Search results for "critical care and intensive care medicine"

Bacterial contamination of inanimate surfaces and equipment in the intensive care unit.

2015

Intensive care unit (ICU)-acquired infections are a challenging health problem worldwide, especially when caused by multidrug-resistant (MDR) pathogens. In ICUs, inanimate surfaces and equipment (e.g., bedrails, stethoscopes, medical charts, ultrasound machine) may be contaminated by bacteria, including MDR isolates. Cross-transmission of microorganisms from inanimate surfaces may have a significant role for ICU-acquired colonization and infections. Contamination may result from healthcare workers' hands or by direct patient shedding of bacteria which are able to survive up to several months on dry surfaces. A higher environmental contamination has been reported around infected patients tha…

Noninvasive respiratory support in the hypoxaemic peri-operative/periprocedural patient: A joint ESA/ESICM guideline.

2020

Hypoxaemia is a potential life-threatening yet common complication in the peri-operative and periprocedural patient (e.g. during an invasive procedure at risk of deterioration of gas exchange, such as bronchoscopy). The European Society of Anaesthesiology (ESA) and the European Society of Intensive Care Medicine (ESICM) developed guidelines for the use of noninvasive respiratory support techniques in the hypoxaemic patient in the peri-operative and periprocedural period. The panel outlined five clinical questions regarding treatment with noninvasive respiratory support techniques [conventional oxygen therapy (COT), high flow nasal cannula, noninvasive positive pressure ventilation (NIPPV) a…

Plexus and peripheral nerve block anaesthesia--a step beyond ultrasound or full circle?

2015

Nutritional parameters associated with prognosis in non-critically ill hospitalized covid-19 patients: the nutri-covid19 study

2021

Background & aims: To investigate the association between the parameters used in nutritional screening assessment (body mass index [BMI], unintentional weight loss [WL] and reduced food intake) and clinical outcomes in non-critically ill, hospitalized coronavirus disease 2019 (COVID-19) patients. Methods: This was a prospective multicenter real-life study carried out during the first pandemic wave in 11 Italian Hospitals. In total, 1391 patients were included. The primary end-point was a composite of in-hospital mortality or admission to ICU, whichever came first. The key secondary end-point was in-hospital mortality. Results: Multivariable models were based on 1183 patients with comple…

Editor's Choice - Frailty and the management of patients with acute cardiovascular disease:A position paper from the Acute Cardiovascular Care Associ…

2018

Frailty is increasingly seen among patients with acute cardiovascular disease. A combination of an ageing population, improved disease survival, treatable long-term conditions as well as a greater recognition of the syndrome has accelerated the prevalence of frailty in the modern world. Yet, this has not been matched by an expansion of research. National and international bodies have identified acute cardiovascular disease in the frail as a priority area for care and an entity that requires careful clinical decisions, but there remains a paucity of guidance on treatment efficacy and safety, and how to manage this complex group. This position paper from the Acute Cardiovascular Care Associa…

Manejo perioperatorio de pacientes con sospecha o infección grave por coronavirus SARS-CoV-2 programados para implante de dispositivos electrónicos p…

2020

Resumen La infeccion por SARS-CoV-2 ha evolucionado hasta convertirse progresivamente en una pandemia declarada por la Organizacion Mundial de la Salud (OMS) que ha obligado a las organizaciones de salud a nivel mundial, regional y local a adoptar una serie de medidas para hacer frente al COVID-19 e intentar disminuir su impacto, no solo en el ambito social sino tambien en el ambito sanitario, modificandose las pautas de actuacion en los servicios de salud. Dentro de estas recomendaciones que incluyen las Unidades de Tratamiento del Dolor, los pacientes con sospecha o infeccion confirmada por SARS-CoV-2 pueden encontrase en situacion de espera para intervencion no demorable para implante o …

Status epilepticus in der Spätschwangerschaft - Eklampsie oder Subarachnoidalblutung?

1997

After a largely inconspicuous pregnancy, a 31-year old primipara suffered from a status epilepticus in the third trimenon. The convulsions could not be terminated by emergency medical services, resulting in aspiration of gastric contents. Assuming eclampsia, an emergency caesarean section was performed immediately in a central hospital. Postoperatively, a pathological pattern of tendon reflexes was noticed. A CT scan revealed subarachnoid haemorrhage. The causal aneurysm of the right A. pericallosa was clipped subsequently. Eclampsia is the leading cause of epileptic seizures during pregnancy. However, a different aetiology should always be considered, especially if medical history does not…

Thiopentalkonzentrationsverlauf im Vollblut von schwangeren und nichtschwangeren Patientinnen in den ersten Minuten nach der Injektion

1991

Thiopentone concentrations in blood following injection of the induction solution (Thiopental, 2.5%) may be critical in the context of lethal complications arising during induction of anaesthesia and thereby the toxicological aspects of this drug can become an issue in forensic considerations. The study was designed to find out whether the dose of injected thiopentone may be calculated from blood levels measured in nine pregnant and ten non-pregnant patients. The doses injected ranged from 4-5 mg per kg body weight. The drug was administered as a single bolus dose to the patients undergoing Caesarean section. In the non-pregnant group the first dose of thiopentone was given over 25 s. After…

Extracorporeal shock wave-mediated changes in proliferation, differentiation, and gene expression of human osteoblasts.

2008

The goal of this study was to determine whether cell proliferation, differentiation, and gene expression of primary human osteoblasts (hOB) are influenced by shock wave application (SWA).Osteoblast cultures were isolated from cancellous bone fragments and treated with 500 impulses of energy flux densities of 0.06 mJ/mm, 0.18 mJ/mm, 0.36 mJ/mm, and 0.50 mJ/mm. Twenty-four hours and 96 hours after SWA cell proliferation, alkaline phosphatase activity, and mineralization were analyzed. The global gene expression profiling was determined 96 hours after SWA employing Affymetrix HG-U133A microarrays.After 24 hours, hOB showed a dose-dependent increase in cell proliferation from 68.7% (at 0.06 mJ/…

Manejo perioperatorio de los anticoagulantes orales directos en cirugía urgente y sangrado. Monitorización y tratamiento hemostático

2015

There is an almost unanimous consensus on the management of the direct new oral anticoagulants, dabigatran, rivaroxaban, and apixaban in elective surgery. However, this general consensus does not exist in relation with the direct new oral anticoagulants use in emergency surgery, especially in the bleeding patient. For this reason, a literature review was performed using the MEDLINE-PubMed. An analysis was made of the journal articles, reviews, systematic reviews, and practices guidelines published between 2000 and 2014 using the terms "monitoring" and "reversal". From this review, it was shown that the routine tests of blood coagulation, such as the prothrombin time and activated partial th…