Medicine and Health Sciences Commons^™

Survival Benefit Of Resin Cartridge Extracorporeal Blood Purification Therapy In Patients With Septic Shock, Serdar Efe, Pervin Hanci, Volkan İnal

Turkish Journal of Medical Sciences

Extracorporeal blood purification (EBP) therapies have shown promise as potential rescue treatments for patientswith septic shock. However, precise evidence regarding their effectiveness is lacking. This case-control study aimed to evaluate the 28-day survival benefit of a resin cartridge-based EBP therapy compared to conventional therapies in patients with septic shock.Materials and methods: The study sample was collected retrospectively from the medical records of patients admitted to the intensivecare unit (ICU) between 2015 and 2020. The study included patients with septic shock aged ≥18 years who had ICU stays >96 h andexcluded those lost to follow-up by 28 days or readmitted. First, …

Significance Of Chronic Kidney Disease On Morbidity And Mortality In Hospitalized Patients With Covid-19, Varsha Suresh, Alexis Finer, Aarushi Varshney, Kay Thi Khine, Ishak Mansi, Abdo Asmar

HCA Healthcare Journal of Medicine

Background

Patients with comorbid illnesses are at risk for worse outcomes with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19). Our research examined patients with chronic kidney disease (CKD) to establish whether it remains an independent risk factor for mortality and morbidity in patients with COVID-19.

Methods

We conducted a retrospective cohort study using an electronic patient database in 2020. An observational dataset from 149 hospitals comprising a United States-based health system (HCA Healthcare) was analyzed. Hospitalized patients (N=11 086), aged 18 and above, with a COVID-19 polymerase chain reaction positive result between January 1, 2020, and September 1, …

Role Of Midodrine On Vasopressor Duration In Patients With Sepsis, Kamah J. Ellena, Jenna L. Combs, Heather M. Draper, Julie J. Belfer

Journal of Shock and Hemodynamics

Existing literature evaluating the off-label use of midodrine has focused primarily on postoperative hypotensive patients requiring a single vasopressor. This study aimed to evaluate the impact of midodrine on vasopressor duration and length of stay in patients receiving vasopressors for sepsis-related hypotension. This is an institutional review board-approved, single-center, retrospective analysis of critically ill patients with hypotension secondary to sepsis who received midodrine and intravenous vasopressors compared to those who received intravenous vasopressors alone. Patients were matched by Acute Physiology and Chronic Health Evaluation II score, suspected source of infection, and presence of bacteremia. One hundred patients were included in …

Conference Proceedings: Select Abstracts Presented At 2023 Advocate Aurora Scientific Day

Journal of Patient-Centered Research and Reviews

This abstract supplement includes findings presented at the 49th annual Advocate Aurora Scientific Day on May 24, 2023. The Scientific Day symposium provides a virtual forum for the sharing of preliminary results from research and case studies conducted by faculty, fellows, residents, and other health professionals associated with Illinois-based Advocate Health Care and Wisconsin-based Aurora Health Care.

Covid-19 Disease Characterization And Outcomes Comparison In Pediatrics, Rachel Rowland, Abigail Schauble, Brendon Cornett

HCA Healthcare Journal of Medicine

Background

It has been reported that children experience less severe COVID-19 symptoms than adults; however, the literature that supports this idea is evolving. The purpose of this study was to retrospectively characterize hospitalized COVID-19-positive pediatric patients with a focus on the assessment of risk factors for poorer outcomes, mortality, and evaluation of interventions utilized and associated clinical outcomes.

Methods

We conducted a multi-center retrospective chart review of patients 18 years old or younger who were COVID-19 positive and admitted to any US HCA Healthcare Pediatric service line between January 1, 2020, and November 30, 2020. We identified 6081 children across …

Quality Of Icu Discharge Summaries Produced By Pediatric Residents: The Memorial Health University Medical Center Experience, Jessica M. Lee, James Ryden, Emma Meehan, Eric Shaw, Mary C. Lytle, Andrew Stack, Ashley Shearman

HCA Healthcare Journal of Medicine

Background

Discharging intensive care unit (ICU) patients directly home is becoming more common. High-quality ICU discharge summaries are crucial in the transition of patient care. Currently, at Memorial Health University Medical Center (MHUMC), there exists no standardized ICU discharge summary template or consistency when discharge documentation is completed. Investigators evaluated the timeliness and completeness of ICU discharge summaries at MHUMC produced by pediatric residents.

