Egyptian Journal of Critical Care Medicine最新文献

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Evaluation of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in critical care patients with synthetic cannabinoid (bonzai) intoxication 合成大麻素中毒重症患者中性粒细胞与淋巴细胞比值(NLR)和血小板与淋巴细胞比值(PLR)的评价
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2018-04-01 DOI: 10.1016/j.ejccm.2018.03.002
Mustafa Kaplan , Alpaslan Tanoglu , Tolga Duzenli , Muhammet Yildirim , Yusuf Serdar Sakin , Musa Salmanoglu , Yalçin Önem
{"title":"Evaluation of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in critical care patients with synthetic cannabinoid (bonzai) intoxication","authors":"Mustafa Kaplan ,&nbsp;Alpaslan Tanoglu ,&nbsp;Tolga Duzenli ,&nbsp;Muhammet Yildirim ,&nbsp;Yusuf Serdar Sakin ,&nbsp;Musa Salmanoglu ,&nbsp;Yalçin Önem","doi":"10.1016/j.ejccm.2018.03.002","DOIUrl":"10.1016/j.ejccm.2018.03.002","url":null,"abstract":"<div><h3>Objective</h3><p>Synthetic cannabinoid drug abuse has been dramatically increasing among young individuals in many countries. There have been reports of serious side effects with SC abuse in these patients. Previous researches have exhibited that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are associated with mortality and morbidity in many chronic diseases. The aim of this study was to evaluate PLR and NLR in critical care patients with synthetic cannabinoid (bonzai) intoxication.</p></div><div><h3>Materials and methods</h3><p>One hundred and seven synthetic cannabinoid intoxication patients requiring intensive care and 40 healthy controls were included in the study. Patients characteristics and the complete blood count (CBC) variables, including white blood cell (WBC), hemoglobin (Hb), platelet count, NLR, PLR as well as AST, ALT, albumin total bilirubin, and other routine biochemical parameters were tested. Data analyses were conducted with SPSS-15 software (SPSS Inc., Chicago, Illinois, USA). Statistical significance was set at a p-value of &lt;0.05.</p></div><div><h3>Results</h3><p>All participants were male, and the mean age of the patients was 21.74 ± 1.57 and healthy controls was 22.62 ± 2.9 years (p &gt; 0.05). All the routine laboratory tests and inflammatory markers (Erythrocyte sedimentation rate and C-reactive protein) were similar between groups. As complete blood cell count; mean WBC values were 9.43 ± 3.27 × 10<sup>3</sup>/mm<sup>3</sup> vs 7.05 ± 2.12 × 10<sup>3</sup>/mm<sup>3</sup> (p &lt; 0.001), mean platelet counts were 237.33 ± 60 × 10<sup>3</sup>/mm<sup>3</sup> vs 263.90 ± 65.98 × 10<sup>3</sup>/mm<sup>3</sup> (p = 0.022), NLR counts were 3.17 ± 1.95 vs 2.32 ± 1.27 (p = 0.003) and PLR values were 114.43 ± 36.39 vs 133.94 ± 45.27 (p = 0.008), in patients and controls, respectively. Cardiac side effects were observed among 36 patients but nobody was died.</p></div><div><h3>Conclusion</h3><p>Our results exhibited a significant increase of NLR values and decrease of PLR counts among critical care patients with synthetic cannabinoid (bonzai) intoxication. After at least 24 h of intensive care stay without side effects, the patients might transfer out to inpatient clinic for ongoing follow up period and psychiatric consultation.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"6 1","pages":"Pages 17-20"},"PeriodicalIF":0.3,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2018.03.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130965704","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}
引用次数: 1
A comparative study of the risk stratification models for pediatric cardiac surgery 儿童心脏外科风险分层模型的比较研究
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2018-04-01 DOI: 10.1016/j.ejccm.2018.03.001
Shahzad Alam , Akunuri Shalini , Rajesh G. Hegde , Rufaida Mazahir , Akanksha Jain
