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Journal articles on the topic 'Acute intensive care unit'

Author: Grafiati

Published: 4 June 2021

Last updated: 4 February 2022

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1

Mumtaz, Hassan. "Etiology of acute kidney injury in intensive care unit settings." Endocrinology and Disorders 4, no. 2 (December 24, 2020): 01–06. http://dx.doi.org/10.31579/2640-1045/059.

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Introduction: Acute kidney injury (AKI) is defined as a rapid loss of kidney function occurring over few hours or days. In intensive care unit settings, acute kidney injury (AKI) is a very prevalent condition as most of the patients who are admitted in intensive care units are critically ill. The incidence of acute kidney injury is increasing throughout the world mainly because of aging population and comorbidities which are associated with aging. In intensive care unit settings, the incidence of AKI may reach up to 67%. Though AKI effects depend on clinical situation yet associated with high morbidity and mortality. Objective: To determine the frequency of etiology of acute kidney injury in medical intensive care unit of KRL Hospital. Setting: Medical ICU, KRL Hospital, Islamabad. Duration: six months from 17th May 2017 to 17th November 2017. Study design: Descriptive case series. Material and method: In this study 118 patients were observed. After screening and application of exclusion criteria, a total of 118 patients who were fulfilling the inclusion criteria were selected as the study sample and were included in the final analysis regarding prevalence of risk factors associated with AKI. AKI was further classified using acute kidney injury network (AKIN) classification system. Patient age, gender, serum creatinine, etiology and outcome in form of recovery or mortality was recorded on specific proforma. Results: Overall incidence of AKI in ICU settings in this study was 37.8%(n=118) .Out of 118 patients who had AKI, 59.3%(n=70) were male , whereas 40.7% (n=48) were females. Most common risk factor associated with development of AKI was sepsis secondary to infectious illnesses and 39% (n=46) of the patients who developed AKI were suffering from infectious illnesses. Gastrointestinal, drugs and cardiac causes constitutes the 32.2% (n=38), 18.6% (n=22) and 10.2% (n=12) respectively of the AKI in ICU settings. Conclusion: Our study concludes that the frequency of etiology including infectious causes was 39%, cardiac pathology 10%, GI causes 32%, drugs was 19%.

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KHAN, HUMAYUN IQBAL, NAILA KHALIQ, and MUHAMMAD FAHEEM AFZAL. "PEDIATRIC INTENSIVE CARE UNIT." Professional Medical Journal 13, no. 03 (June 25, 2006): 358–61. http://dx.doi.org/10.29309/tpmj/2006.13.03.4982.

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Intensive care is predominantly concerned with the managementof patients with acute life threatening conditions in a specialized unit. Children having acute neurological deterioration,respiratory distress, cardiovascular compromise, severe infections and accidental poisonings constitute the majoradmission to a pediatric intensive care unit. Objective: To document the number, disease pattern and outcome ofpatients admitted to Pediatric intensive care unit. Design: Descriptive study. Place and Duration: The study wasconducted in the intensive care unit of department of Pediatrics, King Edward Medical University/Mayo hospital, Lahorefrom July 01, 2004 to June 30, 2005. Patients and Methods: The data of all the admitted patients was analyzed forage, sex, cause of admission and outcome. Results: A total of 1012 children were admitted during the study period.Among them 59.68% were male and 40.32% were female. Bronchopneumonia was the major cause of admission(29.05%) followed by septicemia (14.43%), acute bacterial meningitis (8.1%), acute watery diarrhea (6.92%), congenitalheart diseases (5.14%), tetanus (3.75%) ,acute myocarditis (2.67%) and others (29.94%) including acute bronchialasthma, hepatic encephalopathy, diabetic ketoacidosis, encephalitis, tuberculous meningitis, accidental poisoning andGuillain-Barre syndrome. Out of total admissions, 64.43% were shifted to different units of the department, 4.05%discharged in satisfactory condition, 9.49% left against medical advice (LAMA) and 22.03% died. The case fatality ofsepticemia (65.07%) was highest. Conclusion: Bronchopneumonia and septicemia were the major causes ofadmission while case fatality was highest for septicemia in intensive care unit.

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Pachucki, Marcin A., Erina Ghosh, Larry Eshelman, Krishnamoorthy Palanisamy, Timothy Gould, Matthew Thomas, and Chris P. Bourdeaux. "Descriptive study of differences in acute kidney injury progression patterns in General and Cardiac Intensive Care Units." Journal of the Intensive Care Society 20, no. 3 (April 30, 2018): 216–22. http://dx.doi.org/10.1177/1751143718771261.

