Inicio
Resultado de la búsqueda
4 búsqueda de la palabra clave 'Critical care'
Clasificado(s) por (Año de edición descendente) Refinar búsqueda Genera el flujo rss de la búsqueda
Enlace permanente de la investigaciónGlobal PARITY: study design for a multi-centered, international point prevalence study to estimate the burden of pediatric acute critical illness in resource-limited settings / Eliana López Barón
Título : Global PARITY: study design for a multi-centered, international point prevalence study to estimate the burden of pediatric acute critical illness in resource-limited settings Tipo de documento : documento electrónico Autores : Eliana López Barón, Fecha de publicación : 2022 Títulos uniformes : Frontiers in Pediatrics Idioma : Inglés (eng) Palabras clave : pediatric critical illness acute pediatric care critical care outcome low-and lower-middle-income countries resource utilization low resource setting Resumen : Background: The burden of pediatric critical illness and resource utilization by children with critical illness in resource limited settings (RLS) are largely unknown. Without specific data that captures key aspects of critical illness, disease presentation, and resource utilization for pediatric populations in RLS, development of a contextual framework for appropriate, evidence-based interventions to guide allocation of limited but available resources is challenging. We present this methods paper which describes our efforts to determine the prevalence, etiology, hospital outcomes, and resource utilization associated with pediatric acute, critical illness in RLS globally. Methods: We will conduct a prospective, observational, multicenter, multinational point prevalence study in sixty-one participating RLS hospitals from North, Central and South America, Africa, Middle East and South Asia with four sampling time points over a 12-month period. Children aged 29 days to 14 years evaluated for acute illness or injury in an emergency department) or directly admitted to an inpatient unit will be enrolled and followed for hospital outcomes and resource utilization for the first seven days of hospitalization. The primary outcome will be prevalence of acute critical illness, which Global PARITY has defined as death within 48 hours of presentation to the hospital, including ED mortality; or admission/transfer to an HDU or ICU; or transfer to another institution for a higher level-of-care; or receiving critical care-level interventions (vasopressor infusion, invasive mechanical ventilation, non-invasive mechanical ventilation) regardless of location in the hospital, among children presenting to the hospital. Secondary outcomes include etiology of critical illness, in-hospital mortality, cause of death, resource utilization, length of hospital stay, and change in neurocognitive status. Data will be managed via REDCap, aggregated, and analyzed across sites. Discussion: This study is expected to address the current gap in understanding of the burden, etiology, resource utilization and outcomes associated with pediatric acute and critical illness in RLS. These data are crucial to inform future research and clinical management decisions and to improve global pediatric hospital outcomes. Mención de responsabilidad : Qalab Abbas, Adrian Holloway, Paula Caporal, Eliana López-Barón, Asya Agulnik, Kenneth E. Remy, John A. Appiah, Jonah Attebery, Ericka L. Fink, Jan Hau Lee, Shubhada Hooli, Niranjan Kissoon, Erika Mille, Srinivas Murthy, Fiona Muttalib, Katie Nielsen, Maria Puerto-Torres, Karla Rodrigues, Firas Sakaan, Adriana Teixeira Rodrigues, Erica A. Tabor, Amelie von Saint Andre-von Arnim, Matthew O. Wiens, William Blackwelder, David He, Teresa B. Kortz and Adnan T. Bhutta on behalf of the PALISI Global Health Subgroup the Global PARITY Investigators Referencia : Front Pediatr. 2022 Jan 28;9:793326. DOI (Digital Object Identifier) : 10.3389/fped.2021.793326 PMID : 35155314 Derechos de uso : CC BY En línea : https://www.frontiersin.org/articles/10.3389/fped.2021.793326/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Global PARITY: study design for a multi-centered, international point prevalence study to estimate the burden of pediatric acute critical illness in resource-limited settings [documento electrónico] / Eliana López Barón, . - 2022.