{"title":"A comparative study of the risk stratification models for pediatric cardiac surgery","authors":"Shahzad Alam ,&nbsp;Akunuri Shalini ,&nbsp;Rajesh G. Hegde ,&nbsp;Rufaida Mazahir ,&nbsp;Akanksha Jain","doi":"10.1016/j.ejccm.2018.03.001","DOIUrl":"10.1016/j.ejccm.2018.03.001","url":null,"abstract":"<div><h3>Objective</h3><p>The objective of the study was to compare Risk Assessment for Congenital Heart Surgery (RACHS-1), Aristotle Basic Complexity (ABC) and Society of Thoracic Surgeons – European Association for Cardiothoracic Surgery (STS-EACTS) complexity scoring models for predicting outcome after surgery for congenital heart disease.</p></div><div><h3>Methods</h3><p>This retrospective study included children &lt;18 years. Procedures were categorized based on RACHS-1, ABC and STS-EACTS system. Outcome indicators were prolonged length of ICU stay (upper 25th percentile) and hospital mortality. The stratification models were tested for calibration using Hosmer‑Lemeshow modification of chi-square test and for discrimination using Receiver Operating Characteristic (ROC) curve. Area under the curve (AUC) of individual ROC curves was compared using z-statistics.</p></div><div><h3>Results</h3><p>The study included 920 patients. All 3 models showed good fit for both prolonged ICU stay and mortality on calibration. STS-EACTS outclassed RACHS-1 and ABC models with AUC of 0.759 for prolonged PLOS and 0.870 for hospital mortality. AUC of ROC curve for STS-EACTS was significantly higher than RACHS-1 model for both prolonged PLOS (p – 0.046) and hospital mortality (p – 0.015). No significant difference was observed between the AUC of ROC curves of other models.</p></div><div><h3>Conclusion</h3><p>Risk stratification for pediatric heart surgery is a useful tool to predict the outcome. STS-EACTS risk stratification model has the best discriminative power.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"6 1","pages":"Pages 5-8"},"PeriodicalIF":0.3,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2018.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131627039","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}
引用次数: 8
The first reported case of acute ischemic stroke treated with tissue plasminogen activator at Mansoura University, Egypt 在埃及曼苏拉大学用组织纤溶酶原激活剂治疗急性缺血性中风的第一例报道
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2017-12-01 DOI: 10.1016/j.ejccm.2017.10.001
Ahmed Farouk Donia , Nourelsabah Mohamed Elbialy , Nada Abdelhameed Elsaid , Ayman Fathi Refaie
{"title":"The first reported case of acute ischemic stroke treated with tissue plasminogen activator at Mansoura University, Egypt","authors":"Ahmed Farouk Donia ,&nbsp;Nourelsabah Mohamed Elbialy ,&nbsp;Nada Abdelhameed Elsaid ,&nbsp;Ayman Fathi Refaie","doi":"10.1016/j.ejccm.2017.10.001","DOIUrl":"https://doi.org/10.1016/j.ejccm.2017.10.001","url":null,"abstract":"<div><p>Recombinant Tissue Plasminogen Activator (rTPA) is the standard of care for treatment of acute ischemic stroke. Nevertheless, its widespread use in Egypt is hindered by many factors. We report on the first case of acute ischemic stroke to be treated with rTPA at our University hospitals. She received rTPA 4 h and 20 min after the onset of symptoms despite the occurrence of stroke inside the hospital and the availability of rTPA. The patient showed partial improvement after 3 months. We hope that public and medical staff awareness as well as our developing experience relative to treatment of acute ischemic stroke would improve over time allowing for avoidance of long-term suffering of these patients.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 3","pages":"Pages 99-100"},"PeriodicalIF":0.3,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92105296","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}
引用次数: 3
Short term outcome of patients with hyperglycemia and acute stroke 高血糖和急性脑卒中患者的短期预后
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2017-12-01 DOI: 10.1016/j.ejccm.2017.11.003
