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Admission criteria in intensive care unit

Lital Oz-Alcalay, Shai Ashkenazi, Aharona Glatman-Freedman, Sarit Weisman-Demri, Alexander Lowenthal, Gilat Livni
BACKGROUND: Respiratory syncytial virus (RSV)-related bronchiolitis is a common cause of morbidity in young infants. The recommendations for its passive prevention by palivizumab are currently under intensive debate. OBJECTIVES: To elucidate the optimal prevention strategy by studying the morbidity of RSV disease under the current recommendations for palivizumab prophylaxis in Israel. METHODS: We collected demographic and clinical data of all children hospitalized with microbiologically confirmed RSV bronchiolitis during 2015-2016 at Schneider Children's Medical Center...
February 2019: Israel Medical Association Journal: IMAJ
Bianca Masturzo, Vera Franzè, Chiara Germano, Rossella Attini, Gianluca Gennarelli, Antonella Lezo, Alessandro Rolfo, Claudio Plazzotta, Elena Brunelli, Aly Youssef, Tullia Todros, Antonio Farina
PURPOSE: To estimate the impact of increasing pre-pregnancy Body Mass Index (BMI) on the risk of adverse maternal and perinatal outcomes, in patients who delivered in an Italian tertiary care Obstetric department. METHODS: Data, related to women who delivered at Sant'Anna Hospital, Turin, between 2011 and 2015, were collected retrospectively from the hospital database. According to BMI, women were considered as normal weight, overweight, and class 1, 2 and 3 obese (WHO criteria)...
February 15, 2019: Archives of Gynecology and Obstetrics
Takoua Merhabene, Farah Blel, Amira Jamoussi, Samia Ayed, Jalila Ben Khelil, Mohamed Besbes
BACKGROUND: Rationing in intensive care unit (ICU) beds is common and can leads to admission refusal. Understanding factors involved in triage practices is the first step towards an ethically optimal decision-making process. AIM: To identify determinants and patients' characteristics associated with decisions to deny ICU admission. METHODS: This prospective observational study was conducted in AbderrahmeneMami Hospital's medical ICU, in Ariana, between 1st January and 31th December 2016...
October 2018: La Tunisie Médicale
David Brossier, Isabelle Goyer, Lydia Ziani, Christopher Marquis, Grant Mitchell, Bruno Ozanne, Philippe Jouvet
The purpose of the study was to evaluate the influence of establishing a protocol for the use of combined sodium benzoate and sodium phenylacetate (SBSP) (Ammonul®) to treat acute hyperammonemia. This was a retrospective, single-center study in a 24-bed medical and surgical pediatric intensive care unit (PICU) in a tertiary care teaching maternal-child hospital in Canada. Inclusion criteria were age < 18 years, PICU admission between 1 January 2000 and 30 June 2016, and SBSP treatment. An SBSP delivery protocol was implemented in our hospital on 30 August 2008 in order to improve management of acute hyperammonemia...
January 2019: Journal of Inherited Metabolic Disease
Amrou Sarraj, Michael Mlynash, Sean I Savitz, Jeremy J Heit, Maarten G Lansberg, Michael P Marks, Gregory W Albers
Importance: Although thrombectomy benefit was maintained in transfer patients with ischemic stroke in early-window trials, overall functional independence rates were lower in thrombectomy and medical management-only groups. Objective: To evaluate whether the imaging-based selection criteria used in the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 (DEFUSE 3) trial would lead to comparable outcome rates and treatment benefits in transfer vs direct-admission patients...
February 7, 2019: JAMA Neurology
Rasmus Bo Hasselbalch, Mia Pries-Heje, Martin Schultz, Louis Lind Plesner, Lisbet Ravn, Morten Lind, Rasmus Greibe, Birgitte Nybo Jensen, Thomas Høi-Hansen, Nicholas Carlson, Christian Torp-Pedersen, Lars S Rasmussen, Kasper Iversen
INTRODUCTION: Triage systems with limited room for clinical judgment are used by emergency departments (EDs) worldwide. The Copenhagen Triage Algorithm (CTA) is a simplified triage system with a clinical assessment. METHODS: The trial was a non-inferiority, two-center cluster-randomized crossover study where CTA was compared to a local adaptation of Adaptive Process Triage (ADAPT). CTA involves initial categorization based on vital signs with a final modification based on clinical assessment by an ED nurse...
