Critical Care Research and Practice最新文献

{"title":"Comparison Between Real-Time Ultrasound-Guided Percutaneous Tracheostomy and Surgical Tracheostomy in Critically Ill Patients.","authors":"Hyun Tag Kang,&nbsp;Shin Young Kim,&nbsp;Min Ki Lee,&nbsp;Seung Won Lee,&nbsp;Aerin Baek,&nbsp;Ki Nam Park","doi":"10.1155/2022/1388225","DOIUrl":"https://doi.org/10.1155/2022/1388225","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound-guided percutaneous dilatational tracheostomy (US-PDT) has been adapted for use in intensive care units (ICU). US-PDT is comparable to bronchoscopy-assisted tracheostomy. However, compared to surgical tracheostomy (ST), its safety and effectiveness have not been well studied.</p><p><strong>Objectives: </strong>To determine the efficacy and safety of US-PDT compared to ST.</p><p><strong>Materials and methods: </strong>A total of 90 patients who underwent US-PDT (<i>n</i> = 36) or ST (<i>n</i> = 54) between July 2019 and September 2020 were enrolled. US-PDT was performed in the ICU without a surgical assistant or bronchoscope. Data were collected retrospectively and analyzed regarding clinical characteristics, procedure times and details, complications, and mortality rate.</p><p><strong>Results: </strong>The success rate of US-PDT was 97.4% and the procedure time was shorter than ST (5.2 ± 3.1 vs. 10.5 ± 5.0 min). There were no significant differences in clinical characteristics and procedure details. There was no procedure-related mortality in either of the groups.</p><p><strong>Conclusions: </strong>US-PDT is time-efficient and as safe as ST. Based on our results, US-PDT may be considered a potential alternative to ST in high-risk patients and in those who cannot be transported.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9527437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33490482","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":"Prolonged ICU Stay in Severe and Critically-Ill COVID-19 Patients Who Received Convalescent Plasma Therapy.","authors":"Bambang Pujo Semedi,&nbsp;Nadya Noor Ramadhania,&nbsp;Betty Agustina Tambunan,&nbsp;Siprianus Ugroseno Yudho Bintoro,&nbsp;Soedarsono Soedarsono,&nbsp;Cita Rosita Sigit Prakoeswa","doi":"10.1155/2022/1594342","DOIUrl":"https://doi.org/10.1155/2022/1594342","url":null,"abstract":"<p><strong>Background: </strong>Convalescent plasma administration in severe and critically-ill COVID-19 patients have been proven to not provide improvement in patients' outcome, yet it is still widely used in countries with limited resources due to its high availability and safety. This study aims to investigate its effects on ICU mortality, ICU length of stay (LoS), and improvement of oxygen support requirements.</p><p><strong>Methods: </strong>Data of all severe and critically-ill patients in our COVID-19 ICU was collected retrospectively between May and November 2020. We dichotomized the variables and compared outcome data of 48 patients, who received convalescent plasma to 131 patients, receiving standard of care. Data were analyzed using multiple logistic regression to make prediction models of mortality, length of stay, and oxygen support device requirement.</p><p><strong>Result: </strong>Overall mortality rate in our COVID-19 ICU was 55.3%, with a median overall length of stay of 8 (4-11) days. Less patients that received convalescent plasma presented with the need for mechanical ventilation on ICU admission (<i>p</i> < 0.001), but with comparable PaO₂ to FiO₂ (P/F) ratio (<i>p</i>=0.95). Factors that confounded mortality were obesity (aOR = 14.1; 95% CI (1.25, 166.7); <i>p</i>=0.032), mechanical ventilation (aOR = 333; 95% CI (4.5,1,000); <i>p</i> < 0.001), higher neutrophil-to-lymphocyte ratio (NLR) (aOR = 7.32; 95% CI (1.82, 29.4); <i>p</i>=0.005), and lower P/F ratio (aOR = 7.70; 95% CI (2.04, 29.4); <i>p</i>=0.003). ICU LoS was longer in patients, who had prior history of hypertension (aOR = 2.14; 95% CI (1.05, 4.35); <i>p</i>=0.036) and received convalescent plasma (aOR = 3.88; 95% CI (1.77, 8.05); <i>p</i> < 0.001). Deceased patients, who received convalescent plasma, stayed longer in the ICU with a mean length of stay of 12.87 ± 5.7 days versus 8.13 ± 4.8 days with a significant difference (<i>U</i> = 434; <i>p</i> < 0.000). The chance of improved oxygen support requirements was lower in obese patients (aOR = 9.18; 95%CI (2.0, 42.1); <i>p</i> < 0.004), mechanically ventilated patients (aOR = 13.15; 95% CI (3.75, 46.09); <i>p</i> < 0.001), patients with higher NLR (aOR = 2.5; 95% CI (1.07, 5.85); <i>p</i>=0.034), and lower P/F ratio (aOR = 2.76; 95% CI (1.1, 6.91); <i>p</i>=0.031).