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Background Acute kidney injury is common in critically ill patients with detrimental effects on mortality, length of stay and post-discharge outcomes. The Acute Kidney Injury Network developed guidelines based on urine output and serum creatinine to classify patients into stages of acute kidney injury. Methods In this analysis we utilize the Acute Kidney Injury Network guidelines to evaluate the acute kidney injury stage in patients admitted to general and cardiac intensive care units over a period of 18 months. Acute kidney injury stage was calculated in real time hourly based on the guidelines and using these temporal stage scores calculated for the population; the prevalence and progression of acute kidney injury stage was compared between the two units. We hypothesized that the prevalence and progression of acute kidney injury stage between the two units may be different. Results More cardiac intensive care unit patients had no acute kidney injury (stage <1) during their intensive care unit stay but more cardiac intensive care unit patients developed acute kidney injury (stage >1), compared to the General Intensive Care Unit. Both at intensive care unit admission and discharge, more General Intensive Care Unit patients had acute kidney injury; however, the number of cardiac intensive care unit patients with acute kidney injury was three times higher at discharge than admission. Acute kidney injury developed in a different pattern in the two intensive care units over five days of intensive care unit stay. In the General Intensive Care Unit, acute kidney injury was most prevalent on second day of intensive care unit stay and in cardiac intensive care unit acute kidney injury was most prevalent on the third day of intensive care unit stay. We observed the biggest increase in new acute kidney injury in the first day of General Intensive Care Unit and second day of the cardiac intensive care unit stay. Conclusions The study demonstrates the different trends of acute kidney injury pattern in general and cardiac intensive care unit patient populations highlighting the earlier development of acute kidney injury on General Intensive Care Unit and more prevalence of acute kidney injury on discharge from cardiac intensive care unit.

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Zochodne, Douglas. "Myopathies in the Intensive Care Unit." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 25, S1 (February 1998): S40—S42. http://dx.doi.org/10.1017/s0317167100034727.

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AbstractMyopathies that occur in the intensive care unit can be divided into preexisting myopathies or newly acquired myopathies that develop in the intensive care unit. Myotonic dystrophy is an example of a preexisting myopathy that may render patients susceptible to acute respiratory failure following surgical procedures and anaesthesia. A group of myopathies that develop within the intensive care unit have been labelled acute necrotizing myopathy of intensive care, thick filament myopathy and acute steroid myopathy. Corticosteroids and nondepolarizing muscle blocking agents may play a role in their development.

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5

ROLLAS, Kazım, Atila KARA, Nazmiye Ebru ORTAÇ ERSOY, Kezban ÖZMEN SÜNER, Mehmet Nezir GÜLLÜ, Serpil ÖCAL, and Arzu TOPELİ. "Acute tuberculosis in the intensive care unit." TURKISH JOURNAL OF MEDICAL SCIENCES 45 (2015): 882–87. http://dx.doi.org/10.3906/sag-1408-118.

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6

Kalabalik, Julie, Luigi Brunetti, and Radwa El-Srougy. "Intensive Care Unit Delirium." Journal of Pharmacy Practice 27, no. 2 (December 10, 2013): 195–207. http://dx.doi.org/10.1177/0897190013513804.

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Purpose: The recent literature regarding intensive care unit (ICU) delirium and updated clinical practice guidelines are reviewed. Summary: Recent studies show that ICU delirium in critically ill patients is an independent predictor of higher mortality, longer ICU and hospital stay, and is associated with multiple clinical complications. Delirium has been reported to occur in greater than 80% of hospitalized critically ill patients, yet it remains an underdiagnosed condition. Several subtypes of delirium have been identified including hypoactive, hyperactive, and mixed presentation. Although the exact mechanism is unknown, several factors are thought to interact to cause delirium. Multiple risk factors related to medications, acute illness, the environment, and patient characteristics may contribute to the development of delirium. Practical bedside screening tools have been validated and are recommended to identify ICU patients with delirium. Nonpharmacologic interventions such as early mobilization have resulted in better functional outcomes, decreased incidence and duration of delirium, and more ventilator-free days. Data supporting pharmacologic treatments are limited. Conclusion: Clinicians should become familiar with tools to identify delirium in order to initiate treatment and remove mitigating factors early in hospitalization to prevent delirium. Pharmacists are in a unique position to reduce delirium through minimization of medication-related risk factors and development of protocols.

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7

Pellathy, Tiffany Purcell, Michael R. Pinsky, and Marilyn Hravnak. "Intensive Care Unit Scoring Systems." Critical Care Nurse 41, no. 4 (August 1, 2021): 54–64. http://dx.doi.org/10.4037/ccn2021613.

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Background Illness severity scoring systems are commonly used in critical care. When applied to the populations for whom they were developed and validated, these tools can facilitate mortality prediction and risk stratification, optimize resource use, and improve patient outcomes. Objective To describe the characteristics and applications of the scoring systems most frequently applied to critically ill patients. Methods A literature search was performed using MEDLINE to identify original articles on intensive care unit scoring systems published in the English language from 1980 to 2020. Search terms associated with critical care scoring systems were used alone or in combination to find relevant publications. Results Two types of scoring systems are most frequently applied to critically ill patients: those that predict risk of in-hospital mortality at the time of intensive care unit admission (Acute Physiology and Chronic Health Evaluation, Simplified Acute Physiology Score, and Mortality Probability Models) and those that assess and characterize current degree of organ dysfunction (Multiple Organ Dysfunction Score, Sequential Organ Failure Assessment, and Logistic Organ Dysfunction System). This article details these systems’ differing features and timing of use, score calculation, patient populations, and comparative performance data. Conclusion Critical care nurses must be aware of the strengths, limitations, and specific characteristics of severity scoring systems commonly used in intensive care unit patients to effectively employ these tools in clinical practice and critically appraise research findings based on their use.