2019: PloS One
Henry Tan Chor Lip, Jih Huei Tan, Mathew Thomas, Farrah-Hani Imran, Tuan Nur' Azmah Tuan Mat
Background: Prognostic measures to determine burn mortality are essential in evaluating the severity of individual burn victims. This is an important process of triaging patients with high risk of mortality that may be nursed in the acute care setting. Malaysian burn research is lacking with only one publication identified which describes the epidemiology of burn victims. Therefore, the objective of this study was to go one step further and identify the predictors of burn mortality from a Malaysian burns intensive care unit (BICU) which may be used to triage patients at higher risk of death...
2019: Burns and Trauma
Leah C Kisorio, Gayle C Langley
BACKGROUND: Understanding critically ill patients' experiences of nursing care is an important aspect that can improve quality of care in the intensive care unit. AIM: To elicit critically ill patients' experiences of nursing care in the adult intensive care units. DESIGN: A qualitative descriptive design was utilized. METHODS: Sixteen patients who had a predicted mortality risk of above 50% within the first 24 h of admission to the intensive care unit and had been discharged to the ward were purposively selected...
January 30, 2019: Nursing in Critical Care
James C Borders, Daniel Fink, Joseph E Levitt, Jeffrey McKeehan, Edel McNally, Alix Rubio, Rebecca Scheel, Jonathan M Siner, Stephanie Gomez Taborda, Rosemary Vojnik, Heather Warner, S David White, Susan E Langmore, Marc Moss, Gintas P Krisciunas
Dysphagia is common in hospitalized patients post-extubation and associated with poor outcomes. Laryngeal sensation is critical for airway protection and safe swallowing. However, current understanding of the relationship between laryngeal sensation and aspiration in post-extubation populations is limited. Acute respiratory failure patients requiring intensive care unit admission and mechanical ventilation received a Flexible Endoscopic Evaluation of Swallowing (FEES) within 72 h of extubation. Univariate and multivariable analyses were performed to examine the relationship between laryngeal sensation, length of intubation, and aspiration...
January 29, 2019: Dysphagia
Patcharaporn Siricharoenthai, Vorapong Phupong
OBJECTIVE: To investigate the diagnostic value of glycated hemoglobin A1c (HbA1c) in detecting gestational diabetes mellitus (GDM). METHODS: Pregnant women at gestational age 24 weeks or more, who had abnormal GDM screening test, were enrolled in this prospective study. A HbA1c assessment was performed at the same time of 3-hour 100 g oral glucose tolerance test (OGTT). GDM was diagnosed according to the National Diabetes Data Group for a 3-hour 100 g OGTT. Sensitivity and specificity of HbA1c were evaluated and pregnancy outcome were recorded in aspects of gestational age at delivery, preeclampsia, Primary Cesarean Section rate, birth weight, fetal macrosomia, and neonatal intensive care unit admission...
January 28, 2019: Journal of Maternal-fetal & Neonatal Medicine
Tim Rahmel, Katharina Rump, Jürgen Peters, Michael Adamzik
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: Acute respiratory distress syndrome is defined according to clinical criteria, but lack of precise characterization may contribute to negative trials and impede personalized care. Polymorphisms of aquaporin-5, a key mediator of inflammation, may impact outcome. WHAT THIS ARTICLE TELLS US THAT IS NEW: In acute respiratory distress syndrome attributable to bacterial pneumonia, the C-allele of the aquaporin-5 -1364A/C promoter polymorphism is associated with less pulmonary inflammation and greater survival...
January 3, 2019: Anesthesiology
Jennifer L Barkin, Julie M Stausmire, Minda N Te, Alicia Pazik-Huckaby, Marta Serati, Massimiliano Buoli, Roberta S Harding, Cynthia A Bruss, Kari L Stausmire
OBJECTIVE: Factors associated with maternal functioning in biological mothers whose infants were admitted to a Neonatal Intensive Care Unit (NICU) were identified as measured by a modified version of the Barkin Index of Maternal Functioning. MATERIALS AND METHODS: This multivariable regression analysis explored sociodemographic and clinical data from 146 mother-infant dyads admitted to a Level III NICU between February 2015 and May 2016. Eligible dyads included: (1) adult biological mothers with singleton infants discharged home alive after NICU admission meeting criteria and (2) infants discharged home alive from the NICU with adult, biological mothers after a minimum 6-day admission...
January 25, 2019: Journal of Women's Health
Alejandro Pita, Brian Nguyen, Daisy Rios, Nicolas Maalouf, Mary Lo, Yuri Genyk, Linda Sher, J Perren Cobb
PURPOSE: Recovery after liver transplant (LT) requires extensive resources, including prolonged intensive care unit stays. The objective of this study was to use an assessment tool to determine if LT recipients remain in ICU beyond designated indications. METHODS: Records from 100 consecutive LTs performed in a single institution were retrospectively reviewed. An admission, discharge, and triage screening (ADT) tool was utilized to assess the indications for each ICU day...