</p><p><strong>Conclusion: </strong>The length of stay of patients in the convalescent plasma group was significantly longer than the control group. There was no effect of convalescent plasma in ICU mortality and no improvement was observed in terms of oxygen support requirements.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9473920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40364946","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":"Utility of Pulse Oximetry Oxygen Saturation (SpO₂) with Incorporation of Positive End-Expiratory Pressure (SpO₂ <i>∗</i>10/FiO₂ <i>∗</i>PEEP) for Classification and Prognostication of Patients with Acute Respiratory Distress Syndrome.","authors":"Pratibha Todur,&nbsp;Anitha Nileshwar,&nbsp;Souvik Chaudhuri,&nbsp;Nitin Gupta,&nbsp;Srikant Natarajan,&nbsp;Shwethapriya Rao","doi":"10.1155/2022/7871579","DOIUrl":"https://doi.org/10.1155/2022/7871579","url":null,"abstract":"<p><strong>Background: </strong>Conventionally, PaO₂/FiO₂ (P/F ratio) has been used to categorize severity of acute respiratory distress syndrome (ARDS) and prognostication of outcome. Recent literature has shown that incorporation of positive end-expiratory pressure (PEEP) into the P/F ratio (PaO₂ <i>∗</i>10/FiO₂ <i>∗</i>PEEP or P/FP<i>∗</i>10) has a much better prognostic ability in ARDS as compared to P/F ratio. The aim of this study was to correlate SpO₂ <i>∗</i>10/FiO₂ <i>∗</i>PEEP (S/FP<i>∗</i>10) to PaO₂ <i>∗</i>10/FiO₂ <i>∗</i>PEEP (P/FP<i>∗</i>10) and evaluate the utility of S/FP<i>∗</i>10 as a reliable noninvasive indicator of oxygenation in ARDS to avoid repeated arterial blood sampling.</p><p><strong>Aim: </strong>To evaluate if pulse oximetry is a reliable indicator of oxygenation in ARDS patients by calculating SpO₂ <i>∗</i>10/FiO₂ <i>∗</i>PEEP (S/FP<i>∗</i>10). The primary objective was to determine the correlation of S/FP<i>∗</i>10 to P/FP<i>∗</i>10 ratio in ARDS patients. The secondary objective was to determine the cut-off value of S/FP<i>∗</i>10 ratio to predict severe ARDS and survival.</p><p><strong>Methods: </strong>Patients aged 18-80 years on invasive mechanical ventilation (MV) diagnosed with ARDS as defined by the Berlin definition were included. The values of PaO₂, FiO₂, and SpO₂ were collected at three different time points. They were at baseline, i.e., after intubation and initiation of MV (within one hour of intubation), day one (1-24 hours of MV), and day three (48-72 hours of MV). The primary outcome was survival at the end of intensive care unit (ICU) stay.</p><p><strong>Results: </strong>A total of 85 patients with ARDS on invasive MV were included. The data points were obtained at baseline, day one, and day three of MV. S/FP<i>∗</i>10 ratio has an excellent correlation to P/FP<i>∗</i>10 ratio at baseline and day three of invasive MV (<i>r</i> = 0.831 and 0.853, respectively; <i>p</i> < 0.001) and has a strong correlation on day one of invasive MV (r = 0.733, <i>p</i> < 0.001). S/FP<i>∗</i>10 ratio ≤116 at baseline has excellent discriminant function to be categorized as severe ARDS as per Berlin definition (AUC: 0.925, <i>p</i> < 0.001, 90% sensitivity, 93% specificity, CI: [0.862-0.988]). The increase in S/FP<i>∗</i>10 ratio by ≥64.40 from baseline to day three of MV is a good predictor of survival (AUC: 0.877, <i>p</i> < 0.001, 73.5% sensitivity, 97% specificity, CI: [0.803-0.952]).</p><p><strong>Conclusion: </strong>S/FP<i>∗</i>10 has a strong correlation to P/FP<i>∗</i>10 in ARDS patients. S/FP<i>∗</i>10 ≤116 has an excellent discriminant function to be categorized as severe ARDS. The S/FP<i>∗</i>10 ratio on day three of MV and the change in S/FP<i>∗</i>10 ratio from baseline and day one to day three of MV are good predictors of survival in ARDS patients. This trial i","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9470362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40361191","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":"Epidemiologic Characteristics of Adolescents with COVID-19 Disease with Acute Hypoxemic Respiratory Failure.","authors":"Helen