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8

Mumtaz, Hassan. "Etiology & Outcome of Acute kidney Injury in Intensive Care Unit Settings of a Tertiary Care Hospital." Endocrinology and Disorders 4, no. 2 (December 24, 2020): 01–05. http://dx.doi.org/10.31579/2640-1045/058.

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Introduction: Acute kidney injury (AKI) is defined as a rapid loss of kidney function occurring over few hours or days. In intensive care unit settings, acute kidney injury (AKI) is a very prevalent condition as most of the patients who are admitted in intensive care units are critically ill. The incidence of acute kidney injury is increasing throughout the world mainly because of aging population and co morbidities which are associated with aging. In intensive care unit settings, the incidence of AKI may reach up to 67%. Though AKI effects depend on clinical situation yet associated with high morbidity and mortality. The rationale of this study is that, as acute kidney is one of major factors contributing in mortality and morbidity of ICU patients, this study will be helpful in identifying important risk factor for development of acute kidney injury in ICU settings, leading to its early detection and thus decreasing associated morbidity and mortality. Objective: To determine the frequency of etiology and outcome of acute kidney injury in medical intensive care unit of KRL Hospital. Setting: Medical ICU, KRL Hospital, Islamabad. Duration: six months from 17th May 2017 to 17th November 2017. Study design: Descriptive case series. Material and method: In this study 118 patients were observed. After screening and application of exclusion criteria, a total of 118 patients who were fulfilling the inclusion criteria were selected as the study sample and were included in the final analysis regarding prevalence of risk factors associated with AKI and the outcome associated with AKI. AKI was further classified using acute kidney injury network (AKIN) classification system. Patient age, gender, serum creatinine, etiology and outcome in form of recovery or mortality was recorded. Results: Overall incidence of AKI in ICU settings in this study was 37.8% (n=118). Out of 118 patients who had AKI, 59.3% (n=70) were male, whereas 40.7% (n=48) were females. Most common risk factor associated with development of AKI was sepsis secondary to infectious illnesses and 39% (n=46) of the patients who developed AKI were suffering from infectious illnesses. Gastrointestinal, drugs and cardiac causes constitutes the 32.2 % (n=38), 18.6% (n=22) and 10.2% (n=12) respectively of the AKI in ICU settings. In terms of outcome, mortality rate in patients with AKI was significantly higher as compared to patients without AKI(P =<0.001) and 56.8%(n=67) of the patients who had AKI died during their ICU stay as compared to 30.4%(n=59) in patients without AKI. Conclusion: Our study concludes that the frequency of etiology including infectious causes was 39%, cardiac pathology 10%, GI causes 32%, drugs was 19% and mortality was 56.8% in patients with acute kidney injury.

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Holyoak, A. L., M. J. Trout, R. P. White, S. Prematuranga, and S. Senthuran. "Toxic Leukoencephalopathy in the Intensive Care Unit." Anaesthesia and Intensive Care 42, no. 6 (November 2014): 782–88. http://dx.doi.org/10.1177/0310057x1404200615.

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In this article, we report two cases of acute toxic leukoencephalopathy to highlight this acute clinicoradiological syndrome as an important, although uncommon, consideration in the undifferentiated comatose patient who fails to wake following drug overdose or has unexplained neurology with a history of drug exposure. We then review the current literature and discuss potential differential diagnoses in this setting, along with proposed treatments for this condition. The cases presented demonstrate a more fulminant onset than previously well-defined acute toxic leukoencephalopathy subtypes and highlight the prognostic importance of magnetic resonance imaging in diagnosing a condition from which significant functional recovery seems possible.

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Grignola, Juan C., and Enric Domingo. "Acute Right Ventricular Dysfunction in Intensive Care Unit." BioMed Research International 2017 (2017): 1–15. http://dx.doi.org/10.1155/2017/8217105.

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The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients. Our aim is to clarify the complex effects of mechanical ventilation, fluid therapy, vasoactive drug infusions, and other therapies to resuscitate the critical patient optimally.

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Kanagasundaram, Nigel Suren, and Emil Presley Paganini. "Acute renal failure on the intensive care unit." Clinical Medicine 5, no. 5 (September 1, 2005): 435–40. http://dx.doi.org/10.7861/clinmedicine.5-5-435.

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Kes, Petar, and Nikolina Bašić Jukić. "Acute Kidney Injury in the Intensive Care Unit." Bosnian Journal of Basic Medical Sciences 10, no. 1 (April 20, 2010): 8. http://dx.doi.org/10.17305/bjbms.2010.2639.

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13

Pidhirny, Ya, O. Rusyn, and I. Yakovlev. "Acute kidney injury in the intensive care unit." EMERGENCY MEDICINE, no. 4.99 (February 1, 2019): 61–66. http://dx.doi.org/10.22141/2224-0586.4.99.2019.173934.

