Search results for "intensive care unit"

showing 10 items of 459 documents

Systemic acidemia impairs cardiac function in critically Ill patients.

2021

Background: Acidemia, is associated with reduced cardiac function in animals, but no studies showing an effect of acidemia on cardiac function in humans are reported. In the present study, we examined the effect of acidemia on cardiac function assessed with transpulmonary thermodilution technique with integrated pulse contour analysis (Pulse Contour Cardiac Output, PiCCO™) in a large cohort of critically ill patients. Methods: This was a prospective multicenter observational cross-sectional study of 297 patients from 6 intensive care units in London, England selected from all patients admitted consecutively between May 2018 and March 2019. Measurements of lowest plasma pH and concurrent ass…

Cardiac function curveCardiac outputmedicine.medical_specialtyMedicine (General)PiCCO01 natural scienceslaw.inventionABG-a03 medical and health sciences0302 clinical medicineR5-920lawIntensive careInternal medicinemedicineArterial pH030212 general & internal medicine0101 mathematicsGEFTranspulmonary thermodilutionAcidosisdPmxAcidemiaPoint-of-Care arterial blood gasbusiness.industryCritically illpH010102 general mathematicsCardiac functionGeneral MedicineCIIntensive care unitCOCritical careCardiac contractilityCardiologyCPIThermodilution techniqueSVICFImedicine.symptombusinessAcidosisResearch PaperEClinicalMedicine
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Comparison between doppler-echocardiography and uncalibrated pulse contour method for cardiac output measurement. a multicenter observational study

2016

Objectives: Echocardiography and pulse contour methods allow, respectively, noninvasive and less invasive cardiac output estimation. The aim of the present study was to compare Doppler echocardiography with the pulse contour method MostCare for cardiac output estimation in a large and nonselected critically ill population. Design: A prospective multicenter observational comparison study. Setting: The study was conducted in 15 European medicosurgical ICUs. Patients: We assessed cardiac output in 400 patients in whom an echocardiographic evaluation was performed as a routine need or for cardiocirculatory assessment. Interventions: None. Measurements and Main Results: One echocardiographic car…

Cardiac outputgenetic structuresintensive care unitsBlood PressureDoppler echocardiographyCritical Care and Intensive Care Medicinearterial waveform analysis; cardiac output; Doppler echocardiography; echocardiography; hemodynamic monitoring; pulse contour method; Critical Care and Intensive Care Medicinehemodynamic monitoring0302 clinical medicine030202 anesthesiologyechocardiographyhumansarterial waveform analysisarterial waveform analysis; cardiac output; doppler echocardiography; echocardiography; hemodynamic monitoring; pulse contour method; heart; humans; intensive care units; linear models; monitoring; physiologic; prospective studies; blood pressure; cardiac output; echocardiography; doppler; pulse; critical care and intensive care medicinemedicine.diagnostic_testPulse (signal processing)physiologicblood pressureHeartEchocardiography Dopplercardiovascular systemCardiologysymbolsLinear ModelDoppler effectHumandoppler echocardiographymedicine.medical_specialtyIntensive Care UnitLess invasiveheartpulse contour methoddoppler03 medical and health sciencesCardiac output measurementsymbols.namesakeInternal medicinemedicinePulsearterial waveform analysiMonitoring Physiologicbusiness.industrycardiac output030208 emergency & critical care medicineDoppler echocardiographyprospective studiesProspective StudiemonitoringMulticenter studycritical care and intensive care medicineObservational studylinear modelsbusinesspulse
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How to communicate between surgeon and intensivist?

2020

Purpose of review Communication and teamwork are essential to enhance the quality of care, especially in operating rooms and ICUs. In these settings, the effective interprofessional collaboration between surgeons and intensivists impacts patients' outcome. This review discusses current opinions and evidence for improving communication strategies and the relationship between surgeons and intensivists/anesthesiologist. Recent findings Effective teamwork has been demonstrated to improve patient outcome and foster healthier relationships between professionals.With the expansion of new medical superspecialist disciplines and the latest medical developments, patient care has been put through a pr…

