Early infections in the intensive care unit after liver transplantation ‐etiology and risk factors: A single‐center experience
ConclusionInfections represent a major cause of early postoperative morbidity and mortality. The impact of single risk factors and the results of their preoperative management should be further investigated in order to reduce the incidence and evolution of postoperative infections.
Conclusions: Comprehensive infection control protocols, including active surveillance, may be useful in the setting of A. baumanni infections. Absence of community acquired infections may be due to the tropical climate with high humidity and temperature.
AbstractPurposeTo determine clinical predictors associated with corticosteroid administration and its association with ICU mortality in critically ill patients with severe influenza pneumonia.MethodsSecondary analysis of a prospective cohort study of critically ill patients with confirmed influenza pneumonia admitted to 148 ICUs in Spain between June 2009 and April 2014. Patients who received corticosteroid treatment for causes other than viral pneumonia (e.g., refractory septic shock and asthma or chronic obstructive pulmonary disease [COPD] exacerbation) were excluded. Patients with corticosteroid therapy were compare...
Conclusion EMS is in a position to be the initiator of specialty center destination. In large cities with multiple hospitals, EMS should transport patients to the closest, most appropriate facility based on patient condition, even if this requires passing a closer facility. Where there are hospitals with multiple specialty services, EMS may be asked to activate a specific team, such as the stroke or cardiac team. In rural communities, EMS can communicate with the local hospital and by letting the hospital know of patient condition, help start the interfacility transport process from the field....
Conclusion It’s important for prehospital providers to be able to differentiate metabolic disturbances in the setting of respiratory distress and not be fooled into thinking tachypnea always has a respiratory cause. The physical exam and adjuncts such as end-tidal capnography can assist in the prehospital diagnosis. A COPD exacerbation generally presents as diminished lung sounds, wheezing on exhalation, and a prolonged expiratory phase. Here, a patient will attempt to compensate for the inflammation and mucus accumulation associated with the destruction and narrowing of peripheral airways and a subsequent lack of av...
ConclusionInfections represent a major cause of early postoperative morbidity and mortality. The impact of single risk factors and the results of their preoperative management should be further investigated in order to reduce the incidence and evolution of postoperative infections.This article is protected by copyright. All rights reserved.
Conclusion: Ventilator-associated pneumonia was associated with a significant increase in ICU length of stay, time on mechanical ventilation and different complications.
An independent 82-year-old woman presented with fever (40 ⁰C) less than24 hours after discharge from a prolonged (2-months) admission at another hospital due to an acute coronary syndrome and pulmonary edema which required intubation and mechanical ventilation. Hospitalization was complicated by septic shock due to nosocomial pneumonia due to extended-sp ectrum beta-lactamase (ESBL)-producing klebsiella pneumonia found in multiple sputum, blood and urine cultures. Prior multimorbidity included diabetes, hypertension, myocardial infarction, chronic obstructive pulmonary disease and laminectomy (L2-4).
Conclusions Expanded CURB-65 score is simple, objective and more accurate scoring system for evaluation of CAP severity and can improve the efficiency of predicting the mortality in CAP patients, better than CURB-65 and PSI scores. Also, Expanded CUEB-65 may generate new therapeutic and prognostic modality in CAP especially in patients with liver cirrhosis.
Discussion Several preoperative patient risk factors and postoperative complications greatly increased the odds for patient mortality following 30-days after initial surgery. Orthopaedic surgeons can utilize these predictive risk factors to better improve patient care. Level of evidence Retrospective study. Level IV.
Conclusions SMART – cop score is the most sensitive score in predicting 28-day mortality in the studied patient followed by SMART – co and PSI score). SMART-cop score is the most specific one (Specificity=93%) in followed by Modified ATS score (Specificity=90%).