Methods

A single-center retrospective chart review of pediatric patients discharged directly from a 10-bed Pediatric ICU to home was conducted. Charts were evaluated pre- and post-intervention. The intervention included the implementation of a standardized ICU discharge …

C-Reactive Protein In View Of Prognosis In Sepsis, Ashraf A.H Mahmoud Soliman, Raghad S. Abdellatif, Wael A. E. El Hakeem

Journal of Medicine in Scientific Research

Introduction Sepsis is the host reaction to invading microbes. The septic response generally occurs when immune defenses fail to contain an invading microbe and may also be induced by microbial exotoxins. C-reactive protein (CRP) is an acute-phase protein in humans and an important component of the innate immune system. CRP activates complement's classical route, which is one of its key strategies for defending the host. Patients and methods This study was conducted on 20 patients with systemic sepsis and admitted to the critical care unit; moreover, 20 healthy participants were studied as a control group. Results Both groups were matched …

Conference Proceedings: Select Abstracts Presented At Advocate Aurora Scientific Day 2022

Journal of Patient-Centered Research and Reviews

The abstracts published in this supplement were presented at the 48th annual Advocate Aurora Scientific Day on May 25, 2022. This scholarly symposium provides a closed forum for sharing preliminary results from research studies conducted by faculty physicians and nurses, fellows, residents, scientists, and other health professionals associated with U.S. Midwest-based health system Advocate Aurora Health, publisher of the Journal of Patient-Centered Research and Reviews.

The Effect Of Omega-3 As Diet-Enhanced Immunity On Sepsis Outcome In Critically Ill Patients, A Abd El Rhaman, Hatem A. Attallah, Marwa M. Taha, Wesam E. Salutan

Menoufia Medical Journal

Background Nutritional supplementation of omega-3 fatty acids has been proposed to modulate the balance of proinflammatory and anti-inflammatory mediators in sepsis and acute lung injury. Objectives To evaluate the effect of omega-3 fatty acids as diet-enhanced immunity on sepsis outcome in critically ill patients. Patients and methods Sixty patients with early sepsis were divided equally into two groups: group A who received high-dose omega-3 fatty acids for consecutive 7 days besides conventional sepsis treatment, group B: control group who received only conventional sepsis treatment. Both groups were followed up by inflammatory markers, sequential organ failure assessment score monitoring, need for …

Sleep In The Intensive Care Unit (Icu): An Overlooked Opportunity For Occupational Therapists To Fill A Gap In Health Care Service, Mckenzie C. Bolin, Melissa M. Sweetman

The Open Journal of Occupational Therapy

Sleep hygiene is well-established in the scope of occupational therapy practice; however, this occupation is rarely addressed in the intensive care unit (ICU). The majority of health care practitioners believe patients experience reduced sleep quality in the ICU, which can negatively impact patient outcomes. Through a review of the literature, this paper identifies common factors that negatively influence sleep quality and duration and proposes evidence-based interventions to improve patients’ sleep. Factors that influence sleep and fall in the domain of occupational therapy practice include the environment, psychosocial elements, and patient care. Occupational therapists can use interventions, such as orienting patients …

Conference Proceedings: Select Abstracts Presented At 2021 Advocate Aurora Health Scientific Day

Journal of Patient-Centered Research and Reviews

Abstracts published within this supplement were presented at the 47th annual Advocate Aurora Health Scientific Day, held virtually on May 26, 2021. This research symposium provides a forum for disseminating results from studies conducted by faculty, fellows, residents, and other allied health professionals associated with Midwest-based health system Advocate Aurora Health, which publishes the Journal of Patient-Centered Research and Reviews.

Paula Ferrada, M.D. Facs Trauma And Acute Care Surgery (Interview), Joseph Mceachon

Osmosis Magazine

Interview by Joseph McEachon

Titles at VCU: Professor of Surgery at VCU.

Program Director for the Surgical Critical Care Fellowship.

Medical Director of the Surgical and Trauma Intensive Care Unit.

Methamphetamine Associated Cardiomyopathy In Pregnancy: The Distinctions And The Implications, Ashan Hatharasinghe, Hossein Akhondi

HCA Healthcare Journal of Medicine

Introduction

Methamphetamine associated cardiomyopathy (MAC) and peripartum cardiomyopathy (PPCM) are both rare obstetric conditions. Literature regarding methamphetamine associated cardiomyopathy in the obstetric population is limited, and it can be difficult to make the distinction between the two given the similarities in clinical presentation. However similar, there are significant distinctions in the pathophysiology of these two that can help clinicians with the management process.

Clinical Findings and Outcomes

This case involves a 35-year-old Hispanic G6P5005 at 37 weeks gestation presenting with acute respiratory failure secondary to acute decompensated heart failure with reduced ejection fraction and superimposed preeclampsia leading to urgent cesarean …

Esophageal Cancer Complicated By A Distal Acquired Esophagopulmonary Fistula, Alexander D. Lake, Yousef Almuzaini, Aaron Jaffe, Joseph Staffetti, Mukesh Patel

HCA Healthcare Journal of Medicine

Esophageal respiratory fistulas, commonly found as a tracheoesophageal fistula (TEF), are abnormal connections between the esophagus and trachea. These can be congenital (infants) or acquired (malignancy). A more rare form of an esophageal respiratory fistula is an abnormal connection between the esophagus and the lung parenchyma—also known as an esophagopulmonary fistula. In our case, we present a middle-aged male with a history of esophageal cancer undergoing chemotherapy and radiation presenting into the intensive care unit for increasing shortness of breath and vomiting after eating found to have a rare form of a TEF causing his symptoms.

