Journal of Critical & Intensive Care最新文献_第5页

Retrospective Evaluation of Frequency and Factors Affecting Development of Tracheomalacia in Critically ill Patients with Prolonged Intubation 长时间插管危重患者气管软化症发生频率及影响因素的回顾性分析

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2855

Zuhal Ozer simsek, Gulseren Elay, S. Temel, M. Sungur, K. Gundogan

{"title":"Retrospective Evaluation of Frequency and Factors Affecting Development of Tracheomalacia in Critically ill Patients with Prolonged Intubation","authors":"Zuhal Ozer simsek, Gulseren Elay, S. Temel, M. Sungur, K. Gundogan","doi":"10.37678/dcybd.2021.2855","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2855","url":null,"abstract":"There are two types of tracheomalacia (TM) as acquired and congenital. Acquired TM which is more common is the collapse of airway after expiration due to weakness of tracheal wall (1). Most common causes of acquired TM include prolonged intubation, tracheostomy, and smoking (2). Bronchoscopic visualization of dynamic airway collapse is considered by many experts the diagnostic gold standard. Historically, TM was diagnosed if there was >50 percent decrease in airway lumen size, but data from healthy volunteers has shown that this threshold was met in up to 78 percent (3). During the expiration phase, <70% constriction of initial airway diameter is normal, 70-80% constriction is \"mild\", 80-90% constriction is \"moderate\" and >90% constriction or anterior and posterior walls touch is \"severe\" (3). Possible risk factors include recurrent intubation, prolonged intubation, concurrent high-dose steroid therapy, and cuff pressures >25 cm H2O. The mechanism is uncertain but may include pressure necrosis, impaired blood flow, recurrent infections, mucosal friction, or mucosal inflammation (4). In patients with TM respiratory distress occur after extubation and usually these patients are re-intubated (5). A study reported TM prevalence as 12.7% (6).This study aims to identify development frequency of and factors affecting TM in critically ill patients with prolonged intubation.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975876","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}

引用次数: 0

Type 1 Brugada Type-ECG Pattern Provoked by Fever in a Patient with COVID-19 1例COVID-19患者发热引起的1型Brugada型心电图模式

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2769

F. Ulutaş, Aslı Bozdemir, I. Oguz, Mithat Kahramanoğlu, V. Çobankara, I. Akbudak

引用次数: 0

Persistence of Abnormal Inflammatory and Coagulation Laboratory Tests in Critically-ill COVID-19 Survivors: Case Series COVID-19危重幸存者持续存在异常炎症和凝血实验室检查:病例系列

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2833

I. T. Geldigitti, B. Halaçlı, B. Er, Mehmet Yildirim, Gulay Tok, Ebru Ortaç Ersoy, S. Ocal, A. Topeli

{"title":"Persistence of Abnormal Inflammatory and Coagulation Laboratory Tests in Critically-ill COVID-19 Survivors: Case Series","authors":"I. T. Geldigitti, B. Halaçlı, B. Er, Mehmet Yildirim, Gulay Tok, Ebru Ortaç Ersoy, S. Ocal, A. Topeli","doi":"10.37678/dcybd.2021.2833","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2833","url":null,"abstract":"Aim: In this study, the aim was to evaluate the persistence of abnormalities in laboratory variables regarding inflammation and coagulation during the recovery process of the critically-ill COVID-19 patients. Materials and methods: Medical records of patients who were treated for COVID-19 in our intensive care unit (ICU) were examined retrospectively. Baseline characteristics and latest abnormal test result dates for lymphocyte counts, C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, fibrinogen and D-dimer levels from the first day of ICU admission were noted. Results: In total, 15 patients were enrolled in the final analysis. Overall median value (Interquartile range) for the latest abnormal test result dates from the first day of ICU admission and the ratio of patients with abnormal test results after hospital discharge were 11 (7.5-17) days and 7.7% for lymphocyte count, 15 (8-20) days and 20% for LDH, 15 (10.5-40) days and 30% for CRP, 15.5 (10.3-30.3) days and 25% for ferritin, 17 (12-95.5) days and 50% for fibrinogen, and 28 (18-68.5) days and 71.4% for D-dimer. Conclusion: In critically-ill COVID-19 survivors, abnormality of laboratory tests regarding inflammation and coagulopathy persists after hospital discharge and even after 90 days after ICU admission which suggests the probability of sustained risk for multi-organ damage and thromboembolic events.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975829","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}

引用次数: 0

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2683

B. M. Çilingir, S. Aşkar

引用次数: 0

Factors that May Predict the Need for Invasive Mechanical Ventilation in Severe Acute Bronchiolitis 预测重症急性细支气管炎患者需要有创机械通气的因素