Obra : Frontiers in Pediatrics
Idioma : Inglés (eng)
Palabras clave : pediatric critical illness acute pediatric care critical care outcome low-and lower-middle-income countries resource utilization low resource setting Resumen : Background: The burden of pediatric critical illness and resource utilization by children with critical illness in resource limited settings (RLS) are largely unknown. Without specific data that captures key aspects of critical illness, disease presentation, and resource utilization for pediatric populations in RLS, development of a contextual framework for appropriate, evidence-based interventions to guide allocation of limited but available resources is challenging. We present this methods paper which describes our efforts to determine the prevalence, etiology, hospital outcomes, and resource utilization associated with pediatric acute, critical illness in RLS globally. Methods: We will conduct a prospective, observational, multicenter, multinational point prevalence study in sixty-one participating RLS hospitals from North, Central and South America, Africa, Middle East and South Asia with four sampling time points over a 12-month period. Children aged 29 days to 14 years evaluated for acute illness or injury in an emergency department) or directly admitted to an inpatient unit will be enrolled and followed for hospital outcomes and resource utilization for the first seven days of hospitalization. The primary outcome will be prevalence of acute critical illness, which Global PARITY has defined as death within 48 hours of presentation to the hospital, including ED mortality; or admission/transfer to an HDU or ICU; or transfer to another institution for a higher level-of-care; or receiving critical care-level interventions (vasopressor infusion, invasive mechanical ventilation, non-invasive mechanical ventilation) regardless of location in the hospital, among children presenting to the hospital. Secondary outcomes include etiology of critical illness, in-hospital mortality, cause of death, resource utilization, length of hospital stay, and change in neurocognitive status. Data will be managed via REDCap, aggregated, and analyzed across sites. Discussion: This study is expected to address the current gap in understanding of the burden, etiology, resource utilization and outcomes associated with pediatric acute and critical illness in RLS. These data are crucial to inform future research and clinical management decisions and to improve global pediatric hospital outcomes. Mención de responsabilidad : Qalab Abbas, Adrian Holloway, Paula Caporal, Eliana López-Barón, Asya Agulnik, Kenneth E. Remy, John A. Appiah, Jonah Attebery, Ericka L. Fink, Jan Hau Lee, Shubhada Hooli, Niranjan Kissoon, Erika Mille, Srinivas Murthy, Fiona Muttalib, Katie Nielsen, Maria Puerto-Torres, Karla Rodrigues, Firas Sakaan, Adriana Teixeira Rodrigues, Erica A. Tabor, Amelie von Saint Andre-von Arnim, Matthew O. Wiens, William Blackwelder, David He, Teresa B. Kortz and Adnan T. Bhutta on behalf of the PALISI Global Health Subgroup the Global PARITY Investigators Referencia : Front Pediatr. 2022 Jan 28;9:793326. DOI (Digital Object Identifier) : 10.3389/fped.2021.793326 PMID : 35155314 Derechos de uso : CC BY En línea : https://www.frontiersin.org/articles/10.3389/fped.2021.793326/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
Reservar este documento
Ejemplares (1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001843 AC-2022-014 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-014Adobe Acrobat PDF
Título : The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study Tipo de documento : documento electrónico Autores : Santiago Cardona Marín, Fecha de publicación : 2022 Títulos uniformes : Revista Brasileira de Terapia Intensiva Idioma : Inglés (eng) Palabras clave : Cannula Oxygenation Respiratory rate Airway extubation Pneumonia Critical care Intensive care units Resumen : Objective: To investigate the applicability of the Respiratory Rate-Oxygenation Index to identify the risk of high-flow nasal cannula failure in post-extubation pneumonia patients. Methods: This was a 2-year retrospective observational study conducted in a reference hospital in Bogotá, Colombia. All patients in whom post-extubation high-flow nasal cannula therapy was used as a bridge to extubation were included in the study. The Respiratory Rate-Oxygenation Index was calculated to assess the risk of post-extubation high-flow nasal cannula failure. Results: A total of 162 patients were included in the study. Of these, 23.5% developed high-flow nasal cannula failure. The Respiratory Rate-Oxygenation Index was significantly lower in patients who had high-flow nasal cannula failure [median (IQR): 10.0 (7.7 - 14.4) versus 12.6 (10.1 - 15.6); p = 0.006]. Respiratory Rate-Oxygenation Index > 4.88 showed a crude OR of 0.23 (95%CI 0.17 - 0.30) and an adjusted OR of 0.89 (95%CI 0.81 - 0.98) stratified by severity and comorbidity. After logistic regression analysis, the Respiratory Rate-Oxygenation Index had an adjusted OR of 0.90 (95%CI 0.82 - 0.98; p = 0.026). The area under the Receiver Operating Characteristic curve for extubation failure was 0.64 (95%CI 0.53 - 0.75; p = 0.06). The Respiratory Rate-Oxygenation Index did not show differences between patients who survived and those who died during the intensive care unit stay. Conclusion: The Respiratory Rate-Oxygenation Index is an accessible tool to identify patients at risk of failing high-flow nasal cannula post-extubation treatment. Prospective studies are needed to broaden the utility in this scenario. Mención de responsabilidad : Yuli V. Fuentes, Katherine Carvajal, Santiago Cardona, Gina Sofia Montaño, Elsa D. Ibáñez-Prada, Alirio Bastidas, Eder Caceres, Ricardo Buitrago, Marcela Poveda, Luis Felipe Reyes Referencia : Rev Bras Ter Intensiva. 2022 Sep 19;34(3):360-366. DOI (Digital Object Identifier) : 10.5935/0103-507X.20220477-en PMID : 36134847 Derechos de uso : CC BY En línea : http://rbti.org.br/artigo/detalhes/0103507X-34-3-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis The Respiratory Rate-Oxygenation Index predicts failure of post-extubation high-flow nasal cannula therapy in intensive care unit patients: a retrospective cohort study [documento electrónico] / Santiago Cardona Marín, . - 2022.
