scholarly journals Hyperlactatemia and Lactic Acidosis Results in Longer Stay in Intensive Care Units (ICUs) and Development of Co-morbid in Post-operative Cardiac Surgery Patients

2016 ◽  
Vol 1 (05) ◽  
Author(s):  
Junaid Mahmood Alam ◽  
Aijaz Ahmed, ◽  
Ishrat Sultana ◽  
Syed Riaz Mahmood
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Lactic Acidosis ◽  
Intensive Care Units ◽  
Lactate Level ◽  
Normal Range ◽  
Intensive Care Stay ◽  
Pulmonary Abnormalities

Pathology of Hyperlactatemia and lactic acidosis is convoluted, including tissue hypoxia, pulmonary abnormalities, Ischemic shock, hypohemoglobinemia and generalized an-aerobic conditions. All or any one of these conditions may have occurred due to surgical intervention, long-term cardiogeneic syndromes or after long Intensive care stay. Present study described the assessment and correlation of post-operative Hyperlactatemia in cardiac surgery patients to the longer length of stay in Intensive care units (ICUs). Pre-operative and Post operative blood samples were analyzed in seventy five (Males = 59, females = 16) cardiac surgery patients for Lactate and other biochemical parameters were according to the prescribed methods. Post-operative blood sample analyses were also performed 4-6 hrs after surgery and after 24 hrs post-operatively. Six hours postoperative assessment of lactate, showed alerted levels, manifesting post-operative complications and development of co-morbid. It was also noted that patients (n = 21) with higher lactate >20mg/dl had to stay longer in ICUs (12-18 days stay, average 16.15 ± 2.50 days) as compared to those (n = 54) with normal range of lactate level (5-9 days stay, average 7.20 ± 2.10 days). It is thus concluded that post-operative Hyperlactatemia and lactic acidosis in cardiac surgery patients is a significant condition to detect poor outcome. Additionally post-operative lactate level can predict length of stay in ICUs and any prospect of developing adverse outcome and co-morbid.

Survival, Functional Capacity, and Quality of Life after Cardiac Surgery Followed by Long-Term Intensive Care Stay

2013 ◽  
Vol 61 (08) ◽  
pp. 696-700 ◽  
Author(s):  
Romy Schreier ◽  
Lemir El-Ayoubi ◽  
Stefan Erler ◽  
Aiman Alken ◽  
Gerhard Wimmer-Greinecker ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Functional Capacity ◽  
Intensive Care Stay

Survival after cardiac surgery and long-term intensive care unit stay

2013 ◽  
Vol 61 (S 01) ◽  
Author(s):  
C Schimmer ◽  
K Hamouda ◽  
M Özkur ◽  
SP Sommer ◽  
I Aleksic ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Unit Stay

scholarly journals Postoperative delirium after cardiac surgery of elderly patients as an independent risk factor for prolonged length of stay in intensive care unit and in hospital

2021 ◽  
Author(s):  
Andrea Kirfel ◽  
Jan Menzenbach ◽  
Vera Guttenthaler ◽  
Johanna Feggeler ◽  
Andreas Mayr ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Length Of Stay ◽  
Elderly Patients ◽  
Postoperative Delirium ◽  
Confusion Assessment Method ◽  
Assessment Method ◽  
Hospital Length Of Stay ◽  
Confusion Assessment

Abstract Background Postoperative delirium (POD) is a relevant and underdiagnosed complication after cardiac surgery that is associated with increased intensive care unit (ICU) and hospital length of stay (LOS). The aim of this subgroup study was to compare the frequency of tested POD versus the coded International Statistical Classification of Diseases and Related Health Problems (ICD) diagnosis of POD and to evaluate the influence of POD on LOS in ICU and hospital. Methods 254 elective cardiac surgery patients (mean age, 70.5 ± 6.4 years) at the University Hospital Bonn between September 2018 and October 2019 were evaluated. The endpoint tested POD was considered positive, if one of the tests Confusion Assessment Method for ICU (CAM-ICU) or Confusion Assessment Method (CAM), 4 'A's Test (4AT) or Delirium Observation Scale (DOS) was positive on one day. Results POD occurred in 127 patients (50.0%). LOS in ICU and hospital were significantly different based on presence (ICU 165.0 ± 362.7 h; Hospital 26.5 ± 26.1 days) or absence (ICU 64.5 ± 79.4 h; Hospital 14.6 ± 6.7 days) of POD (p < 0.001). The multiple linear regression showed POD as an independent predictor for a prolonged LOS in ICU (48%; 95%CI 31–67%) and in hospital (64%; 95%CI 27–110%) (p < 0.001). The frequency of POD in the study participants that was coded with the ICD F05.0 and F05.8 by hospital staff was considerably lower than tests revealed by the study personnel. Conclusion Approximately 50% of elderly patients who underwent cardiac surgery developed POD, which is associated with an increased ICU and hospital LOS. Furthermore, POD is highly underdiagnosed in clinical routine.