Kest,&nbsp;Ashlesha Kaushik,&nbsp;Somia Shaheen,&nbsp;William Debruin,&nbsp;Sahil Zaveri,&nbsp;Mario Colletti,&nbsp;Sandeep Gupta","doi":"10.1155/2022/7601185","DOIUrl":"https://doi.org/10.1155/2022/7601185","url":null,"abstract":"<p><p>We report our experience of COVID-19 disease with hypoxemic respiratory failure among patients aged 12-21 years admitted to the intensive care unit at two tertiary care institutions in Northeastern and Midwestern United States. Our results showed that during the main study period that spanned the initial surge at both geographic locations, adolescents with SARS-COV-2 infection admitted to the ICU with respiratory failure were more likely to be male, black, and morbidly obese and with two or more comorbidities. The majority (79%) were admitted with COVID-19-related pneumonia and 15 developed respiratory failure; two-thirds of patients with respiratory failure (9/15, 60%) required mechanical ventilation (MV). More than two-thirds of patients (11/15, 75%) with respiratory failure were obese with BMI > 30 compared to those without respiratory failure (<i>p</i> < 0.0001), and those with BMI > 40 were 4.3 times more likely to develop respiratory failure than those with normal BMI; 40% of patients with respiratory failure had two or more pre-existing medical comorbidities. Inflammatory markers were 2-20 times higher in patients with respiratory failure (<i>p</i> < 0.05). The majority of patients on MV (7/9) developed complications, including ARDS (acute respiratory distress syndrome), acute renal injury, and cerebral anoxic encephalopathy. Patients with respiratory failure had a significantly longer length of hospital stay than patients without respiratory failure (<i>p</i> < 0.05). The majority of the admitted adolescents in the ICU received steroid treatment. None of the patients died. An additional review of a 6-month postvaccination approval period indicated that the majority of ICU admissions were unvaccinated, obese, black patients and all patients who developed respiratory failure were unvaccinated. Our study highlights and supports the need for maximizing opportunities to address vaccination and healthcare gaps in adolescents as well as promoting public health measures including correct use of masks, effective vaccination campaigns for this age group, and additional passive preventive interventions for COVID-19 disease in adolescents especially with comorbid conditions, and in minority populations.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9467822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40358321","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":"Incidence and Impact of Ventilator Associated Multidrug Resistant Pneumonia in Patients with SARS-COV2.","authors":"Seife Yohannes,&nbsp;Zaki Ahmed,&nbsp;Rachel Schelling,&nbsp;Swaminathan Perinkulam Sathyanarayanan,&nbsp;Alexandra Pratt,&nbsp;Mathew P Schreiber","doi":"10.1155/2022/9730895","DOIUrl":"https://doi.org/10.1155/2022/9730895","url":null,"abstract":"<p><strong>Introduction: </strong>Ventilator Associated Pneumonia (VAP) is associated with significant cost, morbidity, and mortality. There is limited data on the incidence of VAP, appropriate antibiotic timing, and the impact of multidrug resistant VAP in intubated Coronavirus disease-19 (COVID-19) patients.</p><p><strong>Methods: </strong>A retrospective study was conducted at 2 tertiary urban academic centers involving 132 COVID-19 patients requiring invasive mechanical ventilation (IMV). The epidemiology of VAP, the impact of prior empiric antibiotic administration on the development of Multidrug Resistant Organism (MDRO) infections, and the impact of VAP on patient outcomes were studied.</p><p><strong>Results: </strong>The average age of the patients was 60.58% were males, 70% were African-Americans and two-thirds of patients had diabetes, hypertension, or heart disease. The average Body Mass Index (BMI) was 32.9. Forty-one patients (27%) developed VAP. Patients with VAP had a significantly higher Sequential Organ Failure Assessment (SOFA) score prior to Intensive Care Unit (ICU) admission. Sixty percent received empiric antibiotics before initiation of IMV, mostly on hospital admission, and 81% received empiric antibiotics at the time of intubation. The administration of empiric antibiotics was not associated with a higher prevalence of VAP. The prevalence of VAP was 22 per 1000 days on ventilation. No difference in mortality was seen between VAP and non-VAP groups at 49% and 57% respectively (<i>p</i> = 0.4). VAP was associated with increased ICU length of stay (LOS), 30 vs. 16 days (<i>p</i> < 0.001), and longer hospital LOS 35 vs. 17 days (<i>p</i> < 0.001). 