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14

Doi, Kent, Naoki Yahagi, Masaomi Nangaku, and Eisei Noiri. "2. Acute Kidney Injury in Intensive Care Unit." Nihon Naika Gakkai Zasshi 103, no. 5 (2014): 1081–87. http://dx.doi.org/10.2169/naika.103.1081.

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15

Briglia, Andrew, and Emil P. Paganini. "ACUTE RENAL FAILURE IN THE INTENSIVE CARE UNIT." Clinics in Chest Medicine 20, no. 2 (June 1999): 347–66. http://dx.doi.org/10.1016/s0272-5231(05)70146-5.

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16

Kupfer, Yizhak, Mitchell S. Cappell, and Sidney Tessler. "ACUTE GASTROINTESTINAL BLEEDING IN THE INTENSIVE CARE UNIT." Gastroenterology Clinics of North America 29, no. 2 (June 2000): 275–307. http://dx.doi.org/10.1016/s0889-8553(05)70117-5.

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Beejay, Umar, and M. Michael Wolfe. "ACUTE GASTROINTESTINAL BLEEDING IN THE INTENSIVE CARE UNIT." Gastroenterology Clinics of North America 29, no. 2 (June 2000): 309–36. http://dx.doi.org/10.1016/s0889-8553(05)70118-7.

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18

Gajic, Ognjen, Luis E. Urrutia, Hassanali Sewani, Darrell R. Schroeder, Daniel C. Cullinane, and Steve G. Peters. "Acute abdomen in the medical intensive care unit." Critical Care Medicine 30, no. 6 (June 2002): 1187–90. http://dx.doi.org/10.1097/00003246-200206000-00001.

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19

Maramattom, Bobby Varkey, and Eelco F. M. Wijdicks. "Acute neuromuscular weakness in the intensive care unit." Critical Care Medicine 34, no. 11 (November 2006): 2835–41. http://dx.doi.org/10.1097/01.ccm.0000239436.63452.81.

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20

Dial, Sandra, and Jennifer Payne. "Managing Acute Delirium in the Intensive Care Unit." Clinical Pulmonary Medicine 9, no. 5 (September 2002): 260–66. http://dx.doi.org/10.1097/00045413-200209000-00003.

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Weisbord, Steven, and Paul Palevsky. "Acute Renal Failure in the Intensive Care Unit." Seminars in Respiratory and Critical Care Medicine 27, no. 3 (June 2006): 262–73. http://dx.doi.org/10.1055/s-2006-945527.

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Vijaykumar, E., S. Raziuddin, and E. N. Wardle. "Acute Renal Failure in the Intensive Care Unit." Nephron 62, no. 4 (1992): 473. http://dx.doi.org/10.1159/000187105.

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Crowley, Susan T., and Aldo J. Peixoto. "Acute Kidney Injury in the Intensive Care Unit." Clinics in Chest Medicine 30, no. 1 (March 2009): 29–43. http://dx.doi.org/10.1016/j.ccm.2008.09.002.

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Leone, Marc, Jean-Yves Lefrant, Claude Martin, and Jean-Michel Constantin. "Acute mesenteric ischemia, procalcitonin, and intensive care unit." Intensive Care Medicine 41, no. 7 (June 3, 2015): 1378. http://dx.doi.org/10.1007/s00134-015-3867-1.

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Bonnefoy-Cudraz, Eric, Hector Bueno, Gianni Casella, Elia De Maria, Donna Fitzsimons, Sigrun Halvorsen, Christian Hassager, et al. "Editor’s Choice - Acute Cardiovascular Care Association Position Paper on Intensive Cardiovascular Care Units: An update on their definition, structure, organisation and function." European Heart Journal: Acute Cardiovascular Care 7, no. 1 (August 17, 2017): 80–95. http://dx.doi.org/10.1177/2048872617724269.

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Acute cardiovascular care has progressed considerably since the last position paper was published 10 years ago. It is now a well-defined, complex field with demanding multidisciplinary teamworking. The Acute Cardiovascular Care Association has provided this update of the 2005 position paper on acute cardiovascular care organisation, using a multinational working group. The patient population has changed, and intensive cardiovascular care units now manage a large range of conditions from those simply requiring specialised monitoring, to critical cardiovascular diseases with associated multi-organ failure. To describe better intensive cardiovascular care units case mix, acuity of care has been divided into three levels, and then defining intensive cardiovascular care unit functional organisation. For each level of intensive cardiovascular care unit, this document presents the aims of the units, the recommended management structure, the optimal number of staff, the need for specially trained cardiologists and cardiovascular nurses, the desired equipment and architecture, and the interaction with other departments in the hospital and other intensive cardiovascular care units in the region/area. This update emphasises cardiologist training, referring to the recently updated Acute Cardiovascular Care Association core curriculum on acute cardiovascular care. The training of nurses in acute cardiovascular care is additionally addressed. Intensive cardiovascular care unit expertise is not limited to within the unit’s geographical boundaries, extending to different specialties and subspecialties of cardiology and other specialties in order to optimally manage the wide scope of acute cardiovascular conditions in frequently highly complex patients. This position paper therefore addresses the need for the inclusion of acute cardiac care and intensive cardiovascular care units within a hospital network, linking university medical centres, large community hospitals, and smaller hospitals with more limited capabilities.