Emergency Department Extracorporeal Membrane Oxygenation May Also Includenoncardiac Arrest Patients, Yunus Emre Özlüer, Mücahi̇t Avci̇l, Duygu Ege, Kezban Şeker Yaşar

Turkish Journal of Medical Sciences

Background/aim: The primary purpose of this study is to report the experience on the extracorporeal membrane oxygenation (ECMO) process for patients in the critical care unit (CCU) of an emergency department of a tertiary hospital in Turkey, from cannulation to decannulation, including follow-up procedures. Materials and methods: This retrospective and observational study included eight patients who received ECMO from January 2018 to January 2020. We evaluated the demographics, indications for ECMO, laboratory values, Respiratory ECMO Survival Prediction, Survival After Veno-Arterial ECMO and ECMO net scores, the management process, and patient outcomes. Blood gas analyses done after the first hour of …

Clinical Characteristics And Risk Factors For 28-Day Mortality In Critically Ill Patients With Covid-19: A Retrospective Cohort Study, Mehmet Nuri̇ Yakar, Begüm Ergan, Bi̇şar Ergün, Murat Küçük, Ali̇ Cantürk, Mahmut Cem Ergon, Naci̇ye Si̇nem Gezer, Erdem Yaka, Bi̇lgi̇n Cömert, Ali̇ Necati̇ Gökmen

Turkish Journal of Medical Sciences

Background: To date, the coronavirus disease 2019 (COVID-19) caused more than 2.6 million deaths all around the world. Risk factors for mortality remain unclear. The primary aim was to determine the independent risk factors for 28-day mortality. Materials and Methods: In this retrospective cohort study, critically ill patients (≥ 18 years) who were admitted to the intensive care unit due to COVID-19 were included. Patient characteristics, laboratory data, radiologic findings, treatments, and complications were analyzed in the study. Results: A total of 249 patients (median age 71, 69.1% male) were included in the study. 28-day mortality was 67.9% (n = …

How Information Sharing Can Improve Patient And Family Experience In Critical Care: A Focus Group Study, Jayne Garner, Sioban Kelly, Girendra Sadera, Victoria Treadway

Patient Experience Journal

The experience of being in hospital critical care has major impacts upon the patient, their family and carers. This situation is likely to be stressful, fast changing and challenging for those involved. Crucial to this encounter are factors relating to information sharing between the clinical team, the patient, family and carers. Focus groups at a UK hospital site with former patients, their families and carers provides insight into their journey and the factors that influence this. Issues that emerged included the format of information, how and who delivered this, communication transition out of critical care and leaving hospital. While participants …

Is This Really Happening? Family-Centered Care During Covid-19: People Before Policy, Terri Savino, Karri Crispino

Patient Experience Journal

In the middle of a global pandemic, hospitals created policies for visitor restrictions to reduce the transmission of coronavirus to protect patients and staff and developed protocols allowing only one support person to call the critical care unit for patient updates. Late on a Tuesday afternoon, the Manager of Patient Experience received a phone call asking her to call Karri, the wife of one of our patients who was on a ventilator. Karri was struggling with updating her mother-in-law because she was very upset with the news she received, making it difficult to call her husband’s mom. Karri asked the …

Value Of Prognostic Scores In Antineutrophil Cytoplasmic Antibody (Anca) Associated Vasculitis Patients In Intensive Care Unit: A Multicenter Retrospective Cohort Study From Turkey, Uğur Özdemi̇r, Nazmi̇ye Ebru Ortaç Ersoy, Recep Ci̇van Yüksel, Erhan Kaya, Şahender Gülbi̇n Aygencel Bikmaz, Melda Türkoğlu, Arzu Topeli̇ İski̇t, Muhammet Güven, Murat Sungur, Neri̇man Defne Altintaş

Turkish Journal of Medical Sciences

Background/aim: There is a need for a scoring system for predicting ICU prognosis of patients with ANCA-associated vasculitis (AAV), but there are limited data on it in the literature. Therefore, we aimed to determine the scores that can estimate the prognosis of patients with AAV during intensive care follow up.Materials and methods: All adult patients admitted to the medical ICUs of 4 reference university hospitals in Turkey due to AAV activation and/or disease/treatment complications in the last 10 years were included in this study. Demographic data, treatments before ICU, the Birmingham Vasculitis Activity Score (BVAS) score at the time of …

The Physiological Basis For Vitamin C As A Potential Treatment For Sepsis, Jennifer Johnston

BU Well

Accounting for one third of all hospital patient deaths in America, sepsis remains one of the most deadly and complicated conditions that healthcare providers treat. Septic shock, a progressed form of sepsis, is even more troublesome, as mortality rates typically fall between 50-72%. It has been proposed that administration of high doses of vitamin C could be an effective treatment for the condition due to the nutrient’s anti-stress and anti-shock properties. This investigation of the physiological reasoning for administering high doses of vitamin C evaluates the viability of its use in patients with septic shock.