40% of VAPs were caused by MDROs. The most common organism was <i>Staphylococcus aureus</i> (28%), with almost half (48%) being methicillin resistant <i>Staphylococcus aureus</i> (MRSA).</p><p><strong>Conclusion: </strong>VAP was a common complication of patients intubated for COVID-19 pneumonia. Most patients received empiric antibiotics upon the hospital and/or ICU admission. There was a 40% incidence of multidrug resistant pneumonia. Patients who developed VAP had almost twice as long hospital and ICU LOS.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33467163","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":"Effect of Local Warm Compression on Restless Leg Syndrome and Fatigue among Critical Care Nurses: A Parallel Randomized Clinical Trial.","authors":"Maryam Ameri,&nbsp;Hossein Ebrahimi,&nbsp;Ahmad Khosravi,&nbsp;Seyedmohammad Mirhosseini,&nbsp;Mohammad Reza Khatibi","doi":"10.1155/2022/7330308","DOIUrl":"https://doi.org/10.1155/2022/7330308","url":null,"abstract":"<p><strong>Methods and materials: </strong>This parallel randomized clinical trial was conducted on 120 CCNs in Shahroud by the census sampling method. Inclusion criteria included suffering from restless leg syndrome and having no wound or inflammation over the organ. The participants were assigned into two groups by the use of quadruple blocks. The intervention group received the warm compress for 12 sessions lasting 4 weeks and the control group did not receive an intervention. Data were collected using multidimensional fatigue inventory (MFI) and the Restless Legs Syndrome Scale and then analyzed using descriptive and inferential statistics (chi-squared test, independent sample <i>t</i>-test, and pair sample <i>t</i>-test).</p><p><strong>Results: </strong>The two groups were homogeneous in terms of demographic characteristics. Prior to the intervention, the two groups of warm compression and control did not have a significant difference in terms of mean fatigue and restless leg syndrome scores; however, after the intervention, a significant reduction was observed in the intervention group (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>According to the results of the current study, the use of warm compression is an effective intervention in alleviating fatigue and restless leg syndrome, so it is recommended to implement this intervention as a nonpharmacological strategy among CCNs. <i>Clinical Trial Registration Number</i>. IRCT20190723044316N1.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40353136","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":"Readmission Following Perioperative Myocardial Injury: Clinical Predictors and Impact on Mortality.","authors":"Alex Anzelmi,&nbsp;Yasser Khalil,&nbsp;Martin E Matsumura","doi":"10.1155/2022/7674962","DOIUrl":"https://doi.org/10.1155/2022/7674962","url":null,"abstract":"<p><strong>Background: </strong>Perioperative myocardial injury (PMI) following noncardiac surgery is associated with a high risk for mortality, and readmission within 30 days of PMI increases this risk. Identifying risk factors for readmission among survivors of PMI is critical to improving outcomes in PMI. We examined risk factors for readmission following discharge after surgery complicated by PMI and the effect of readmission on 1-year mortality.</p><p><strong>Methods: </strong>The study is a retropective cohort analysis of patients diagnosed with PMI in a single health system over a 10-year period. Univariate predictors of readmission were used to construct a multivariable logistic regression model. Mortality was assessed using Kaplan-Meyer survival analysis.