Ahmed Al-Weshahy , Rania El-Sherif , Khaled Abd Al-Wahhab Selim , Ayman Heikal
{"title":"Short term outcome of patients with hyperglycemia and acute stroke","authors":"Ahmed Al-Weshahy ,&nbsp;Rania El-Sherif ,&nbsp;Khaled Abd Al-Wahhab Selim ,&nbsp;Ayman Heikal","doi":"10.1016/j.ejccm.2017.11.003","DOIUrl":"10.1016/j.ejccm.2017.11.003","url":null,"abstract":"<div><h3>Background</h3><p>Preexisting hyperglycemia worsens the clinical outcome of acute stroke. Do non-diabetic patients with stress hyperglycemia have a similar outcome to those with diabetes mellitus (DM)?</p><p>We aimed to assess the glycemic status after acute stroke and its role on stroke outcome.</p></div><div><h3>Methods</h3><p>61 consecutive patients with acute stroke were included. 41 had hyperglycemia (20 diabetics and 21 non diabetics) and 20 were control. Admission blood glucose level, CT brain and NIHSS were performed. 30 days mortality was the study endpoint.</p></div><div><h3>Results</h3><p>60.7% males with mean age of 62.9 ± 10.5 years. Compared to control, patients with hyperglycemia had a higher incidence of posterior circulation affection (19.5% vs. 0%, P = .03). The NIHSS was statistically higher than control (14.9 ± 5.9 vs.7.8 ± 3.5, p = .000). The mortality rate and the hospital length of stay were higher than control (65.9% vs. 5.0%, P &lt; .001 and 12.5 ± 9.1 vs. 3.0 ± 4.2 days, P &lt; .001 respectively). NIHSS score, and 30 days mortality were higher in stress hyperglycemia compared to diabetics (17 ± 5.1 vs. 12.7 ± 6.1, P = .018, and 85.7% vs. 45%, P = .006 respectively). Predictors of 30 days mortality were: history of hypertension (P = .04), NIHSS ≥ 10 (sensitivity 91% and specificity 100%) and admission blood glucose ≥ 223 mg/dL (sensitivity 63% and specificity 96%).</p></div><div><h3>Conclusions</h3><p>Hyperglycemia is associated with poor outcomes after acute stroke. History of HTN, admission glucose level ≥ 223 mg/dL and NIHSS ≥ 10 were predictors of worse stroke outcome.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 3","pages":"Pages 93-98"},"PeriodicalIF":0.3,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.11.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115734305","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}
引用次数: 10
Laryngeal ultrasound versus cuff leak test in prediction of post-extubation stridor 喉超声与袖带泄漏试验预测拔管后喘鸣
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2017-12-01 DOI: 10.1016/j.ejccm.2017.10.002
Mai A. Sahbal, Kamel A. Mohamed, Hanan H. Zaghla, Mahmoud M. Kenawy
{"title":"Laryngeal ultrasound versus cuff leak test in prediction of post-extubation stridor","authors":"Mai A. Sahbal,&nbsp;Kamel A. Mohamed,&nbsp;Hanan H. Zaghla,&nbsp;Mahmoud M. Kenawy","doi":"10.1016/j.ejccm.2017.10.002","DOIUrl":"https://doi.org/10.1016/j.ejccm.2017.10.002","url":null,"abstract":"<div><h3>Background</h3><p>Cuff leak test (CLT) has been proposed as a simple method of predicting post-extubation stridor (PES), however due to different cut-off point of cuff-leak volume between previous studies, the laryngeal ultrasonography (US) including measurement of air column width was used to predict PES. The aim of the present study was to evaluate the value of laryngeal US versus cuff leak test in predicting PES.</p></div><div><h3>Methods</h3><p>The study included fifty patients admitted to the Critical Care Department, Cairo University Hospitals from the period of November 2014 to January 2016, intubated for at least 24 h and examined prior to extubation using CLT and laryngeal ultrasound.</p></div><div><h3>Results</h3><p>Four cases developed PES. CLT identified PES patients with a sensitivity of 75%, with PPV of 50% for leakage volume of 132.5 ml. Laryngeal ultrasound showed a sensitivity of 50% for those patients with air column width before deflation less than 10.955 mm and air column width difference (ACWD) of 0.905 mm with PPV of 11.8% and 14.3% for both respectively.</p></div><div><h3>Conclusion</h3><p>Both CLT and laryngeal US might have low sensitivity and PPV in predicting PES and should be used with caution in prediction of PES.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 3","pages":"Pages 83-86"},"PeriodicalIF":0.3,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92149811","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}