ICU admissions: Consequences after discharge

2020 ◽  
Vol 13 (9) ◽  
pp. 550-556
Author(s):  
Minal Karavadra ◽  
Ricky Bell
Keyword(s):  
Intensive Care ◽  
Cognitive Decline ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Psychiatric Disturbance ◽  
Intensive Care Department ◽  
Previous Level ◽  
The Uk

The intensive care department may seem a long way from the GP's consulting room, but every year tens of thousands of critically ill patients are admitted to intensive care units (ICUs) across the UK. Patients are often left with long term sequelae that may require GP input. Physical weakness, psychiatric disturbance and cognitive decline are not uncommon after an illness that requires a stay in an ICU. These hinder a patient’s return to their previous level of function and impact caregivers after discharge. This article aims to highlight the chronic symptoms patients can acquire during ICU admission that may come to the attention of GPs for their advice and treatment.

Characteristics and outcome of admissions to general intensive care units following cardiac surgery

2004 ◽  
Vol 21 (Supplement 33) ◽  
pp. 25
Author(s):  
S. M. Walther ◽  
D. A. Harrison ◽  
A. R. Brady ◽  
K. Rowan
Keyword(s):  
Cardiac Surgery ◽  
Intensive Care ◽  
Intensive Care Units

scholarly journals Primary versus Staged Closure of Exomphalos Major: Cardiac Anomalies Do Not Affect Outcome

2017 ◽  
Vol 28 (03) ◽  
pp. 279-284 ◽  
Author(s):  
Clare Rees ◽  
Lucinda Tullie ◽  
Agostino Pierro ◽  
Edward Kiely ◽  
Joe Curry ◽  
...  
Keyword(s):  
Intensive Care ◽  
Length Of Stay ◽  
Primary Closure ◽  
Single Center ◽  
Fascial Defect ◽  
Pentalogy Of Cantrell ◽  
Cardiac Anomalies ◽  
Intensive Care Stay ◽  
Congenital Cardiac Anomalies ◽  
Liver Herniation

Aim The objective of the study is to describe management of exomphalos major and investigate the effect of congenital cardiac anomalies. Methods A single-center retrospective review (with audit approval) was performed of neonates with exomphalos major (fascial defect ≥ 5cm ± liver herniation) between 2004 and 2014.Demographic and operative data were collected and outcomes compared between infants who had primary or staged closure. Data, median (range), were analyzed appropriately. Results A total of 22 patients were included, 20 with liver herniation and 1 with pentalogy of Cantrell. Gestational age was 38 (30–40) weeks, birth weight 2.7 (1.4–4.6) kg, and 13 (60%) were male. Two were managed conservatively due to severe comorbidities, 5 underwent primary closure, and 15 had application of Prolene (Ethicon Inc) mesh silo and serial reduction. Five died, including two managed conservatively, none primarily of the exomphalos. Survivors were followed up for 38 months (2–71). Cardiac anomalies were present in 20 (91%) patients: 8 had minor and 12 major anomalies. Twelve (55%) patients had other anomalies. Primary closure was associated with shorter length of stay (13 vs. 85 days, p = 0.02), but infants had similar lengths of intensive care stay, duration of parenteral feeds, and time to full feeds. Infants with cardiac anomalies had shorter times to full closure (28 vs. 62 days, p = 0.03), but other outcomes were similar. Conclusion Infants whose defect can be closed primarily have a shorter length of stay, but other outcomes are similar. Infants with more significant abdominovisceral disproportion are managed with staged closure; the presence of major cardiac anomalies does not affect surgical outcome.

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