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2570

H. S. Kıhtır, E. Ongun

{"title":"Factors that May Predict the Need for Invasive Mechanical Ventilation in Severe Acute Bronchiolitis","authors":"H. S. Kıhtır, E. Ongun","doi":"10.37678/dcybd.2021.2570","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2570","url":null,"abstract":"Objective: Severe acute bronchiolitis patients may require mechanical ventilation despite other non-invasive respiratory support modalities in the intensive care unit. Referral of the patients who may require intubation to experienced centers, may reduce invasive ventilation associated complications. The objective of this study is to determine the risk factors at PICU admission that may predict the mechanical ventilation requirement in severe acute bronchiolitis patients. Methods: Retrospective chart review of patients admitted to the PICU due to severe acute bronchiolitis between 01.08.2018-01.11.2019 were included in to the study. Results: One hundred and five patients were enrolled. High flow nasal cannula was used in 70 patients (66.6%), non-invasive ventilation (spontaneous/time mode) was used in 19 (18.1%) patients and invasive mechanical ventilation was used in 16 (15.3%) patients. Birth weight (Odds Ratio [OR]:0.99), admission weight (OR:0.749), age in months (OR:0.763), history of prematurity (OR:3.06), presence of chronic respiratory diseases (OR:4.61), presence of chronic cardiac diseases (OR:3.23) and respiratory syncytial virus infection (OR:4.37) were significant for intubation requirement in logistic regression analysis. Age ≤4 months (sensitivity: 50% specificity: 85.3%) and birth weight ≤3000 g (sensitivity: 75% specificity: 75.8%) were found significant in receiver operating characteristics curve analysis. Conclusion: Invasive mechanical ventilation in severe acute bronchiolitis is a challenging process that requires experience. History of prematurity without chronic lung disease appears not to be a significant risk factor for intubation. Patients with chronic lung disease, low birth weight, history of prematurity especially when these are complicated with RSV infection should be transferred to experienced centers in the early period.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975782","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}

引用次数: 0

The Relationship between Hypothermia Duration and Amount of Bleeding After Open Heart Surgery 心脏直视手术后低温持续时间与出血量的关系

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2820

Gizem Acikgoz, Özlem İbrahimoğlu

{"title":"The Relationship between Hypothermia Duration and Amount of Bleeding After Open Heart Surgery","authors":"Gizem Acikgoz, Özlem İbrahimoğlu","doi":"10.37678/dcybd.2021.2820","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2820","url":null,"abstract":"Aim: This study was conducted to examine the relationship between hypothermia duration and amount of bleeding after open heart surgery. Study Design: This is a retrospective, descriptive, and correlational study. Materials and Methods: The data were obtained by examining the hospital records of 45 patients who underwent open heart surgery between January 2018 and January 2019 in the cardiovascular surgery clinic of an education and research hospital in Istanbul. Results: The mean age of the patients was 65.30±10.05 years, and 33 (73.3%) of them were women. The mean hypothermia duration of the patients in the postoperative period was 10.35 hours, and the mean amount of bleeding was 600 ml. It was determined that the amount of bleeding increased as the duration of hypothermia increased after open heart surgery (r=0.302, p<0.05), and there was a statistically significant relationship between the presence of chronic disease and body mass index, and the hypothermia duration and the amount of bleeding. Conclusion: In this study, a significant correlation was found between the postoperative hypothermia duration and the amount of bleeding. Prolonged hypothermia after open heart surgery is an important parameter that may adversely affect the amount of bleeding in patients. For this reason, surgical nurses should be aware that hypothermia causes an increase in the amount of bleeding in the early period after cardiac surgery, and awareness of patients should be increased to protect them from hypothermia.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975812","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}

引用次数: 0

Anticholinergic Syndrome Due to the Use of Datura Stramonium Seeds for Constipation: A Story of Prolonged ICU Stay 曼陀罗籽治疗便秘引起的抗胆碱能综合征:一个延长ICU住院时间的故事

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2673

Selda Kayaaltı, S. Temel, Kadir Bulut, Ali Yeşiltepe, Aysim Erturk, M. Sungur, K. Gundogan

{"title":"Anticholinergic Syndrome Due to the Use of Datura Stramonium Seeds for Constipation: A Story of Prolonged ICU Stay","authors":"Selda Kayaaltı, S. Temel, Kadir Bulut, Ali Yeşiltepe, Aysim Erturk, M. Sungur, K. Gundogan","doi":"10.37678/dcybd.2021.2673","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2673","url":null,"abstract":"Datura stramonium is grown widely in some regions of Turkey. Datura stramonium seed is used in the treatment of various diseases such as constipation and acne and causes anticholinergic toxicity when taken in overdose. In the literature, patients presenting with mild symptoms are the majority, and intensive care follow-up is often not required for these patients. In this case report, we present a 50-year-old male patient who received around 200 Datura stramonium seeds for the treatment of chronic constipation. When the patient admitted to the emergency department, he was unconscious, and his pupils were dilated. The patient who had severe vomiting and contractions was intubated. With the diagnosis of anticholinergic syndrome, physostigmine 0.5 mg (one dose) and 1 mg (two times) were administered to the patient with central nervous system findings. The patient who developed sepsis due to aspiration pneumonia during the follow-up stayed in the intensive care unit for 40 days with the support of mechanical ventilator for 37 days. The patient was discharged after 26 days of treatment in the physical therapy service. Accidental ingestion of Datura stramonium seed used for herbal therapy in high doses may cause life-threatening consequences due to its anticholinergic effects or complications related to these effects.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975904","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}