Obra : Revista Brasileira de Terapia Intensiva
Idioma : Inglés (eng)
Palabras clave : Cannula Oxygenation Respiratory rate Airway extubation Pneumonia Critical care Intensive care units Resumen : Objective: To investigate the applicability of the Respiratory Rate-Oxygenation Index to identify the risk of high-flow nasal cannula failure in post-extubation pneumonia patients. Methods: This was a 2-year retrospective observational study conducted in a reference hospital in Bogotá, Colombia. All patients in whom post-extubation high-flow nasal cannula therapy was used as a bridge to extubation were included in the study. The Respiratory Rate-Oxygenation Index was calculated to assess the risk of post-extubation high-flow nasal cannula failure. Results: A total of 162 patients were included in the study. Of these, 23.5% developed high-flow nasal cannula failure. The Respiratory Rate-Oxygenation Index was significantly lower in patients who had high-flow nasal cannula failure [median (IQR): 10.0 (7.7 - 14.4) versus 12.6 (10.1 - 15.6); p = 0.006]. Respiratory Rate-Oxygenation Index > 4.88 showed a crude OR of 0.23 (95%CI 0.17 - 0.30) and an adjusted OR of 0.89 (95%CI 0.81 - 0.98) stratified by severity and comorbidity. After logistic regression analysis, the Respiratory Rate-Oxygenation Index had an adjusted OR of 0.90 (95%CI 0.82 - 0.98; p = 0.026). The area under the Receiver Operating Characteristic curve for extubation failure was 0.64 (95%CI 0.53 - 0.75; p = 0.06). The Respiratory Rate-Oxygenation Index did not show differences between patients who survived and those who died during the intensive care unit stay. Conclusion: The Respiratory Rate-Oxygenation Index is an accessible tool to identify patients at risk of failing high-flow nasal cannula post-extubation treatment. Prospective studies are needed to broaden the utility in this scenario. Mención de responsabilidad : Yuli V. Fuentes, Katherine Carvajal, Santiago Cardona, Gina Sofia Montaño, Elsa D. Ibáñez-Prada, Alirio Bastidas, Eder Caceres, Ricardo Buitrago, Marcela Poveda, Luis Felipe Reyes Referencia : Rev Bras Ter Intensiva. 2022 Sep 19;34(3):360-366. DOI (Digital Object Identifier) : 10.5935/0103-507X.20220477-en PMID : 36134847 Derechos de uso : CC BY En línea : http://rbti.org.br/artigo/detalhes/0103507X-34-3-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
Reservar este documento
Ejemplares (1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001952 AC-2022-113 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
AC-2022-113Adobe Acrobat PDF
Título : Delirium during the first evaluation of children aged five to 14 years admitted to a paediatric critical care unit Tipo de documento : documento electrónico Autores : Mussatyé Elorza Parra, ; Katerine Uribe Hernández, Fecha de publicación : 2018 Títulos uniformes : Intensive & Critical Care Nursing Idioma : Inglés (eng) Palabras clave : Critical care delirium nursing diagnosis prevalence Resumen : Objectives: To describe the prevalence and characteristics of delirium during the initial evaluation of critically ill patients aged 5–14 years. Method/design: This is a cross-sectional descriptive study in a critical care unit. For six months, all patients were evaluated within the first 24–72 hours or when sedation permitted the use of the paediatric confusion assessment method for the intensive care unit (PCAM-ICU) and the Delirium Rating Scale-Revised-98 items #7 and #8 to determine motor type. We report the characteristics of PCAM-ICU delirium (at least three of the required items scored positive) and of subthreshold score cases (two positive items). Results: Of 77 admissions, 15 (19.5%) had delirium, and 11 (14.2%) were subthreshold. A total of 53.3% of delirium and 45.5% of subthreshold cases were hypoactive. The prevalence of delirium and subthreshold PCAM-ICU was 83.3% and 16.7% in mechanically ventilated children. The most frequent combination of PCAM-ICU alterations in subthreshold cases was acute onset-fluctuation with altered alertness. The main nursing diagnoses were related to reduced cellular respiration. Conclusions: Delirium is common in critically ill children. It is necessary to assess whether certain nursing diagnoses imply an increase in delirium. Longitudinal studies of subthreshold PCAM-ICU cases are needed to understand their importance better. Mención de responsabilidad : Eliana María Cano Londoño, Isabel Cristina Mejía Gil, Katerine Uribe Hernández, Carmenza Alexandra Ricardo Ramírez, Matilde Ligia Álvarez Gómez, Ricardo Antonio Consuegra Peña, Camilo Andrés Agudelo Vélez, Susana Zuluaga Penagos, Mussatye Elorza Parra, José G Franco Vásquez Referencia : Intensive Crit Care Nurs. 2018 Apr;45:37-43. DOI (Digital Object Identifier) : 10.1016/j.iccn.2017.12.010 PMID : 29428252 En línea : https://linkinghub.elsevier.com/retrieve/pii/S0964339717300678 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Delirium during the first evaluation of children aged five to 14 years admitted to a paediatric critical care unit [documento electrónico] / Mussatyé Elorza Parra, ; Katerine Uribe Hernández, . - 2018.