Care processOperating RoomsSituation awarenessmedia_common.quotation_subjectInterprofessional RelationseducationIntensive Care UnitMEDLINEIntensivist03 medical and health sciencesSurgeon0302 clinical medicinemedicineHumansIn patientQuality (business)030212 general & internal medicinemedia_commonQuality of Health CarePatient Care TeamSurgeonsTeamworkbusiness.industryCommunication030208 emergency & critical care medicinemedicine.diseaseAnesthesiologistsIntensive Care UnitsAnesthesiology and Pain MedicineOperating RoomPerioperative careMedical emergencyAnesthesiologistbusinessHumanCurrent opinion in anaesthesiology
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Comparison of heparin to citrate as a catheter locking solution for non-tunneled central venous hemodialysis catheters in patients requiring renal re…

2014

Background The incidence of acute kidney injury (AKI) is estimated at 10 to 20% in patients admitted to intensive care units (ICU) and often requires renal replacement therapy (RRT). ICU mortality in AKI patients can exceed 50%. Venous catheters are the preferred vascular access method for AKI patients requiring RRT, but carry a risk of catheter thrombosis or infection. Catheter lock solutions are commonly used to prevent such complications. Heparin and citrate locks are both widely used for tunneled, long-term catheters, but few studies have compared citrate versus heparin for patients with short-term, non-tunneled catheters. We aim to compare citrate 4% catheter lock solution versus hepar…

Catheter Obstructionmedicine.medical_specialtyCatheterization Central VenousTime Factorsmedicine.medical_treatmentHemodialysis CatheterCatheter ObstructionMedicine (miscellaneous)urologic and male genital diseasesHospitals UniversityStudy ProtocolAcute renal failureClinical ProtocolsDouble-Blind MethodRenal DialysisCitrate lockIntensive careUpper Extremity Deep Vein ThrombosisProhibitinsmedicineCentral Venous CathetersHumansPharmacology (medical)Heparin lockRenal replacement therapyCitratesProspective StudiesContraindicationbusiness.industryHeparinAcute kidney injuryAnticoagulantsEquipment DesignAcute Kidney Injurymedicine.diseasefemale genital diseases and pregnancy complicationsSurgeryCatheterIntensive Care UnitsTreatment OutcomeResearch DesignHemodialysisHemodialysisFranceCritically ill patientbusinessCatheter lockTrials
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Analyzing central-line associated bloodstream infection prevention bundles in 22 countries: The results of ID-IRI survey

2022

International audience; BACKGROUND: Because central line-associated bloodstream infections (CLABSIs) are a significant complication of central venous access, it is critical to prevent CLABSIs through the use of central line bundles. The purpose of this study was to take a snapshot of central venous access bundles in various countries. METHODS: The participants in intensive care units (ICUs) completed a questionnaire that included information about the health center, infection control procedures, and central line maintenance. The countries were divided into 2 groups: those with a low or low-middle income and those with an upper-middle or high income. RESULTS: Forty-three participants from 22…

CatheterInfection ControlCatheterization Central VenousCross InfectionEpidemiologyHealth PolicyPublic Health Environmental and Occupational HealthBundle ; CLABSI ; Catheter ; Central line ; Infection ; SepsisBundleCLABSIIntensive Care UnitsInfectious Diseases[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseasesCatheter-Related InfectionsSurveys and QuestionnairesSepsisCentral lineHumansCentral Venous CathetersInfectionPatient Care Bundles
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High-flow nasal therapy versus noninvasive ventilation in COPD patients with mild-to-moderate hypercapnic acute respiratory failure: study protocol f…

2019

Background Noninvasive ventilation (NIV) is indicated to treat respiratory acidosis due to exacerbation of chronic obstructive pulmonary disease (COPD). Recent nonrandomized studies also demonstrated some physiological effects of high-flow nasal therapy (HFNT) in COPD patients. We designed a prospective, unblinded, multicenter, randomized controlled trial to assess the noninferiority of HFNT compared to NIV with respect to the reduction of arterial partial pressure of carbon dioxide (PaCO2) in patients with hypercapnic acute respiratory failure with mild-to-moderate respiratory acidosis. Methods We will enroll adult patients with acute hypercapnic respiratory failure, as defined by arterial…