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Malleshappa, Pavan, Anup Chaudhari, and hemant Mehta. "Spectrum of Acute Kidney Injury and its Outcome in Intensive Care Unit in Tertiary Care Center in India." Turkish Nephrology Dialysis Transplantation 24, no. 01 (January 26, 2015): 74–81. http://dx.doi.org/10.5262/tndt.2015.1001.10.

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Harrar, Dana B., Basil T. Darras, and Partha S. Ghosh. "Acute Neuromuscular Disorders in the Pediatric Intensive Care Unit." Journal of Child Neurology 35, no. 1 (September 10, 2019): 17–24. http://dx.doi.org/10.1177/0883073819871437.

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Background: The neuromuscular disorders encountered in the pediatric intensive care unit (PICU) encompass a broad spectrum of pathologies. These include acute disorders (eg, Guillain-Barre syndrome), acute-on-chronic disorders (eg, myasthenia gravis), progressive disorders (eg, muscular dystrophy), and disorders that develop in the PICU (eg, critical illness myopathy/polyneuropathy). Familiarity with the presenting features of these disorders is of paramount importance in facilitating timely diagnosis. Methods: We conducted a retrospective review of the medical records of patients admitted to the PICU or Intermediate Care Program (ICP) at a single tertiary children’s hospital from 2006 to 2017 with an acute or acute-on-chronic neuromuscular disorder. We did not include patients with a known progressive neuromuscular disorder or critical illness myopathy/polyneuropathy. Results: Twenty-four patients were admitted to the PICU/ICP with acute or acute-on-chronic neuromuscular disorders. Diagnosis and indication for ICU/ICP admission were Guillain-Barre syndrome (n = 6; respiratory failure: 3, respiratory monitoring: 2, autonomic instability: 1), myasthenia gravis (n = 5; airway clearance: 3, respiratory failure: 2), acute flaccid myelitis (n = 3; respiratory failure: 2, respiratory monitoring: 1), periodic paralysis (n = 3; intravenous potassium replacement), rhabdomyolysis (n = 3; monitoring for electrolyte derangements), infant botulism (n = 2; respiratory failure), chronic demyelinating polyneuropathy (n = 1; respiratory failure), and congenital myasthenic syndrome (n = 1; apnea). No patients were admitted to the PICU/ICP with a diagnosis of tick paralysis, acute intermittent porphyria, or inflammatory myopathy. Conclusions: Although acute and acute-on-chronic neuromuscular disorders are encountered relatively rarely in the PICU, familiarity with the presenting features of these disorders is important in facilitating timely diagnosis. This, in turn, enables the institution of effective management strategies, thereby avoiding complications associated with diagnostic delays.

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Martin, Claude. "Acute Renal Failure in the Intensive Therapy Unit." Critical Care Medicine 19, no. 8 (August 1991): 1095. http://dx.doi.org/10.1097/00003246-199108000-00033.

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Humphreys, Stacey, and Balagangadhar R. Totapally. "Rapid Response Team Calls and Unplanned Transfers to the Pediatric Intensive Care Unit in a Pediatric Hospital." American Journal of Critical Care 25, no. 1 (January 1, 2016): e9-e13. http://dx.doi.org/10.4037/ajcc2016329.

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Background Variability in disposition of children according to the time of rapid response calls is unknown. Objective To evaluate times and disposition of rapid response alerts and outcomes for children transferred from acute care to intensive care. Methods Deidentified data on demographics, time and disposition of the child after activation of a rapid response, time of transfer to intensive care, and patient outcomes were reviewed retrospectively. Data for rapid-response patients on time of activation of the response and unplanned transfers to the intensive care unit were compared with data on other patients admitted to the unit. Results Of 542 rapid responses activated, 321 (59.2%) were called during the daytime. Out of all rapid response activations, 323 children (59.6%) were transferred to intensive care, 164 (30.3%) remained on the general unit, and 19 (3.5%) required resuscitation. More children were transferred to intensive care after rapid response alerts (P = .048) during the daytime (66%) than at night (59%). During the same period, 1313 patients were transferred to intensive care from acute care units. Age, sex, risk of mortality, length of stay, and mortality rate did not differ according to the time of transfer. Mortality among unplanned transfers (3.8%) was significantly higher (P < .001) than among other intensive care patients (1.4%). Conclusion Only 25% of transfers from acute care units to the intensive care unit occurred after activation of a rapid response team. Most rapid responses were called during daytime hours. Mortality was significantly higher among unplanned transfers from acute care than among other intensive care admissions.

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Hart, Stephen A., Ronn E. Tanel, Alaina K. Kipps, Amanda K. Hoerst, Margaret A. Graupe, Steven C. Cassidy, Anthony M. Hlavacek, et al. "Intensive Care Unit and Acute Care Unit Length of Stay After Congenital Heart Surgery." Annals of Thoracic Surgery 110, no. 4 (October 2020): 1396–403. http://dx.doi.org/10.1016/j.athoracsur.2020.01.033.