Obra : Intensive & Critical Care Nursing
Idioma : Inglés (eng)
Palabras clave : Critical care delirium nursing diagnosis prevalence Resumen : Objectives: To describe the prevalence and characteristics of delirium during the initial evaluation of critically ill patients aged 5–14 years. Method/design: This is a cross-sectional descriptive study in a critical care unit. For six months, all patients were evaluated within the first 24–72 hours or when sedation permitted the use of the paediatric confusion assessment method for the intensive care unit (PCAM-ICU) and the Delirium Rating Scale-Revised-98 items #7 and #8 to determine motor type. We report the characteristics of PCAM-ICU delirium (at least three of the required items scored positive) and of subthreshold score cases (two positive items). Results: Of 77 admissions, 15 (19.5%) had delirium, and 11 (14.2%) were subthreshold. A total of 53.3% of delirium and 45.5% of subthreshold cases were hypoactive. The prevalence of delirium and subthreshold PCAM-ICU was 83.3% and 16.7% in mechanically ventilated children. The most frequent combination of PCAM-ICU alterations in subthreshold cases was acute onset-fluctuation with altered alertness. The main nursing diagnoses were related to reduced cellular respiration. Conclusions: Delirium is common in critically ill children. It is necessary to assess whether certain nursing diagnoses imply an increase in delirium. Longitudinal studies of subthreshold PCAM-ICU cases are needed to understand their importance better. Mención de responsabilidad : Eliana María Cano Londoño, Isabel Cristina Mejía Gil, Katerine Uribe Hernández, Carmenza Alexandra Ricardo Ramírez, Matilde Ligia Álvarez Gómez, Ricardo Antonio Consuegra Peña, Camilo Andrés Agudelo Vélez, Susana Zuluaga Penagos, Mussatye Elorza Parra, José G Franco Vásquez Referencia : Intensive Crit Care Nurs. 2018 Apr;45:37-43. DOI (Digital Object Identifier) : 10.1016/j.iccn.2017.12.010 PMID : 29428252 En línea : https://linkinghub.elsevier.com/retrieve/pii/S0964339717300678 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
Reservar este documento
Ejemplares (1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000719 AC-2018-006 Archivo digital Producción Científica Artículos científicos Disponible
Título : The potential impact of admission insulin levels on patient outcome in the intensive care unit Tipo de documento : documento electrónico Autores : Gisela de la Rosa Echavez, ; Esdras Martín Vásquez Mejía, ; Jorge Hernando Donado Gómez, ; Marisol Bedoya Arias, ; Álvaro Humberto Restrepo Cuartas, ; Gustavo Roncancio, ; Carlos Alberto Cadavid Gutiérrez, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2013 Títulos uniformes : Journal of Trauma and Acute Care Surgery Idioma : Inglés (eng) Palabras clave : Insulin insulin resistance critical care critical illness outcome Resumen : Background: Blood levels of insulin in patients with critical illness at admission to the intensive care unit (ICU) and its association with in hospital mortality are not fully defined. Our objective was to determine this association in a cohort of patients with critical illness who attended in a mixed ICU. Methods: Prospective cohort was nested in a randomized clinical trial conducted in a 12-bed mixed ICU in a tertiary hospital in Medellin (Colombia). One hundred sixty consecutively admitted patients, 15 years or older, were analyzed. Blood insulin and blood glucose levels were measured at admission to the ICU, as well as Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. A logistic regression model was created with in-hospital mortality as the outcome. Results: In-hospital mortality was 57 (35.6%) of 160. Survivors had lower Acute Physiology and Chronic Health Evaluation II (median, 13 vs. 17) and lower insulin levels (median, 6.5 vs. 9 µU/mL) than did nonsurvivors. More women than men died (27 [48.2%] of 56 vs. 30 [28.8%] of 