Can We Predict Patients That Will Not Benefit From Invasive Mechanical Ventilation? A Novel Scoring System In Intensive Care: The Imv Mortality Prediction Score (Impres), Tevfi̇k Özlü, Mehtap Pehli̇vanlar Küçük, Akin Kaya, Esra Yarar, Sami̇ Cenk Kirakli, Özlem Şengören Di̇ki̇ş, Hale Kefeli̇ Çeli̇k, Serdar Özkan, Hayri̇ye Bektaş Aksoy, Ahmet Oğuzhan Küçük

Turkish Journal of Medical Sciences

Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic …

Mortality Predictors Of Patients Suffering Of Acute Pancreatitis And Development Of Intraabdominal Hypertension, Maja Stojanovic, Petar Svorcan, Aleksandar Karamarkovic, Nebojsa Ladjevic, Radmilo Jankovic, Predrag Stevanovic

Turkish Journal of Medical Sciences

Background/aim: Intraabdominal hypertension (IAH) occurs frequently in patients with acute pancreatitis and adds to their morbidity and mortality. The main aim of the study was to identify the determination of the predictive factors connected to IAH that influence the evolution of acute pancreatitis. Materials and methods: The prospective cohort study was conducted on 100 patients who had acute pancreatitis. According to obtained intraabdominal pressure (IAP) values, the patients were divided into two groups: one group (n = 40) with normal IAP values and the other (IAH group, n = 60) with increased IAP values. Deceased patients were specially analyzed within …

Therapeutic Hypothermia For Children After In-Hospital Cardiac Arrest Not Helpful, Bradley Kolb

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent discussion regarding the merits of therapeutic hypothermia in a comatose pediatric patient following in-hospital cardiac arrest and return of spontaneous circulation.

A Comparative Study To Assess The Risk Of Varicose Vein Among Critical Care Nurses And Nurses Working In Other Nursing Units Of Selected Hospital, Guwahati, Assam, Rony Bosco Shadap Mr, Manashi Sengupta Ms, Rikupar Iawin Ms

Manipal Journal of Nursing and Health Sciences

Background: Varicose veins is increasing worldwide, since the nurses especially the critical care nurses spend most of the time standing, they are prone to get lower limb symptoms like itchiness, cramps, burning sensation, and pain especially when standing which result in superficial swollen veins and later develop to varicose veins. Objective: The main objective of the study is to assess the risk of varicose vein among critical care nurses and nurses working in other general units of selected hospital. Method: A non-experimental descriptive research design was adopted for the study. In this study 100 staff nurses working in Guwahati Neurological …

Critical Care Nurses’ Stories Of Eol Care Obstacles, Robin Grigg, Beckstrand Renea

Journal of Undergraduate Research

The purpose of this project was to discover critical care nurses’ perspectives of obstacles in providing end-of-life (EOL) care to patients. Because 20% of Americans die in an Intensive Care Unit (ICU) (CDC, 2011), EOL care is a vital component of critical care nursing. Therefore, discerning and overcoming obstacles to EOL care is necessary in order for critical care nurses to provide quality EOL care. Additionally, The National Institute of Nursing Research’s strategic plan lists five areas of focus, the third being EOL care, emphasizing the need for EOL care research (NINR, 2014).

The Incidence Of Pressure Ulcer In Patients On Mechanical Ventilation Andeffects Of Selected Risk Factors On Pressure Ulcer Development*, Özgül Karayurt, Özay Akyol, Necmi̇ye Kiliçaslan, Nuray Akgün, Ümran Sargin, Meli̇ke Kondakçi, Hanim Eki̇nci̇, Nesli̇han Sari

Turkish Journal of Medical Sciences

Background/aim: This study aimed to determine the incidence of pressure ulcers in patients on mechanical ventilation and selected risk factors likely to play a role in pressure ulcer development. Materials and methods: The study included 110 patients recruited from an anesthesia critical care unit of a university hospital. Data were collected with a demographic and clinical characteristics form. The form was composed of questions about demographic characteristics and clinical features including diagnosis, duration of mechanical ventilation, general well-being, oxygenation, perfusion, and skin condition. Results: The incidence of pressure ulcer was 15.5%. Duration of mechanical ventilation was longer and the body …