引用次数: 8
Mortality association factors in hematologic cancer patients requiring mechanical ventilation for more than one day in a developing country. A prospective cohort study 发展中国家需要机械通气超过一天的血液病患者死亡率相关因素一项前瞻性队列研究
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2017-12-01 DOI: 10.1016/j.ejccm.2017.11.001
Enas Abd El motlb, Alaa El-Deeb
{"title":"Mortality association factors in hematologic cancer patients requiring mechanical ventilation for more than one day in a developing country. A prospective cohort study","authors":"Enas Abd El motlb,&nbsp;Alaa El-Deeb","doi":"10.1016/j.ejccm.2017.11.001","DOIUrl":"https://doi.org/10.1016/j.ejccm.2017.11.001","url":null,"abstract":"<div><h3>Background</h3><p>The potential benefit of intensive care unit (ICU) admission of hematologic cancer patient requiring mechanical ventilation (MV) still controversial especially with increased cost of needed life support measures.</p></div><div><h3>Objective</h3><p>To seek clinical predictors of ICU mortality in hematologic cancer patients requiring (MV) during the first day of admission to the ICU.</p><p>Design, Setting, Participants: 448 patients were included in this prospective observational cohort study, between May 2014 and May 2016 at the oncology center of Mansoura university hospital.</p></div><div><h3>Measurements and Main Results</h3><p>ICU mortality was (350 out of 448 patients). Indications of (MV) were sepsis (42%), airway/ pulmonary invasion by tumor (33%), cardiopulmonary arrest (3%), coma (16%) and pulmonary embolism (5%). The independent risk factors for mortality were performance status 3–4(odds ratio, 2.49; 95% confidence interval [1.35:4.60]); cancer recurrence/ progression (odds ratio, 9.31;95% confidence interval, [4.18:21.24]); pao2/ fio2 ratio &lt; 150 (odds ratio, 2.47; 95% confidence interval, [1.344:4.68]); airway/ pulmonary involvement by tumor as a cause of M.V. (odds ratio, 6.73; 95% confidence interval, [2.2:10.05]); sequential organ failure assessment score(excluding respiratory points, each 4 points; odds ratio 2.14; 95% confidence interval, [1.16:3.133]); use of vasopressors (odds ratio, 3.39; confidence interval, [1.73:6.44]).</p></div><div><h3>Conclusion</h3><p>Poor performance status, cancer status, severity of acute organ failure, use of vasopressors and airway/pulmonary involvement by tumor were the main predictors of mortality. Making use of such clinical data may help to provide intensive care for patients with a potential chance of survival.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 3","pages":"Pages 77-82"},"PeriodicalIF":0.3,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92105294","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}
引用次数: 1
Test the antiarrhythmic effect of intravenous nitroglycerine on ischemic Premature Ventricular Contractions Bigeminy 静脉注射硝酸甘油对缺血性室性早搏的抗心律失常作用试验
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2017-12-01 DOI: 10.1016/j.ejccm.2017.08.002
Yasser Mohammed Hassanain Elsayed
{"title":"Test the antiarrhythmic effect of intravenous nitroglycerine on ischemic Premature Ventricular Contractions Bigeminy","authors":"Yasser Mohammed Hassanain Elsayed","doi":"10.1016/j.ejccm.2017.08.002","DOIUrl":"https://doi.org/10.1016/j.ejccm.2017.08.002","url":null,"abstract":"<div><p>Premature Ventricular Contractions is one of the manifestations of ischemic heart disease. Moreover, nitroglycerin is a standard anti-ischemic agent. So why don’t use it as<!--> <!-->anti-arrhythmic in like our case?</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 3","pages":"Pages 101-103"},"PeriodicalIF":0.3,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92110102","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}
