Search results for "030208 emergency & critical care medicine"

Unmet needs in emergency department patients as an important aspect of the increasing number of hospitalizations

2017

Background. Unmet needs in the medical care of high-need patients may increase costs due to the use of emergency departments (EDs) instead of primary care. Objectives. To establish the possible correlation between the unmet needs of patients and the number of hospitalizations, and the probability of influence of the former aspect on the latter, and to analyze the level of satisfied needs of ED patients in relation to sociodemographic data. Material and methods. An original questionnaire and a modified version of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS) were used to assess the level of satisfaction of the social, medical, psychological and environmental needs of 15…

Ventilator-Associated Pneumonia in Patients with COVID-19: A Systematic Review and Meta-Analysis

2021

The aim of this systematic review and meta-analysis was to estimate the pooled occurrence of ventilator-associated pneumonia (VAP) among patients admitted to an intensive care unit with COVID-19 and mortality of those who developed VAP. We performed a systematic search on PubMed, EMBASE and Web of Science from inception to 2nd March 2021 for nonrandomized studies specifically addressing VAP in adult patients with COVID-19 and reporting data on at least one primary outcome of interest. Random effect single-arm meta-analysis was performed for the occurrence of VAP and mortality (at the longest follow up) and ICU length of stay. Twenty studies were included in the systematic review and meta-an…

Comparisons of two diaphragm ultrasound-teaching programs: a multicenter randomized controlled educational study

2019

Abstract Background This study aims to ascertain whether (1) an educational program is sufficient to achieve adequate Diaphragm Ultrasound (DUS) assessments on healthy volunteers and (2) combining a video tutorial with a practical session is more effective in making learners capable to obtain accurate DUS measurements, as opposed to sole video tutorial. Results We enrolledstep 1: 172 volunteers naïve to ultrasound. After watching a video tutorial, a questionnaire was administered and considered to be passed when at least 70% of the questions were correctly answered. Course participants who passed the theoretical test were randomized to either intervention or control group. Learners randomiz…

Le burn-out en réanimation : évaluation, prévention et dispositifs d’intervention

2020

Les professionnels de réanimation sont confrontés de façon répétitives et intenses à de nombreux facteurs de stress les rendant plus vulnérables au développement d’un burn-out. Le burn-out constitue le stade final d’une rupture d’adaptation suite à un déséquilibre entre les exigences professionnelles et les ressources de l’individu. Il affecte directement la santé mentale et physique des professionnels et est associé à une diminution de la qualité et de la sécurité des soins et à une augmentation des départs des professionnels les plus expérimentés pour d’autres services. En réanimation de nombreuses études ont été menées sur les professionnels et les organisations lancent des appels à l’ac…

Oleic Acid-Injection in Pigs As a Model for Acute Respiratory Distress Syndrome

2018

The acute respiratory distress syndrome is a relevant intensive care disease with an incidence ranging between 2.2% and 19% of intensive care unit patients. Despite treatment advances over the last decades, ARDS patients still suffer mortality rates between 35 and 40%. There is still a need for further research to improve the outcome of patients suffering from ARDS. One problem is that no single animal model can mimic the complex pathomechanism of the acute respiratory distress syndrome, but several models exist to study different parts of it. Oleic acid injection (OAI)-induced lung injury is a well-established model for studying ventilation strategies, lung mechanics and ventilation/perfus…

Speckle tracking analysis in intensive care unit: A toy or a tool?

2018

The use of conventional echocardiography in the intensive care unit (ICU) is today established to assess left and right ventricular systolic function, for preload determination and procedural guidance. Next step in ICU echocardiography could be the use of novel ultrasound techniques such as strain echocardiography to assist in the management of patients with acute coronary syndrome, heart failure, or pulmonary embolism. This review has gathered the available evidence supporting the incremental value of strain in the diagnostic workup of cardiac diseases treated in ICU.

Epidemiología de la transfusión sanguínea en los Servicios de Medicina Intensiva en España: «Transfusion Day»

2022

Objective To describe the transfusion practice in the ICUs in Spain, according to national and international recommendations (guidelines).DesignProspective, cross-sectional, multi-centre study.ScopeData collection was carried out by means of a questionnaire sent electronically to the Heads of Service of 111 ICUs in Spain.Participants1,448 patients were included, aged 61.8 (SD 15.7) years, 66.2% male, with an SOFA of 4.7 ± 3.8 and average stay of 10.62 ± 17.49 days.VariablesDemographic and clinical variables of the patients were collected, as well as variables related to the transfusion act.ResultsOf the 1,448 patients, 9.9% received al least one transfusion of any blood product, 3.7% fresh …

A systematic approach to ultrasound-guided central venous catheter placement—desirable modifications

2017

Infraclavicular access to the axillary vein-new possibilities for the catheterization of the central veins in the intensive care unit

2016

Central vein cannulation is one of the most commonly performed procedures in intensive care. Traditionally, the jugular and subclavian vein are recommended as the first choice option. Nevertheless, these attempts are not always obtainable for critically ill patients. For this reason, the axillary vein seems to be a rational alternative approach. In this narrative review, we evaluate the usefulness of the infraclavicular access to the axillary vein. The existing evidence suggests that infraclavicular approach to the axillary vein is a reliable method of central vein catheterization, especially when performed with ultrasound guidance.

Caustic ingestion: CT findings of esophageal injuries and thoracic complications

2020

Ingestion of caustic substances, whether accidental or for the purpose of suicide, can cause severe lesions of the lips, oral cavity, pharynx, upper gastrointestinal system, and upper airways. In particular, caustic agents could be responsible for severe esophageal injuries resulting in short- and long-term complications. Because of these important clinical implications, timely diagnosis and appropriate management are crucial. In the evaluation of esophageal injuries, thoraco-abdominal computed tomography (CT) is preferable to endoscopy as it avoids the risk of esophageal perforation and allows the evaluation of esophageal injuries as well as of the surrounding tissue. In this review, we re…