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Kim, Eileen, Charles Kast, Anika Afroz-Hossain, Michael Qiu, Karalyn Pappas, and Liron Sinvani. "Bridging the Gap Between the Intensive Care Unit and the Acute Medical Care Unit." American Journal of Critical Care 30, no. 3 (May 1, 2021): 193–200. http://dx.doi.org/10.4037/ajcc2021591.

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Background Despite a growing cohort of intensive care unit (ICU) survivors, little is known about the early ICU aftercare period. Objective To identify gaps in early ICU aftercare and factors associated with poor hospital outcomes. Methods A multisite, retrospective study (January 1 to December 31, 2017) was conducted among randomly selected patients admitted to the medical ICU and subsequently transferred to acute medical care units. Records were reviewed for patient characteristics, ICU course, and early ICU aftercare practices and syndromes. Associations between practices and hospital outcomes were calculated with χ2 and Wilcoxon rank sum tests, followed by logistic regression. Results One hundred fifty-one patients met inclusion criteria (mean [SD] age, 64.2 [19.1] years; 51.7% male; 44.4% White). The most frequent diagnoses were sepsis (35.8%) and respiratory failure (33.8%). During early ICU aftercare, 46.4% had dietary restrictions, 25.8% had bed rest orders, 25.0% had a bladder catheter, 26.5% had advance directive documentation, 33.8% had dysphagia, 34.3% had functional decline, and 23.2% had delirium. Higher Charlson Comorbidity Index (odds ratio, 1.6) and midodrine use on medical units (odds ratio, 7.5) were associated with in-hospital mortality; mechanical ventilation in the ICU was associated with rapid response on medical unit (odds ratio, 12.9); and bladder catheters were associated with ICU readmission (odds ratio, 5.2). Conclusions Delirium, debility, and dysphagia are frequently encountered in early ICU aftercare, yet bed rest, dietary restriction, and lack of advance directive documentation are common. Future studies are urgently needed to characterize and address early ICU aftercare.

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Deimantavičienė, Živilė, Nerijus Klimas, Aurimas Pečkauskas, Giedrė Bakšytė, Andrius Macas, Linas Pieteris, and Aurelija Repšienė. "Complications of thrombolysis in an intensive care unit." Acta medica Lituanica 19, no. 3 (October 1, 2012): 251–54. http://dx.doi.org/10.6001/actamedica.v19i3.2460.

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Background. Thrombolysis is often the only way in treating people with life-threatening conditions, like acute myocardial infarction (AMI), pulmonary embolism (PE) and acute ischemic stroke (AIS). Complications of thrombolytic therapy are not rare and have clear influence in the quality of life, hospital stay, outcomes and mortality. Most common complications are intracranial hemorrhage, severe injection site, nose, vaginal bleeding and peripheral hematomas. Methods and materials. A retrospective study took place in the Department of Intensive Care, Hospital of Lithuanian University of Health Sciences Kaunas Clinics. Medical data of 83 patients, who underwent treatment with thrombolytic drugs in the period of 2007–2011, were analyzed. All patients were treated with intravenous infusion of Alteplase. Inclusion criteria were as follows: • AMI, AIS or PE treatable with thrombolytic therapy. Results. 72.3% (n = 60) of patients experienced massive PE, 13.3% (n = 11) AMI and 14.4% (n = 12) AIS. There were 8.43% (n = 7) of patients who had bleeding complications – 2.4% (n = 2) experienced nose bleed during or shortly after thrombolytic therapy, 3.6% (n = 3) had injection site bleeding and 1.2% (n = 1) experienced multiple skin hemorrhages. 11.7% (n = 7) of patients in the group of massive PE were thrombolised during CPR and only one of them experienced bleeding to the pleural cavity. There were no internal or external bleeding observed neither in AMI nor in AIS groups. In-hospital mortality after thrombolytic therapy was 20.5% (n = 17). Conclusions. Thrombolytic therapy very often is the only way in treating acute, life-threatening diseases, like acute myocardial infarction, pulmonary embolism or acute ischemic stroke. Intracranial hemorrhage, injection site, nose, vaginal bleeding and peripheral hematomas are the most common complications of thrombolysis. Risk factors should be evaluated before starting the thrombolytic therapy. Data of our hospital experience do not dramatically differ from worldwide data.

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33

Beltrami, Flávia Gabe, Xuân-Lan Nguyen, Claire Pichereau, Eric Maury, Bernard Fleury, and Simone Fagondes. "Sleep in the intensive care unit." Jornal Brasileiro de Pneumologia 41, no. 6 (December 2015): 539–46. http://dx.doi.org/10.1590/s1806-37562015000000056.

