteriorated the following day with AMS and generalized muscle weakness consistent with IMS and was intubated for airway protection. Despite further complication by Klebsiella and COVID-19 infections, he recovered to hospital discharge on day 14.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135594297","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":"An assessment of serum magnesium levels in critically ill patients: A prospective observational study","authors":"DeepakS Laddhad, Vinayak Hingane, TusharRamrao Patil, DhruvDeepak Laddhad, AishwaryaDhruv Laddhad, ShantanuDeepak Laddhad","doi":"10.4103/ijciis.ijciis_11_23","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_11_23","url":null,"abstract":"Background: A specific magnesium level is essential to be maintained to ensure appropriate neuromuscular excitability and cardiac function; an increase or decrease in its levels usually leads to critical abnormality. Hypomagnesemia in critically ill patients has many potential ramifications and is found to be an important factor in hindering their recovery. Thus, the study aimed to assess the serum magnesium levels in critically ill participants and explore its effect on their condition. Methods: A prospective observational study was conducted for 21 months, from February 2019 to October 2020, among all critically ill participants admitted to the medical intensive care unit (ICU) of a tertiary care hospital. The Acute Physiology and Chronic Health Evaluation II score questionnaire was used to determine the severity of their condition and blood samples were collected within 24 h of their ICU admission for analysis. Results: One hundred participants were enrolled, of which 40% were between the age group of 46 and 65 years and 71% were males. Among all participants with hypomagnesemia, 52% were diabetic, 19% had a history of alcohol use disorder, and 27% had normal calcium and potassium levels. Hypomagnesemia significantly correlated with a longer duration of ICU stay among participants. Conclusion: A significant correlation was observed between hypomagnesemia and increased ICU length of stay and mortality but not the duration of mechanical ventilation. Monitoring and appropriate supplementation of serum magnesium is recommended to limit further comorbidity and mortality in the critical care setting.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"118 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596692","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":"The optimal time for endotracheal intubation in subjects with coronavirus disease 2019 pneumonia: A retrospective observational study","authors":"Rashid Nadeem, Nadia Nadeem, RawanMohamad Albwidani, FatimaHakim Falih, HatimRiyaz Husain, AhmadZouhir Krrak, ManojPazhampallil Mathews, KarimSaid Hammouda Hussein, Fatema Abdulkarim, Farooq Dar","doi":"10.4103/ijciis.ijciis_79_22","DOIUrl":"https://doi.org/10.4103/ijciis.ijciis_79_22","url":null,"abstract":"Background: The optimal timing of intubation has been debated among healthcare professionals, current studies do not show any differences between early and late intubation. most studies failed to show any significant difference in clinical outcomes between early or late intubation. Methods: The study was conducted as a retrospective review of subjects with confirmed coronavirus disease 2019 admitted to the Dubai Hospital intensive care unit (ICU). Study variables included time to intubation, duration of supplemental oxygen requirement >15 L/min, and cumulative duration of tachypnea and tachycardia while on the aforementioned oxygen requirement on this oxygen usage level. Each time duration was assessed for correlation with clinical variables including mortality and length of stay in ICU and hospital. Results: Subjects who require endotracheal intubation within 4 h after the start of oxygen >15 L/min have lower survival (P = 0.03). Subjects who have tachypnea on the aforementioned oxygen requirement for 6–19.5 h (P = 0.01) before they require intubation have better survival. No duration of tachycardia has any significant effect on survival. Only the duration of invasive mechanical ventilation (MV) correlated with the hospital length of stay. Conclusions: Subjects who require endotracheal intubation within 4 h after the start of oxygen >15 L/min have lower survival. The optimal time for intubation is after tachypnea of 6 h but before 19.5 h. No duration of tachycardia has any significant effect on survival. Only the duration of invasive MV correlated with the hospital length of stay.","PeriodicalId":13938,"journal":{"name":"International Journal of Critical Illness and Injury Science","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135596424","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}