Chronic ObstructiveTime FactorsExacerbationRespiratory ratemedicine.medical_treatmentMedicine (miscellaneous)Equivalence Trials as TopicAcute respiratory failurelaw.inventionPulmonary DiseaseHypercapnia03 medical and health sciencesPulmonary Disease Chronic ObstructiveStudy Protocol0302 clinical medicineAcute respiratory failure; Carbon dioxide; Chronic obstructive pulmonary disease; Emergency department; High-flow oxygen therapy through nasal cannula; Intensive care unit; Noninvasive ventilation; Acute Disease; Equivalence Trials as Topic; Humans; Hypercapnia; Italy; Lung; Multicenter Studies as Topic; Oxygen Inhalation Therapy; Prospective Studies; Pulmonary Disease Chronic Obstructive; Respiratory Insufficiency; Time Factors; Treatment Outcome; Noninvasive VentilationRandomized controlled triallawHigh-flow oxygen therapy through nasal cannulamedicineHumansMulticenter Studies as TopicPharmacology (medical)Intensive care unit030212 general & internal medicineProspective StudiesLungTidal volumeMechanical ventilationCOPDlcsh:R5-920business.industryEmergency departmentChronic obstructive pulmonary diseaseOxygen Inhalation Therapymedicine.diseaseIntensive care unitRespiratory acidosisTreatment OutcomeItalyCarbon dioxideAnesthesiaAcute DiseasebusinessRespiratory Insufficiencylcsh:Medicine (General)Acute respiratory failure; Carbon dioxide; Chronic obstructive pulmonary disease; Emergency department; High-flow oxygen therapy through nasal cannula; Intensive care unit; Noninvasive ventilationNoninvasive ventilation030217 neurology & neurosurgeryTrials
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Successful control of an outbreak of colonization by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae sequence type 258 in a neonatal inte…

2013

This article reports an outbreak of colonization by Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-Kp) sequence type (ST) 258 in a neonatal intensive care unit (NICU) in Palermo, Italy. KPC-Kp ST258 was detected by an active surveillance culture programme. Between 18th September and 14th November 2012, KPC-Kp was isolated from 10 out of 54 neonates admitted in the outbreak period. No cases of infection were recorded. Male sex was associated with colonization, whereas administration of ampicilline-sulbactam plus gentamicin was protective. Infection control interventions interrupted the spread of KPC-Kp without the need to close the NICU to new admissions. (C) 2013 The Healt…

ColonizationMaleMicrobiology (medical)Settore MED/07 - Microbiologia E Microbiologia ClinicaPediatricsmedicine.medical_specialtyNeonatal intensive care unitKlebsiella pneumoniaeMultidrug resistanceSettore MED/42 - Igiene Generale E ApplicataST258beta-LactamasesDisease OutbreaksNeonatal intensive care unitSettore MED/38 - Pediatria Generale E SpecialisticaBacterial ProteinsDrug Resistance Multiple BacterialIntensive Care Units NeonatalAmpicillinpolycyclic compoundsmedicineHumansInfection controlColonizationInfection ControlKPC-Klebsiella pneumoniaebiologybusiness.industryInfant NewbornOutbreakGeneral MedicineSulbactambiochemical phenomena metabolism and nutritionbacterial infections and mycosesbiology.organism_classificationKlebsiella InfectionsKlebsiella pneumoniaeInfectious DiseasesItalyFemaleGentamicinbusinessMultilocus Sequence Typingmedicine.drugJournal of Hospital Infection
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Exposure to Gastric Acid Inhibitors Increases the Risk of Infection in Preterm Very Low Birth Weight Infants but Concomitant Administration of Lactof…

2018

Objective: To investigate whether exposure to inhibitors of gastric acidity, such as H2 blockers or proton pump inhibitors, can independently increase the risk of infections in very low birth weight (VLBW) preterm infants in the neonatal intensive care unit. Study design: This is a secondary analysis of prospectively collected data from a multicenter, randomized controlled trial of bovine lactoferrin (BLF) supplementation (with or without the probiotic Lactobacillus rhamnosus GG) vs placebo in prevention of late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) in preterm infants. Inhibitors of gastric acidity were used at the recommended dosages/schedules based on the clinical judgmen…