引用次数: 1

A Survey of Percutaneous Endoscopic Gastrostomy Procedures in The Intensive Care Units of Turkey 经皮内镜胃造口术在土耳其重症监护病房的调查

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2578

Burcu Acar Cinleti, Aykut Sarıtaş, T. Yavuz, H. Özkarakaş, N. Şenoğlu

引用次数: 0

The Prevalence of Sepsis and Septic Shock in a Middle-Income Country: Experience of Two Tertiary Hospitals in Jordan 脓毒症和感染性休克在中等收入国家的流行:约旦两家三级医院的经验

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2795

Saleh Al Omar, J. Alshraideh, B. Khassawneh, Shahd M. Al Muhaisen

{"title":"The Prevalence of Sepsis and Septic Shock in a Middle-Income Country: Experience of Two Tertiary Hospitals in Jordan","authors":"Saleh Al Omar, J. Alshraideh, B. Khassawneh, Shahd M. Al Muhaisen","doi":"10.37678/dcybd.2021.2795","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2795","url":null,"abstract":"Aim: This study was conducted to describe the prevalence rates for sepsis and septic shock and the length of stay (LOS) among adult patients in intensive care units (ICUs) at two tertiary hospitals in Jordan. Study design: A cross-sectional descriptive design was used. Materials and methods: A total of 914 patients admitted to adult medical and surgical ICUs at two tertiary hospitals for three months were screened for sepsis and septic shock, and followed up during their hospitalization. The data were collected using a flowchart for screening patients with sepsis/ septic shock. In addition, another tool was used to assess patients’ socio-demographics and clinical variables. Results: The overall three-month period prevalence rate for both sepsis and septic shock was 16.6%. Of these, 48.7% of patients developed sepsis and 51.3% had septic shock. The mean LOS in hospital of patients with sepsis/ septic shock was 21.4 days, compared to 10.5 days for patients without sepsis/ septic shock (p <.001). The mean LOS in ICU of patients with sepsis/ septic shock was 11.1 days, while for patients without sepsis/ septic shock it was 4.4 days (P<.001). The mean Sequential Organ Failure Assessment (SOFA) score was 7.6 ± 3.8 (range = 2.0 – 18.0) for patients with sepsis/septic shock. Conclusion: The prevalence rate of sepsis and septic shock was comparable to, or lower than, the prevalence rate at adult ICUs of hospitals in different countries. Sepsis and septic shock were significant health problems among patients in the adult ICUs in Jordan, doubling their LOS.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69976279","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}

引用次数: 0

The Effect of Infection Agents Obtained From Intensive Care Patients on the Resistance Pattern and Patient Outcomes 重症监护患者感染因子对耐药模式和患者预后的影响

Journal of Critical & Intensive Care Pub Date : 2021-01-01 DOI: 10.37678/dcybd.2021.2682

K. Gonderen, Gulsen Simavlioglu, Duygu Ibil

{"title":"The Effect of Infection Agents Obtained From Intensive Care Patients on the Resistance Pattern and Patient Outcomes","authors":"K. Gonderen, Gulsen Simavlioglu, Duygu Ibil","doi":"10.37678/dcybd.2021.2682","DOIUrl":"https://doi.org/10.37678/dcybd.2021.2682","url":null,"abstract":"Objective: Infection is a significant problem associated with increased morbidity and mortality in intensive care units (ICU). This study aimed to examine the effect of infectious agents obtained from Medical ICU on the resistance pattern and the patient outcomes in a 3 year period retrospectively. Material and Method: The patients with positive culture results while hospitalized in a tertiary level medical ICU between January 2016 and April 2019 were included in the study. The patients were grouped as survivors and non-survivors. These groups were compared for infection foci, infectious agents, mortality, and the sensitivity of the infectious pathogens to the antibiotics. Results: From a total of 426 patients admitted to ICU with the diagnosis of infection, culture positivity was determined in 212 samples. The highest rates of positivity were determined from the urinary tract specimens (n:90, 42.4%), followed by bloodstream specimens (n:62, 29.2%) and then lower respiratory tract specimens (n:47, 22.1%). The most frequently isolated micro-organisms were gram-negative bacteria (n.152, 70.6%) and within these, the most common micro-organism was Escherichia coli (n:59, 27.8%). When the microorganisms evaluated according their antibiotic susceptibility it was found that, A. baumanii strains were sensitive to colistin, and K. pneumonia, E.coli, and Pseudomonas aeruginosa (P. aeruginosa) strains were sensitive to aminoglycosides and colistin. The mortality rate of the hospitalized patients because of infection was found to be 51.8% (n:112). Conclusion: When selecting empirical antibiotics in the treatment of infection in critically ill patients, the intensive care unit flora and the antibiotic resistance patterns must be known. Therefore, it is important to periodically determine the infectious agents and antibiotic sensitivity.","PeriodicalId":40137,"journal":{"name":"Journal of Critical & Intensive Care","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69975967","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}

引用次数: 0