Search results for "Critical"

Clinical outcome of critically ill, not fully recompensated, patients undergoing MitraClip therapy

2014

Aims As periprocedural risk is low, MitraClip implantation is often performed in critically ill, not fully recompensated patients, who are in NYHA functional class IV at the time of the procedure, to accelerate convalescence. We herein sought to evaluate the procedural and 30-day outcome of this patient group. Methods and results A total of 803 patients undergoing MitraClip implantation were included in the German Mitral Valve Registry, and 30-day outcomes were prospectively assessed. Patients were separated based on NYHA functional class [(NYHA IV (n = 143), III (n = 572), and I/II (n = 88)]. No difference was noted in co-morbities and echocardiographic parameters of LV function between gr…

Medical simulation for ICU staff: does it influence safety of care?

2016

Dear Editor, We read with great interest the article by Garrouste-Orgeas et al. entitled ‘‘Understanding medical errors and adverse events in ICU patients’’ [1]. In particular, two sentences caught our attention: ‘‘medical errors are the consequence of multiple actions of a whole chain of organizational and humans interaction...’’ and ‘‘leadership, trust, respect, open communication, non-punitive actions and coordination of behavior are essential for a multidisciplinary ICU team to provide safe care’’. In a teamworking setting like the ICU, shared knowledge and non-technical skills are pivotal to deliver a high quality of care and to reduce medical errors. Medical simulation has been demons…

Alteraciones emocionales y necesidades psicológicas de pacientes en una Unidad de Cuidados Intensivos

2007

Desde el momento en que se diagnostica una enfermedad cuyo tratamiento va a requerir un ingreso hospitalario para la realización de una intervención quirúrgica, tanto el paciente como sus familiares o cuidadores primarios se ven implicados en un proceso durante el cual pueden experimentar diversas alteraciones emocionales. El objetivo de este trabajo se centra en la descripción de los diferentes problemas psicológicos y las necesidades manifestadas por los pacientes que precisan, como parte del proceso de tratamiento y control de la recuperación, ser ingresados en una Unidad de Cuidados Intensivos (UCI). Durante su estancia en la UCI, las alteraciones emocionales citadas con mayor frecuenci…

Video laryngoscopy vs. direct laryngoscopy – Influence of the training status on the performance in both settings: An interim evaluation of a prospec…

2017

Use of Thromboelastography in severe sepsis a case-control Study

2011

Thromboelastography (TEG) is a global test of coagulation that records the viscoelastic changes in blood during clot formation. Cardiosurgery and liver transplantation are established fields of application for TEG. Severe sepsis is often characterized by an imbalance of the haemostatic equilibrium between clot formation and fibrinolysis in favor of a procoagulant status, especially in the first phase. A hypocoagulant status due to coagulation factor consumption could occur later. In spite of this, the correlation between TEG and sepsis is not clearly established. Moreover, there are doubts about which TEG-detected variable is best correlated with sepsis. The aim of this study is to clarify …

Discordancia clínico-radiológica y resolución espontánea de un hematoma postcateterización epidural

2008

Neuraxial techniques are considered safe if certain guidelines are followed, but they are not risk free. We report the case of an 81-year-old woman with an invasive bladder tumor who underwent radical cystectomy with a Bricker-type procedure. General anesthesia was used and epidural analgesia was also provided for surgical and postoperative pain management. Late in the postoperative recovery period a large epidural hematoma was diagnosed based on radiologic signs of spinal cord compression, in the absence of symptoms other than mild and progressive back pain that developed after extubation. The surgeon decided against emergency surgery to reduce compression. Symptoms resolved gradually, and…

[Antimicrobically coated venous catheters--must? Contra].

2002

CA125 but not NT-proBNP predicts the presence of a congestive intrarenal venous flow in patients with acute heart failure

2021

Abstract Background Intrarenal venous flow (IRVF) measured by Doppler ultrasound has gained interest as a potential surrogate marker of renal congestion and adverse outcomes in heart failure. In this work, we aimed to determine if antigen carbohydrate 125 (CA125) and plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) are associated with congestive IRVF patterns (i.e., biphasic and monophasic) in acute heart failure (AHF). Methods and results We prospectively enrolled a consecutive cohort of 70 patients hospitalized for AHF. Renal Doppler ultrasound was assessed within the first 24-h of hospital admission. The mean age of the sample was 73.5 ± 12.3 years; 47.1% were female, and…

The erector spinae plane block: a narrative review

2019

Regional anesthesia and pain management have experienced advances in recent years, especially with the advent of fascial plane blocks. The erector spinae plane block is one of the newest techniques to be described. In the past two years, publications referring to ESP block have increased significantly. The objective of this review is to analyze the articles about ESP block that have been published to date. We performed a search in the main databases and identified 368 articles. After a selection of the relevant articles, 125 studies were found eligible and were included in the review. The ESP block is performed by depositing the local anesthetic in the fascial plane, deeper than the erector…

Sedation During Neurocritical Care

2019

AbstractSedation is an essential therapeutic strategy in the care of neurocritical patients. Intravenous sedative agents are the most widely used, with promising alternatives (dexmedetomidine, ketamine, and volatile agents) to propofol and midazolam arising. Studies designed to evaluate superiority and avoid biases are required. A neurological awakening test is safe in most patients. Potential risks and benefits of limiting deep sedation and daily interruption of sedation in these patients remain unclear. The aim of this review was to report recent clinical evidence on sedation in this subgroup of patients, focusing on its effects on clinical prognosis.