ColonizationProton Pump InhibitorNeonatal intensive care unitAdministration OralHistamine H2 AntagonistProbioticGastroenterologyPediatricsH2 blocker0302 clinical medicineRisk FactorsInfant Very Low Birth Weight030212 general & internal medicineCandidaVLBW neonateLacticaseibacillus rhamnosusGestational agePerinatology and Child HealthHistamine H2 AntagonistsItalyNecrotizing enterocolitismedicine.symptomInfectionInfant PrematureHumanmedicine.medical_specialtyBirth weightGastric AcidSepsis03 medical and health sciencesEnterocolitis NecrotizingIntensive Care Units NeonatalSepsis030225 pediatricsInternal medicinemedicineH2 blockersHumansDietary Supplementbusiness.industryRisk FactorProbioticsInfant NewbornProton Pump Inhibitorsmedicine.diseaseLow birth weightLactoferrinConcomitantDietary SupplementsPediatrics Perinatology and Child HealthVLBW neonatesCandida; Colonization; H2 blockers; Infection; Lactoferrin; VLBW neonates; Pediatrics Perinatology and Child HealthGastric acidLactobacillus rhamnosubusinessNew Zealand
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The multidimensional prognostic index (MPI) for the prognostic stratification of older inpatients with COVID-19: A multicenter prospective observatio…

2021

Background: The topic of prognosis in COVID-19 research may be important in adopting appropriate clinical decisions. Multidimensional prognostic index (MPI) is a frailty assessment tool widely used for stratifying prognosis in older people, but data regarding inpatients, affected by COVID-19, are not available. Objectives: To evaluate whether MPI can predict in-hospital mortality and the admission to intensive care unit (ICU) in older inpatients hospitalized for COVID-19 infection. Methods: In this longitudinal, Italian, multi-center study, older patients with COVID-19 were included. MPI was calculated using eight different domains typical of comprehensive geriatric assessment and categoriz…

Comprehensive geriatric assessment; COVID-19; Frailty; Intensive care unit; Mortality; Multidimensional prognostic index; Prognosis; Aged; Aged 80 and over; Female; Geriatric Assessment; Humans; Italy; Male; Prognosis; Prospective Studies; SARS-CoV-2; COVID-19; InpatientsMaleAgingmedicine.medical_specialtyHealth (social science)Coronavirus disease 2019 (COVID-19)Comprehensive geriatric assessmentintensive care unitArticlePrognostic stratificationlaw.inventionCOVID-19 Multidimensional prognostic index Mortality Intensive care unit Prognosis Frailty Comprehensive geriatric assessment03 medical and health sciences0302 clinical medicinelaw80 and overHumansMedicineProspective Studies030212 general & internal medicineProspective cohort studyGeriatric AssessmentAgedAged 80 and overInpatientsFrailty030214 geriatricsSARS-CoV-2business.industryHazard ratioArea under the curveCOVID-19mortalityIntensive care unitmultidimensional prognostic indexConfidence intervalItalyEmergency medicineFemaleprognosisGeriatrics and GerontologybusinessGerontologyCohort study
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Congenital heart defects in newborns with apparently isolated single gastrointestinal malformation: A retrospective study.

2015

Abstract Background Congenital gastrointestinal system malformations/abdominal wall defects (GISM) may appear as isolated defects (single or complex), or in association with multiple malformations. The high incidence of association of GISM and congenital heart defects (CHD) in patients with syndromes and malformative sequences is known, but less expected is the association of apparently isolated single GISM and CHD. The aim of this study was to investigate the frequency of CHD in newborns with isolated GISM, and the possibility to modify the diagnostic-therapeutic approach just before the onset of cardiac symptoms or complications. Methods Anamnestic, clinical, and imaging data of newborns …

Congenital abnormalitieHeart Defects CongenitalMalePediatricsmedicine.medical_specialtyHeart diseaseGastrointestinal Diseasesmedicine.medical_treatment030204 cardiovascular system & hematologyVentricular septal defectAbdominal wallSepsis03 medical and health sciences0302 clinical medicine030225 pediatricsInternal medicineIntensive Care Units NeonatalmedicineEndocarditisHumansRetrospective Studiesbusiness.industryIntestinal atresiaCardiovascular abnormalitieInfant NewbornObstetrics and GynecologyRetrospective cohort studymedicine.diseaseIntestinal atresiaGastrointestinal Tractmedicine.anatomical_structureMesenterium defectDigestive system abnormalitiePediatrics Perinatology and Child HealthCardiologyFemalebusinessCentral venous catheterAbdominal surgeryEarly human development
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