• Title/Summary/Keyword: Post-Intensive Care Syndrome

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Early Mobilization and Rehabilitation of Critically-Ill Patients

  • Hye Min Ji;Yu Hui Won
    • Tuberculosis and Respiratory Diseases
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    • v.87 no.2
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    • pp.115-122
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    • 2024
  • Post-intensive care unit (ICU) syndrome may occur after ICU treatment and includes ICU-acquired weakness (ICU-AW), cognitive decline, and mental problems. ICU-AW is muscle weakness in patients treated in the ICU and is affected by the period of mechanical ventilation. Diaphragmatic weakness may also occur because of respiratory muscle unloading using mechanical ventilators. ICU-AW is an independent predictor of mortality and is associated with longer duration of mechanical ventilation and hospital stay. Diaphragm weakness is also associated with poor outcomes. Therefore, pulmonary rehabilitation with early mobilization and respiratory muscle training is necessary in the ICU after appropriate patient screening and evaluation and can improve ICU-related muscle weakness and functional deterioration.

Risk Factors for Postoperative Delirium after Liver Transplantation in the Intensive Care Unit (간이식 후 중환자실에서의 섬망 발생 위험요인)

  • Cha, Ok-Hee;Yoo, Yang-Sook;Choi, Jung-Eun;Kim, Nam-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.16 no.3
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    • pp.290-299
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    • 2009
  • Purpose: The objectives of this study were to determine the prevalence, incidence, duration and risk factors for delirium following liver transplantation while the patients were in the acute stage and admitted to the intensive care unit. Method: A retrospective chart review of 106 patients who had liver transplantation was conducted. A delirium risk factor checklist was used, to collect preoperative and postoperative data. Descriptive analysis, t-test, x2-test, and logistic regression analyses were used for data analysis. Results: The post-transplantation incidence of delirium was 29.3% (n=31). Multivariate analysis revealed that risk factors were preoperative conditions in the patients including spontaneous bacterial peritonitis, hepatorenal syndrome, and postoperative laboratory test results, such as hyperbilirubinemia. Conclusion: Therefore, a daily delirium risk factor assessment should be conducted before liver transplantation as a way to identify risk of delirium after the liver transplantation and to effectively manage delirium when it occurs.

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Transfusion of red blood cells in neonatology

  • BENNAOUI, Fatiha;SLITINE, N El Idrissi;QORCHI, H.;MAOULAININE, F.M.R
    • The Korean Journal of Food & Health Convergence
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    • v.6 no.3
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    • pp.23-29
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    • 2020
  • Blood transfusion in the neonatal period remains a therapeutic act, that no one dares to consider it as perfectly innocuous and that it is advisable to make rare, considering its risks as well immunological as infectious. The present work is a retrospective study, conducted in neonatal intensive care unit, in the University Hospital MOHAMED VI, Marrakech, during the period from January 1st to December 31st, 2019. All newborns were included in this work, who received one or multiple transfusions of red blood cells (RBC). Our study covered 60 neonates with a total of birth: 794 neonates, with a prevalence of 7.55%, hospitalized for various indications (60% of newborns were at term, 31.7% premature and 8, 33% were post-mature. The majority of transfusion procedures were performed during the first week of life. This is explained by the frequency of haemolytic anemias by fœto-maternal incompatibility. The main indications for transfusion were haemolysis, anemic syndrome and haemorrhagic syndrome. The average number of transfusion episodes was 1.95 +/- 1.47 per patient. Newborns were polytransfused in 18.33% of cases. A single transfusion accident was found in our study. However, we did not observe a correlation between the maternal diseases, the state of the newborn, and the transfusional indication.

PSE (pale, soft, exudative) Pork : The Causes and Solutions - Review -

  • Lee, Y.B.;Choi, Y.I.
    • Asian-Australasian Journal of Animal Sciences
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    • v.12 no.2
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    • pp.244-252
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    • 1999
  • Intensive selection for muscle development and against fat deposition in pigs during the last 50 years has contributed to the increased incidence of porcine stress syndrome (PSS) and pale soft exudative pork (PSE). Genetics, nutrition and management, preslaughter animal handling, stunning, dehairing and carcass chilling influence the incidence and magnitude of the PSE condition. The normal incidence of PSE has been reported to range from 10 to 30%, but in some isolated instances is up to 60%. The elimination of halothane-positive pigs in breeding programs has reduced PSS and PSE. Further improvements in meat quality by terminal sire evaluation and selection can be achieved within halothane-negative populations because around 20% of the variation in meat color and water binding capacity seems to be genetically related. Pre-slaughter handling on the farm, during transit to the packing plant and at the packing plant can greatly influence the meat quality, contributing 10 to 25% of the variation. An effective stunning method, skinning instead of scalding/dehairing and rapid post-slaughter chilling further reduce the incidence of PSE pork. In addition to proper care and handling a carcass-merit based marketing system, that reflected the value differential between desirable and undesirable meat quality in the pricing system for pigs, would provide a great incentive to change pork production systems in order to improve meat quality, thus improving the image and usefulness of pork as food.

Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019

  • Lee, Jang Hoon;Youn, YoungAh;Chang, Yun Sil
    • Clinical and Experimental Pediatrics
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    • v.63 no.8
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    • pp.284-290
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    • 2020
  • Korea currently has the world's lowest birth rate but a rapidly inreasing number of preterm infants. The Korean Neonatal Network (KNN), launched by the Korean Society of Neonatology under the support of Korea Centers for Disease Control, has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. In terms of the short-term outcomes of VLBWIs born from 2013 to 2016 registered in the KNN, the survival rate of all VLBWIs was 86%. Respiratory distress syndrome and bronchopulmonary dysplasia were observed in 78% and 30% of all VLBWIs, respectively. Necrotizing enterocolitis occurred in 7%, while 8% of the VLBWIs needed therapy for retinopathy of prematurity in the neonatal intensive care unit (NICU). Sepsis occurred in 21% during their NICU stay. Intraventricular hemorrhage (grade ≥III) was diagnosed in 10%. In terms of the long-term outcomes for VLBWIs born from 2013 to 2014 registered in the KNN, the post-discharge mortality rate was approximately 1.2%-1.5%, mainly owing to their underlying illness. Nearly half of the VLBWIs were readmitted to the hospital at least once in their first 1-2 years of life, mostly as a result of respiratory diseases. The overall prevalence of cerebral palsy was 6.2%-6.6% in Korea. Bilateral blindness was reported in 0.2%-0.3% of VLBWIs, while bilateral hearing loss was found in 0.8%-1.9%. Since its establishment, the KNN has published annual reports and papers that facilitate the improvement of VLBWI outcome and the formulation of essential healthcare policies in Korea.

Clinical and Imaging Characteristics of SARS-CoV-2 Breakthrough Infection in Hospitalized Immunocompromised Patients

  • Jong Eun Lee;Jinwoo Kim;Minhee Hwang;Yun-Hyeon Kim;Myung Jin Chung;Won Gi Jeong;Yeon Joo Jeong
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.481-492
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    • 2024
  • Objective: To evaluate the clinical and imaging characteristics of SARS-CoV-2 breakthrough infection in hospitalized immunocompromised patients in comparison with immunocompetent patients. Materials and Methods: This retrospective study analyzed consecutive adult patients hospitalized for COVID-19 who received at least one dose of the SARS-CoV-2 vaccine at two academic medical centers between June 2021 and December 2022. Immunocompromised patients (with active solid organ cancer, active hematologic cancer, active immune-mediated inflammatory disease, status post solid organ transplantation, or acquired immune deficiency syndrome) were compared with immunocompetent patients. Multivariable logistic regression analysis was performed to evaluate the effect of immune status on severe clinical outcomes (in-hospital death, mechanical ventilation, or intensive care unit admission), severe radiologic pneumonia (≥ 25% of lung involvement), and typical CT pneumonia. Results: Of 2218 patients (mean age, 69.5 ± 16.1 years), 274 (12.4%), and 1944 (87.6%) were immunocompromised an immunocompetent, respectively. Patients with active solid organ cancer and patients status post solid organ transplantation had significantly higher risks for severe clinical outcomes (adjusted odds ratio = 1.58 [95% confidence interval {CI}, 1.01-2.47], P = 0.042; and 3.12 [95% CI, 1.47-6.60], P = 0.003, respectively). Patient status post solid organ transplantation and patients with active hematologic cancer were associated with increased risks for severe pneumonia based on chest radiographs (2.96 [95% CI, 1.54-5.67], P = 0.001; and 2.87 [95% CI, 1.50-5.49], P = 0.001, respectively) and for typical CT pneumonia (9.03 [95% CI, 2.49-32.66], P < 0.001; and 4.18 [95% CI, 1.70-10.25], P = 0.002, respectively). Conclusion: Immunocompromised patients with COVID-19 breakthrough infection showed an increased risk of severe clinical outcome, severe pneumonia based on chest radiographs, and typical CT pneumonia. In particular, patients status post solid organ transplantation was specifically found to be associated with a higher risk of all three outcomes than hospitalized immunocompetent patients.