</p><p><strong>Results: </strong>Of the 207,729 surgical patients, 5159 (2.5%) had PMI. By 30 days following PMI, 1254 patients (24.3%) died, 1142 (22.2%) were readmitted but alive at 30 days, and 2763 patients (53.5%) were alive and had not been readmitted. Readmitted patients were older, had higher peak troponin levels, and were more likely to have prior coronary, neoplastic, lung, and kidney disease. Multivariable logistic regression revealed increasing age and peak troponin, prior cancer diagnosis, and chronic lung and kidney disease as independent predictors of readmission. Readmitted patients had higher 1-year mortality than those not readmitted (33.9% vs. 22.2%, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Readmission following PMI is associated with increased mortality in the following year. Patients suffering from PMI who are at risk of readmission are older, have a greater extent of myocardial injury, and are more likely to have chronic comorbidities. Identification of patients at risk of readmission following PMI is critical to improving both outcomes and utilization of hospital resources.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40632653","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":"Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure.","authors":"Killen H Briones-Claudett, Mónica H Briones-Claudett, Mariuxi Del Pilar Cabrera Baños, Killen H Briones Zamora, Diana C Briones Marquez, Luc J I Zimmermann, Antonio W D Gavilanes, Michelle Grunauer","doi":"10.1155/2022/4333345","DOIUrl":"10.1155/2022/4333345","url":null,"abstract":"<p><strong>Background: </strong>Bilevel positive airway pressure in spontaneous/time and average volume-assured pressure support (BiPAP·S/T-AVAPS) could maintain an adequate tidal volume by reducing the patient's inspiratory effort; however, this ventilatory strategy has not been compared with other ventilatory modes, especially the conventional BiPAP S/T mode, when noninvasive mechanical ventilation (NIMV) is used. The primary objective of this study was to determine the rate of success and failure of the use of BiPAP·S/T-AVAPS versus BiPAP·S/T alone in patients with mild-to-moderate \"de novo\" hypoxemic respiratory failure.</p><p><strong>Methods: </strong>This was a matched-cohort study. Subjects with mild-to-moderate de novo hypoxemic respiratory failure were divided into two groups according to the ventilatory strategy used. The subjects in the BiPAP·S/T group were paired with those in the BiPAP·S/T-AVAPS group.</p><p><strong>Results: </strong>A total of 58 subjects were studied. Twenty-nine subjects in the BiPAP·S/T group were paired with 29 subjects in the BiPAP·S/T-AVAPS group. Twenty patients (34.5%) presented with \"failure of NIMV,\" while 38 (65.5%) patients did not. In addition, 13 (22.4%) patients died, while 45 (77.6%) recovered. No differences were found in the percentage of intubation (<i>P</i>=0.44) and mortality (<i>P</i>=0.1).</p><p><strong>Conclusion: </strong>The BiPAP S/T-AVAPS ventilator mode was not superior to the BiPAP·S/T mode. A high mortality rate was observed in patients with NIMV failure in both modes. This trial is registered with https://doi.org/10.1186/ISRCTN17904857.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9365614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40628061","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":"Is the Critical Care Resuscitation Unit Sustainable: A 5-Year Experience of a Beneficial and Novel Model.","authors":"Elizabeth Powell,&nbsp;Iana Sahadzic,&nbsp;Daniel Najafali,&nbsp;Emilie Berman,&nbsp;Katie Andersen,&nbsp;Leenah Z Afridi,&nbsp;Zoe Gasparotti,&nbsp;Erin Niles,&nbsp;Jeffrey Rea,&nbsp;Thomas Scalea,&nbsp;Daniel J Haase,&nbsp;Quincy K Tran","doi":"10.1155/2022/6171598","DOIUrl":"https://doi.org/10.1155/2022/6171598","url":null,"abstract":"<p><strong>Background: </strong>The 6-bed critical care resuscitation unit (CCRU) is a unique and specialized intensive care unit (ICU) that streamlines the interhospital transfer (IHT-transfer between different hospitals) process for a wide range of patients with critical illness or time-sensitive disease. Previous studies showed the unit successfully increased the number of ICU admissions while reducing the time of transfer in the first year of its establishment. However, its sustainability is unknown.</p><p><strong>Methods: </strong>This was a descriptive retrospective analysis of adult, non-trauma patients who were transferred to an 800-bed quaternary medical center. Patients transferred to our medical center between January 1, 2014 and December 31, 2018 were eligible. We used interrupted time series (ITS) and descriptive analyses to describe the trend and compare the transfer process between patients who were transferred to the CCRU versus those transferred to other adult inpatient units.