January 9, 2019: Journal of Critical Care
Ronan McKenna, Lindsay Joseph, Philip Sargent, Meryta May, Sarah Tozer, Seweryn Bialasiewicz, Claire Heney, Luregn J Schlapbach, Julia E Clark
AIM: The human parechovirus (HPeV) has emerged as a pathogen causing sepsis-like presentations in young infants, but there is a lack of data on HPeV presentations requiring intensive care support. We aimed to characterise the clinical presentation, disease severity, management and outcome of a population-based cohort of children with microbiologically confirmed HPeV infection requiring admission to paediatric intensive care units (PICUs) in Queensland, Australia during a recent outbreak...
January 24, 2019: Journal of Paediatrics and Child Health
Carolina Simões, Sara Santos, Madalena Vicente, Filipe Sousa Cardoso
Background and Aims: Acute liver failure (ALF) is a rare disease with potentially high mortality rates. We aimed to study the recent epidemiology of ALF in one of the Portuguese liver transplant (LT) regions. Methods: We assessed a retrospective cohort including 34 consecutive patients with ALF admitted to the intensive care unit (ICU) of Curry Cabral Hospital (Lisbon, Portugal) between October 2013 and December 2016. Results: The median age (IQR) was 49 (31-67) years, and 21 (62%) of the cohort were female...
December 2018: GE Portuguese Journal of Gastroenterology
Jesse Cohen, Javier Sotoca, Shikha Gandhi, Anusha K Yeshokumar, Eliza Gordon-Lipkin, Romergyko G Geocadin, Kevin D Frick, John C Probasco, Arun Venkatesan
OBJECTIVE: To assess the inpatient hospitalization burden and costs of patients with autoimmune encephalitis (AE) at a tertiary care institution. METHODS: Adult inpatients with AE were identified retrospectively from July 1, 2005, to June 30, 2015. Demographic and clinical data were collected and analyzed. Billing data were compared to those of patients with herpes simplex encephalitis (HSE). Charges were adjusted for inflation. RESULTS: Of 244 admissions for encephalitis reviewed, 63 patients met criteria for probable or definite AE...
January 23, 2019: Neurology
H Thabrew, A Nagahawatte, G B Wijayaratne
Introduction: The ability to predict candidaemia gives a significant advantage to the clinician by enabling pre-emptive treatment to reduce mortality. Objectives: To identify the prevalence, risk factors, and to validate candida colonization index (CI), candida score (CS) to reliably predict the development of candidaemia in the identified study sample. Methods: Cross sectional analytical study of consecutive admissions fulfilling inclusion criteria to intensive care units (ICUs) of Teaching Hospital Karapitiya from 1st December 2015 to 30th March 2016...
December 31, 2018: Ceylon Medical Journal
Zachary I Willis, Maribeth R Nicholson, Adam J Esbenshade, Meng Xu, James C Slaughter, Debra L Friedman, Kathryn M Edwards, Maria C Di Pentima
Clostridium difficile infection (CDI) is common in pediatric oncology patients and is often associated with recurrences and complications. We hypothesized that higher intensity of chemotherapy would be associated with these outcomes. We conducted a retrospective cohort study including all cases of primary CDI in children with malignancy in our institution for over 7 years. Intensity of chemotherapy was measured by the Intensity of Treatment Rating Scale, third edition, ranging from level 1 (minimal) to 4 (highest)...
January 16, 2019: Journal of Pediatric Hematology/oncology
Ashley N Battarbee, Lynn M Yee
OBJECTIVE:  To measure the association of fast food density (FFD) and supermarket density (SD) with adverse neonatal outcomes in pregnancies with gestational diabetes mellitus (GDM). STUDY DESIGN:  This was a retrospective cohort study of women with GDM who delivered at a tertiary care center in a large metropolitan area (1/2010-2/2016). ZIP codes were used to link women with surrounding food environment. FFD and SD were calculated as the number of establishments per 100,000 residents for each ZIP code and classified into quartiles...
January 15, 2019: American Journal of Perinatology
P Rostin, B J Teja, S Friedrich, S Shaefi, K R Murugappan, S K Ramachandran, T T Houle, M Eikermann
It is unclear which criteria should be used to define readiness for tracheal extubation in the operating theatre. We studied the effects of desaturation in the operating theatre immediately after tracheal extubation on long-term outcomes. Performing a pre-specified, retrospective analysis of 71,025 cases involving previously independent adults undergoing non-cardiac surgery, we evaluated the association between desaturation events (oxygen saturation < 90%) within 10 min of tracheal extubation and adverse discharge (to a skilled nursing facility or long-term care facility)...
January 10, 2019: Anaesthesia
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