引用次数: 6
Pre versus post application of a 0.12% chlorhexidine based oral hygiene protocol in an Egyptian pediatric intensive care unit: Practice and effects 在埃及儿童重症监护室应用0.12%氯己定口腔卫生方案的前后对比:实践和效果
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2017-12-01 DOI: 10.1016/j.ejccm.2017.11.002
Mohamed Mustafa Gomaa, Yahya Wahba, Mohammed Attia El-Bayoumi
{"title":"Pre versus post application of a 0.12% chlorhexidine based oral hygiene protocol in an Egyptian pediatric intensive care unit: Practice and effects","authors":"Mohamed Mustafa Gomaa,&nbsp;Yahya Wahba,&nbsp;Mohammed Attia El-Bayoumi","doi":"10.1016/j.ejccm.2017.11.002","DOIUrl":"https://doi.org/10.1016/j.ejccm.2017.11.002","url":null,"abstract":"<div><h3>Background</h3><p>The role of oral hygiene in the intensive care unit is indisputable. Several studies were carried out in different pediatric intensive care units using different oral hygiene regimes. Chlorhexidine preparations are widely used in oral care regimes.</p></div><div><h3>Aim</h3><p>This study was conducted in the pediatric intensive care unit of Children’s Hospital of Mansoura University, Egypt to unravel the effect of adoption of an oral hygiene protocol using 0.12% chlorhexidine solution on the outcome of mechanically ventilated patients.</p></div><div><h3>Methods</h3><p>The study comprised 50 patients admitted in the period from January 2013 to August 2016. The sample was analyzed as follow: intervention group (28 patients) and control group (22 patients). The intervention group received a 0.12% chlorhexidine based oral hygiene protocol while the control group received usual oral care without chlorhexidine. Mann-Whitney and Chi-square tests were used.</p></div><div><h3>Results</h3><p>Duration of mechanical ventilation and length of stay were significantly reduced in the intervention group (p =.003 and .007 respectively). Statistically insignificant difference in development of ventilation-associated pneumonia and mortality between both groups was shown (p = .068 and .208 respectively).</p></div><div><h3>Conclusions</h3><p>Adoption of a 0.12% chlorhexidine based oral hygiene regime was associated with improved outcome in pediatric intensive care unit.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 3","pages":"Pages 87-91"},"PeriodicalIF":0.3,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.11.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92105315","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}
引用次数: 2
Ventilator-associated pneumonia in adult intensive care unit prevalence and complications 成人重症监护病房呼吸机相关性肺炎的患病率和并发症
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.1016/j.ejccm.2017.06.001
Ahmed Abdelrazik Othman , Mohsen Salah Abdelazim
{"title":"Ventilator-associated pneumonia in adult intensive care unit prevalence and complications","authors":"Ahmed Abdelrazik Othman ,&nbsp;Mohsen Salah Abdelazim","doi":"10.1016/j.ejccm.2017.06.001","DOIUrl":"10.1016/j.ejccm.2017.06.001","url":null,"abstract":"<div><h3>Background</h3><p>Ventilator-associated pneumonia (VAP) remains a common cause of intensive care unit (ICU) and hospital morbidity and mortality despite advances in diagnostic techniques and management. We aimed to determine the prevalence, possible complications and in-hospital prognosis of VAP in mechanically ventilated patients.</p></div><div><h3>Methods</h3><p>This prospective observational, case-control study, was carried out from September 2012 to August 2013. Forty-eight adult patients maintained on mechanical ventilation for more than 48 h in our ICU were enrolled in the study. VAP was diagnosed as new persistent pulmonary infiltrates on chest radiographs and, at least two of following: (1) fever of ≥38.3<!