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ABSTRACT Poor sleep quality is a consistently reported by patients in the ICU. In such a potentially hostile environment, sleep is extremely fragmented and sleep architecture is unconventional, with a predominance of superficial sleep stages and a limited amount of time spent in the restorative stages. Among the causes of sleep disruption in the ICU are factors intrinsic to the patients and the acute nature of their condition, as well as factors related to the ICU environment and the treatments administered, such as mechanical ventilation and drug therapy. Although the consequences of poor sleep quality for the recovery of ICU patients remain unknown, it seems to influence the immune, metabolic, cardiovascular, respiratory, and neurological systems. There is evidence that multifaceted interventions focused on minimizing nocturnal sleep disruptions improve sleep quality in ICU patients. In this article, we review the literature regarding normal sleep and sleep in the ICU. We also analyze sleep assessment methods; the causes of poor sleep quality and its potential implications for the recovery process of critically ill patients; and strategies for sleep promotion.

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34

Moon, Seung Hyug, Sang Hoon Song, Ho Seuk Jung, Dong Jin Yeun, Su Tack Uh, Yong Hoon Kim, and Choon Sik Park. "Acute Respiratory Distress Syndrome in Respiratory Intensive Care Unit." Tuberculosis and Respiratory Diseases 45, no. 6 (1998): 1252. http://dx.doi.org/10.4046/trd.1998.45.6.1252.

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35

Kaydu, Ayhan, Ferit Akil, Esref Arac, Ozgur Yilmaz, Erhan Gökcek, Yakup Aksoy, and Cem Kıvılcım Kaçar. "Acute Intoxications Admitted to Intensive Care Unit: Retrospective Evaluation." Van Medical Journal 24, no. 4 (2017): 232–37. http://dx.doi.org/10.5505/vtd.2017.44366.

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36

Sheridan, R. L., C. M. Ryan, and R. G. Tompkins. "Acute adrenal insufficiency in the burn intensive care unit." Burns 19, no. 1 (February 1993): 63–66. http://dx.doi.org/10.1016/0305-4179(93)90103-f.

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37

Lunn, A. J. F. "Acute renal insufficiency in the neonatal intensive care unit." Archives of Disease in Childhood - Fetal and Neonatal Edition 91, no. 5 (September 1, 2006): F388. http://dx.doi.org/10.1136/adc.2005.092023.

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38

Dar, Owais, and Martin R. Cowie. "Acute heart failure in the intensive care unit: Epidemiology." Critical Care Medicine 36, Suppl (January 2008): S3—S8. http://dx.doi.org/10.1097/01.ccm.0000296264.41365.80.

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39

Pordeus, Ana Carolina B., Leila Katz, Mariana C. Soares, Sabina B. Maia, and Melania M. R. Amorim. "Acute pulmonary edema in an obstetric intensive care unit." Medicine 97, no. 28 (July 2018): e11508. http://dx.doi.org/10.1097/md.0000000000011508.

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40

van der Kolk, Marion B. M., and Graham Ramsay. "Management of acute pancreatitis in the intensive care unit." Current Opinion in Critical Care 6, no. 4 (August 2000): 271–75. http://dx.doi.org/10.1097/00075198-200008000-00006.

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41

Gauvin, France, Jacques Lacroix, Pierre Robillard, Hélène Lapointe, and Heather Hume. "Acute transfusion reactions in the pediatric intensive care unit." Transfusion 46, no. 11 (November 2006): 1899–908. http://dx.doi.org/10.1111/j.1537-2995.2006.00995.x.

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42

Hojs, Radovan, Robert Ekart, Andreja Sinkovic, and Tanja Hojs-Fabjan. "Rhabdomyolysis and Acute Renal Failure in Intensive Care Unit." Renal Failure 21, no. 6 (January 1999): 675–84. http://dx.doi.org/10.3109/08860229909094161.

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43

Liew, Felicity, and Daniel Martin. "Acute respiratory distress syndrome on the intensive care unit." British Journal of Hospital Medicine 75, no. 12 (December 2, 2014): 672–77. http://dx.doi.org/10.12968/hmed.2014.75.12.672.

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44

Mahmood, Nazneen, Md Fazlur Rahman, Md Mostafizur Rahman, SM Hossain Shahid, and Md Mahmudur Ahman Siddiqui. "Acute Kidney Injury in Patients of Intensive Care Unit." Anwer Khan Modern Medical College Journal 8, no. 1 (February 19, 2017): 38–44. http://dx.doi.org/10.3329/akmmcj.v8i1.31656.