</p><p><strong>Results: </strong>From 2014 to 2018, 50,599 patients were transferred to our medical center; 31,582 (62%) were non-trauma adults. Compared with the year prior to the opening of the CCRU, ITS showed a significant increase in IHT after the establishment of the CCRU. The CCRU received a total of 7,788 (25%) IHTs during this period or approximately 20% of total transfers per year. Most transfers (41%) occurred via ground. Median and interquartile range [IQR] of transfer times to other ICUs (156 [65-1027] minutes) were longer than the CCRU (46 [22-139] minutes, <i>P</i> < 0.001). For the CCRU, the most common accepting services were cardiac surgery (16%), neurosurgery (11%), and emergency general surgery (10%).</p><p><strong>Conclusions: </strong>The CCRU increases the overall number of transfers to our institution, improves patient access to specialty care while decreasing transfer time, and continues to be a sustainable model over time. Additional research is needed to determine if transferring patients to the CCRU would continue to improve patients' outcomes and hospital revenue.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9325651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40660775","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":"Patient Perception of Informed Consent and Its Associated Factors among Surgical Patients Attending Public Hospitals in Dessie City Administration, Northeast Ethiopia.","authors":"Hana Gebrehiwot,&nbsp;Nathan Estifanos,&nbsp;Yosef Zenebe,&nbsp;Tamrat Anbesaw","doi":"10.1155/2022/6269921","DOIUrl":"https://doi.org/10.1155/2022/6269921","url":null,"abstract":"<p><strong>Background: </strong>Poor perception of informed consent compromises patients' autonomy and self-determination; as a result, they feel powerless and unaccountable for their treatment. This study aimed to assess patients' perception of informed consent and its associated factors among surgical patients attending public hospitals in Dessie City Administration, Northeast Ethiopia.</p><p><strong>Methods: </strong>Facility-based cross-sectional study was conducted on 422 surgical patients. A systematic sampling technique was used to select the study participants. Data were collected using a pretested structured interviewer-administered questionnaire. EpiData version 3.1 was used for data entry, and then data were exported to SPSS version 25 for analysis. Multivariable logistic regression analysis was done to identify factors associated with the outcome variable among the participants. Variables with <i>p</i> value less than 0.05 were considered statistically significant factors.</p><p><strong>Results: </strong>The prevalence of poor perception of informed consent for surgical procedures was found to be 33.2% (95% CI: 28.8-37.8). In multivariable analysis, educational status with inability to read and write (AOR = 5.71; 95% CI: 2.76-11.80) and basic ability to read and write (AOR = 6.03; 95% CI: 2.57-14.16), rural residence (AOR = 3.71; 95% CI: 1.94-7.07), marital status being widowed and divorced (AOR = 3.85; 95% CI: 1.83-8.08), language of written informed consent different from mother tongue (AOR = 4.196; 95% CI: 1.12-15.78), poor patient-physician relationship (AOR = 2.35; 95% CI: 1.31-4.24), and poor knowledge of surgical informed consent (AOR = 3.05; 95% CI: 1.56-5.97) were significantly associated with poor perception of surgical informed consent.</p><p><strong>Conclusion: </strong>In this study, one-third of surgical patients appear to have poor perceptions of informed consent for surgical procedures. Educational status, being rural residents, being widowed/divorced, language of written informed consent, poor patient-physician relationship, and poor knowledge of surgical informed consent were variables that are independent predictors of poor perception of informed consent for surgical procedures. The ministry of health and healthcare providers should develop a plan to raise patients' awareness about the informed consent process for surgical procedures.</p>","PeriodicalId":46583,"journal":{"name":"Critical Care Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9270118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40604764","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}