--> <!-->°C, (2) leukocytosis of ≥12,000⧹mm<sup>3</sup>, and (3) purulent tracheobronchial secretions. Endotracheal aspirate (ETA) samples of suspected cases were collected and processed as per standard protocols.</p></div><div><h3>Results</h3><p>The primary underlying diagnosis was acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in 25 patients, congestive heart failure in 10, pneumonia in 6, post-operative in 5, neurological diseases in 2 patients. VAP developed in 17 patients (35.4%), gram-negative agents were the major offending pathogen (<em>Pseudomonas aeruginosa</em> accounting for 22.9%). The length of ventilation (LOV) and the length of ICU stay (LOS<sub>ICU</sub>) were significantly higher in the VAP group (P<!--> <!-->=<!--> <!-->0.001, 0.0001 respectively). Severe sepsis/septic shock, acute respiratory distress syndrome (ARDS), atelectasis, and infection with multi-drug resistant organisms were more common in the VAP group. <em>Conclusion:</em> Ventilator-associated pneumonia was associated with a significant increase in ICU length of stay, time on mechanical ventilation and different complications.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 2","pages":"Pages 61-63"},"PeriodicalIF":0.3,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.06.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122505374","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}
引用次数: 39
Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure 用心电测量法预测脓毒症合并急性循环衰竭患者的体液状态和生存
IF 0.3
Egyptian Journal of Critical Care Medicine Pub Date : 2017-08-01 DOI: 10.1016/j.ejccm.2017.03.001
Randa Soliman
{"title":"Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure","authors":"Randa Soliman","doi":"10.1016/j.ejccm.2017.03.001","DOIUrl":"10.1016/j.ejccm.2017.03.001","url":null,"abstract":"<div><p>Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure.</p></div><div><h3>Background</h3><p>Septic hemodynamic instability imposes challenges to critical care physician in deciding fluid management to optimize preload dependency state.</p></div><div><h3>Methods</h3><p>Thirty patients with severe sepsis and hypotension (Mean arterial pressure i.e. MAP<!--> <!-->&lt;<!--> <!-->65<!--> <!-->mmHg) and evidence of tissue hypotension i.e. lactate level ≥4<!--> <!-->mmol/L were enrolled in our study. Fluid resuscitation (30<!--> <!-->ml/kg) was administered. Fluid response was defined as MAP<!--> <!-->≥<!--> <!-->65<!--> <!-->mmHg with lactate level &lt;4<!--> <!-->mmol/L cardiac output (CO), measured by electrical cardiometry, in guiding fluid therapy.</p></div><div><h3>Results</h3><p>The study included 13 males (43.3%) with age 47.8<!--> <!-->±<!--> <!-->19.7. Paired comparison showed significant change in MAP readings (P value<!--> <!-->&lt;<!--> <!-->0.001). ROC curve showed cutoff 12.5% for delta CO to predict fluid responsiveness with Area under Curve (AUC) 0.927, sensitivity 90.0%, and specificity 70.0%. ROC also showed delta CO cutoff 12.5% to predict survival with AUC 0.756, sensitivity 66.7% and specificity 66.7%.</p></div><div><h3>Conclusion</h3><p>Delta change in cardiac output, measured by electric cardiometry could be used to predict fluid response and survival in acute circulatory failure in septic critically ill patients.</p></div>","PeriodicalId":31233,"journal":{"name":"Egyptian Journal of Critical Care Medicine","volume":"5 2","pages":"Pages 65-68"},"PeriodicalIF":0.3,"publicationDate":"2017-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.ejccm.2017.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130102215","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}
引用次数: 7
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