Search results for "Intensive care unit."

Choice of fluids in critically ill patients

2018

Background Fluids are by far the most commonly administered intravenous treatment in patient care. During critical illness, fluids are widely administered to maintain or increase cardiac output, thereby relieving overt tissue hypoperfusion and hypoxia. Main text Until recently, because of their excellent safety profile, fluids were not considered “medications”. However, it is now understood that intravenous fluid should be viewed as drugs. They affect the cardiovascular, renal, gastrointestinal and immune systems. Fluid administration should therefore always be accompanied by careful consideration of the risk/benefit ratio, not only of the additional volume being administered but also of th…

Neutrophil CD64 as a marker of infection in patients admitted to the emergency department with acute respiratory failure

2014

Andrea Cortegiani, Vincenzo Russotto, Francesca Montalto, Grazia Foresta, Pasquale Iozzo, Santi Maurizio Raineri, Antonino Giarratano Department of Biopathology and Medical and Forensic Biotechnologies (DIBIMEF), Section of Anesthesiology, Analgesia, Emergency and Intensive Care, Policlinico “P Giaccone”, University of Palermo, Palermo, Italy Introduction: Cluster of differentiation 64 (CD64) is expressed on neutrophils during bacterial infections and sepsis. The aim of our study was to assess the CD64 expression in patients admitted to the emergency department (ED) with a triage diagnosis of acute respiratory failure (ARF) and/or dyspnea and to verify a relationship bet…

Hemodynamic Monitoring in Patients With Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis

2020

Aneurysmal subarachnoid hemorrhage (aSAH) often causes cardiopulmonary dysfunction. Therapeutic strategies can be guided by standard (invasive arterial/central venous pressure measurements, fluid balance assessment), and/or advanced (pulse index continuous cardiac output, pulse dye densitometry, pulmonary artery catheterization) hemodynamic monitoring. We conducted a systematic review and meta-analysis of the literature to determine whether standard compared with advanced hemodynamic monitoring can improve patient management and clinical outcomes after aSAH. A literature search was performed for articles published between January 1, 2000 and January 1, 2019. Studies involving aSAH patients …

Optimised versus standard dosing of vancomycin in infants with Gram-positive sepsis (NeoVanc): a multicentre, randomised, open-label, phase 2b, non-i…

2022

Summary Background Vancomycin is the most widely used antibiotic for neonatal Gram-positive sepsis, but clinical outcome data of dosing strategies are scarce. The NeoVanc programme comprised extensive preclinical studies to inform a randomised controlled trial to assess optimised vancomycin dosing. We compared the efficacy of an optimised regimen to a standard regimen in infants with late onset sepsis that was known or suspected to be caused by Gram-positive microorganisms. Methods NeoVanc was an open-label, multicentre, phase 2b, parallel-group, randomised, non-inferiority trial comparing the efficacy and toxicity of an optimised regimen of vancomycin to a standard regimen in infants aged …

A first dedicated heart valve unit: safe and streamlined patient care for the rapidly growing field of transcatheter heart valve interventions

2021

Abstract Background A dedicated Heart Valve Unit was launched in 2018 to meet the demands of the growing transcatheter heart valve program by optimizing patient care in a single dedicated unit. Purpose To assess the performance of the heart valve unit (all steps of patient care in a single unit with intermediate care facilities) over a conventional approach (preparation on a normal ward, postprocedural intensive care unit (ICU) monitoring and transfer to an additional monitoring ward before discharge) in a high volume center. Methods Retrospective analysis including patients undergoing transcatheter mitral or tricuspid valve repair who were admitted to the Heart Valve Unit (02/2018–01/2020)…

An intensive midsummer night’s dream

2018

SARS-CoV-2 RNA load in the lower respiratory tract, viral RNAemia and N-antigenemia in critically ill adult COVID-19 patients: relationship with biom…

2021

ABSTRACTBackgroundLittle is known about the comparative kinetics of SARS-CoV-RNA load in the lower respiratory tract and in blood compartment in patients admitted to the intensive care unit, and how these relate to biomarkers of COVID-19 severity.MethodsSeventy-three consecutive critically ill COVID-19 patients (median age, 65 years) were recruited. Serial lower respiratory tract (n=165) and plasma (n=340) specimens were collected. RT-PCR and lateral flow immunochromatography assay were used for SARS-CoV-2 RNA quantitation and N protein detection in plasma, respectively. Serum levels of inflammatory and tissue-damage biomarkers in paired specimens were analyzed.ResultsSARS-CoV-RNA was detec…

Bloodstream infections in intensive care unit patients: Distribution and antibiotic resistance of bacteria

2015

Vincenzo Russotto,1 Andrea Cortegiani,1 Giorgio Graziano,2 Laura Saporito,2 Santi Maurizio Raineri,1 Caterina Mammina,2 Antonino Giarratano1 1Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anaesthesia, Analgesia, Intensive Care and Emergency, Paolo Giaccone University Hospital, University of Palermo, Palermo, Italy; 2Department of Sciences for Health Promotion and Mother-Child Care, University of Palermo, Palermo, Italy Abstract: Bloodstream infections (BSIs) are among the leading infections in critically ill patients. The case-fatality rate associated with BSIs in patients admitted to intensive care units (ICUs) reaches 35%–50%. The emergence and diffusi…

Analysis of Candida auris candidemia cases in an Intensive Care Unit of a tertiary hospital

2021

Abstract Candida auris is a multi-resistant emerging fungus. Objectives To analyze the relationship between colonization by C. auris and the appearance of invasive candidiasis. Description of the sample of colonized patients, risk factors for colonization and/or infection, and calculation of mortality rates. Methodology Longitudinal observational study in an anesthesia intensive care unit in 2018. Results 2130 patients were admitted. Surveillance studies were positive in 124 patients; 118 cases involved skin colonization and 52 were pharyngeal. Patients with a positive blood culture were identified. A statistically significant association was found between pharyngeal colonization and the ap…

PS-075 Evaluation of fall risks in elderly patients

2014

Background Falls among hospitalised elderly patients are a major public health concern since they can cause loss of independence, injury and sometimes patient death. Purpose To examine risk factors, especially drugs, potentially related to falls in elderly patients and to define possible actions. Materials and methods A retrospective (May 1 2010–March 31 2013) study was performed at ISMETT, a 90-bed hospital. Patient characteristics (age/gender/body mass index, BMI), clinical conditions (diagnosis/comorbidity), ward (Intensive Care Unit, Step-Down Unit, Cardiothoracic Surgery Unit and Abdominal Surgery Unit), length of stay, number of medicines taken within three days before falling and sev…