104), and 39% of the deaths (n = 22) occurred in patients with sepsis. Patients with insulin levels greater than 15 µU/mL had a higher mortality rate compared with patients with values of 5 µU/mL to 15 µU/mL (odds ratio, 3.57; 95% confidence interval, 1.18–10.8). Conclusion: At admission to the ICU, patients with critical illness showed hyperglycemia and relatively decreased insulin levels. High levels of insulin were independently associated with in-hospital mortality in this study population. Mención de responsabilidad : Gisela De La Rosa, Esdras Martin Vasquez, Alvaro Mauricio Quintero, Jorge Hernando Donado, Marisol Bedoya, Alvaro Humberto Restrepo, Gustavo Roncancio, Carlos Alberto Cadavid, Fabian Alberto Jaimes, Grupo de Investigacion en Cuidado Intensivo GICI-HPTU Referencia : J Trauma Acute Care Surg. 2013 Jan;74(1):270-5. DOI (Digital Object Identifier) : 10.1097/TA.0b013e3182788042 PMID : 23271103 En línea : https://journals.lww.com/jtrauma/Abstract/2013/01000/The_potential_impact_of_adm [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis The potential impact of admission insulin levels on patient outcome in the intensive care unit [documento electrónico] / Gisela de la Rosa Echavez, ; Esdras Martín Vásquez Mejía, ; Jorge Hernando Donado Gómez, ; Marisol Bedoya Arias, ; Álvaro Humberto Restrepo Cuartas, ; Gustavo Roncancio, ; Carlos Alberto Cadavid Gutiérrez, ; Fabián Alberto Jaimes Barragán, . - 2013.
Obra : Journal of Trauma and Acute Care Surgery
Idioma : Inglés (eng)
Palabras clave : Insulin insulin resistance critical care critical illness outcome Resumen : Background: Blood levels of insulin in patients with critical illness at admission to the intensive care unit (ICU) and its association with in hospital mortality are not fully defined. Our objective was to determine this association in a cohort of patients with critical illness who attended in a mixed ICU. Methods: Prospective cohort was nested in a randomized clinical trial conducted in a 12-bed mixed ICU in a tertiary hospital in Medellin (Colombia). One hundred sixty consecutively admitted patients, 15 years or older, were analyzed. Blood insulin and blood glucose levels were measured at admission to the ICU, as well as Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores. A logistic regression model was created with in-hospital mortality as the outcome. Results: In-hospital mortality was 57 (35.6%) of 160. Survivors had lower Acute Physiology and Chronic Health Evaluation II (median, 13 vs. 17) and lower insulin levels (median, 6.5 vs. 9 µU/mL) than did nonsurvivors. More women than men died (27 [48.2%] of 56 vs. 30 [28.8%] of 104), and 39% of the deaths (n = 22) occurred in patients with sepsis. Patients with insulin levels greater than 15 µU/mL had a higher mortality rate compared with patients with values of 5 µU/mL to 15 µU/mL (odds ratio, 3.57; 95% confidence interval, 1.18–10.8). Conclusion: At admission to the ICU, patients with critical illness showed hyperglycemia and relatively decreased insulin levels. High levels of insulin were independently associated with in-hospital mortality in this study population. Mención de responsabilidad : Gisela De La Rosa, Esdras Martin Vasquez, Alvaro Mauricio Quintero, Jorge Hernando Donado, Marisol Bedoya, Alvaro Humberto Restrepo, Gustavo Roncancio, Carlos Alberto Cadavid, Fabian Alberto Jaimes, Grupo de Investigacion en Cuidado Intensivo GICI-HPTU Referencia : J Trauma Acute Care Surg. 2013 Jan;74(1):270-5. DOI (Digital Object Identifier) : 10.1097/TA.0b013e3182788042 PMID : 23271103 En línea : https://journals.lww.com/jtrauma/Abstract/2013/01000/The_potential_impact_of_adm [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_dis Reserva
Reservar este documento
Ejemplares (1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000233 AC-2013-001 Archivo digital Producción Científica Artículos científicos Disponible