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Background: Acute Kidney Injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU) and numerous causes are responsible for its development. The aim of the present study is to assess the incidence, risk factors, and outcome of patients who develop AKI in our ICU.Methodology: This study was conducted by the Department of Nephrology, Anwer Khan Modern Medical College Hospital (AKMMCH), a tertiary level center of Dhaka, during the period of January 2015 to December 2015. This is a Cross Sectional Descriptive type of Observational study on patients of Acute Kidney Injury (AKI) admitted to Intensive Care Unit (ICU) of AKMMCH.Result: A total number of 271 patients were admitted. Out of 271 patients, 59 (21.77%) patients with AKI who met our study requirements were included in the study and were evaluated. Among 59 patients 32 (54.23%) were males and 27 (45.77%) were females, with a male to female ratio of 1.19:1. The cause of admission were Diabetes mellitus with complication 11 (18.64%), Hepato-renal syndrome 10 (16.94%), Malignancy 7 (11.86%), Septicaemia 6 (10.18% ), Pneumonia 6 (10.18%), Intra-uterine death (IUD) 5 (8.48%) and others (Acute Myocardial Infarction, Non ST segment Elevated MI, Cerebro Vascular Disease, Gullain Burre Syndrome, Laparatomy, Type I and Type II Respiratory failure) 14 (23.72%). According to RIFLE's criteria most of the patients were from Injury group 32 (54.23%). Next to this, was Risk group 17 (28.83%) and in Failure, Loss and ESRD group were 7 (11.86%), 1(1.69%) and 2 (3.39%) accordingly. Regarding biochemical abnormality, mean Serum creatinine was 3.68 ± 2.15 and that of Urine output, HbA1C and HCO3 level ( in ABG ) were 4.57 ± 8.89, 6.91±1.4 and 17.14 ± 3.8 respectively. Out of 59 patients 10 (16.95%) needed Haemodialysis. According to RIFLE's criteria 7 (70%) were from Failure group, 1 patient from Loss group and 2 from ESRD group who received haemodialysis. 72.88% (43) patients improved, out of which 57.62% (34) got discharged from ICU after full recovery. 6.48% (4) patients expired and 3.38% (2) turned into ESRD and advised for regular haemodialysis.Conclusion: The incidence of AKI is high in patients admitted to ICU, and the development of AKI is associated with poor outcome and reduced survival. AKI significantly increases the duration of ICU stay, and this is likely to add to the healthcare burden. Age, gender or the presence of comorbidities do not appear to influence the incidence of AKI in our ICU patients.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 38-44

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Holland, Eric M., and Travis J. Moss. "Acute Noncardiovascular Illness in the Cardiac Intensive Care Unit." Journal of the American College of Cardiology 69, no. 16 (April 2017): 1999–2007. http://dx.doi.org/10.1016/j.jacc.2017.02.033.

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46

Cameron, J. S. "Acute renal failure in the intensive care unit today." Intensive Care Medicine 12, no. 2 (March 1986): 64–70. http://dx.doi.org/10.1007/bf00254514.

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Carrion, Andres F., and Paul Martin. "Non–Intensive Care Unit Management of Acute Liver Failure." Clinics in Liver Disease 22, no. 2 (May 2018): 389–401. http://dx.doi.org/10.1016/j.cld.2018.01.009.

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48

Bourke, Michael E. "Coronary Care Unit to Cardiac Intensive Care Unit: Acute Medical Cardiac Care—Adapting With the Times." Canadian Journal of Cardiology 32, no. 10 (October 2016): 1197–99. http://dx.doi.org/10.1016/j.cjca.2016.02.001.

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49

Davies, Rebecca, Kenneth Murphy, and Faisil Sethi. "Sensory room in a psychiatric intensive care unit." Journal of Psychiatric Intensive Care 16, no. 1 (April 1, 2020): 23–28. http://dx.doi.org/10.20299/jpi.2019.016.

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Background: The use of sensory-based treatment developed in paediatric and neurodevelopment care is a relatively new practice in psychiatric intensive care and acute mental health settings. This report briefly reviews the literature on the use of sensory rooms in psychiatric intensive care units and acute mental health settings, and outlines the development of a sensory room in a female psychiatric intensive care unit.<br/> Method: We provide an account of the process of establishing a sensory room in a psychiatric intensive care unit setting, including considerations, protocol, training and feedback. The literature on sensory room use in psychiatric intensive care and acute mental health settings was reviewed using the PubMed database and Google Scholar for 'grey' literature.<br/> Results: Widespread positive patient and staff perspectives on sensory room use in psychiatric settings were identified in the literature. Some studies have identified links between sensory-based care and reduced rates of restrictive practice. Feedback from patients using the sensory room established in the report revealed themes of patients enjoying and valuing the practice, and highlighted the need for patient-centred choice in its provision.<br/> Conclusions: This report outlines the development of a sensory room in a female psychiatric intensive care unit and briefly reviews the literature on such, considering its efficacy in both patient experience and possible developments in reducing more restrictive practices in care in this clinical setting. It provides a basis for further evaluation and research on sensory room interventions and their effectiveness in improving clinical outcomes.

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50

Parulekar, Prashant, Ed Neil-Gallacher, and Alex Harrison. "Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible." Journal of the Intensive Care Society 19, no. 4 (March 8, 2018): 313–18. http://dx.doi.org/10.1177/1751143718762685.

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Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine. The archived images were reviewed by a Radiologist for adequacy and diagnostic quality. In 28 of 30 patients both kidneys were identified. Adequate archived images of both kidneys each in two planes were possible in 23 of 30 patients. The commonest reason for failure was dressings and drains from abdominal surgery. Only one patient had hydronephrosis. Our results suggest that intensive care unit clinicians can provide focussed renal tract ultrasound. The low incidence of hydronephrosis has implications for delivering the Core Ultrasound in Intensive Care competencies.

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