scholarly journals Prognostic Role of High-sensitivity Cardiac Troponin I and Soluble Suppression of Tumorigenicity-2 in Surgical Intensive Care Unit Patients Undergoing Non-cardiac Surgery

2018 ◽  
Vol 38 (3) ◽  
pp. 204-211 ◽  
Author(s):  
Hyun Suk Yang ◽  
Mina Hur ◽  
Ahram Yi ◽  
Hanah Kim ◽  
Jayoun Kim
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cardiac Troponin ◽  
Troponin I ◽  
High Sensitivity ◽  
Surgical Intensive Care Unit ◽  
Prognostic Role ◽  
Surgical Intensive Care

Survey of Physiotherapy Practice in Ontario Cardiac Surgery Intensive Care Units

2021 ◽  
pp. e20200069
Author(s):  
Anastasia N.L. Newman ◽  
Michelle E. Kho ◽  
Jocelyn E. Harris ◽  
Alison Fox-Robichaud ◽  
Patricia Solomon
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Critically Ill ◽  
Outcome Measures ◽  
Median Number ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Physiotherapy Practice

Purpose: This article describes current physiotherapy practice for critically ill adult patients requiring prolonged stays in critical care (> 3 d) after complicated cardiac surgery in Ontario. Method: We distributed an electronic, self-administered 52-item survey to 35 critical care physiotherapists who treat adult cardiac surgery patients at 11 cardiac surgical sites. Pilot testing and clinical sensibility testing were conducted beforehand. Participants were sent four email reminders. Results: The response rate was 80% (28/35). The median (inter-quartile range) reported number of cardiac surgeries performed per week was 30 (10), with a median number of 14.5 (4) cardiac surgery beds per site. Typical reported caseloads ranged from 6 to 10 patients per day pe therapist, and 93% reported that they had initiated physiotherapy with patients once they were clinically stable in the intensive care unit. Of 28 treatments, range of motion exercises (27; 96.4%), airway clearance techniques (26; 92.9%), and sitting at the edge of the bed (25; 89.3%) were the most common. Intra-aortic balloon pump and extracorporeal membrane oxygenation appeared to limit physiotherapy practice. Use of outcome measures was limited. Conclusions: Physiotherapists provide a variety of interventions with critically ill cardiac surgery patients. Further evaluation of the limited use of outcome measures in the cardiac surgical intensive care unit is warranted.

Staphylococcus AureusRectal Carriage and its Association with Infections in Patients in a Surgical Intensive Care Unit and a Liver Transplant Unit

2002 ◽  
Vol 23 (9) ◽  
pp. 495-501 ◽  
Author(s):  
Cheryl Squier ◽  
John D. Rihs ◽  
Kathleen J. Risa ◽  
Asia Sagnimeni ◽  
Marilyn M. Wagener ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Liver Transplant ◽  
Nasal Carriage ◽  
Pulsed Field Gel Electrophoresis ◽  
Surgical Intensive Care Unit ◽  
Transplant Recipients ◽  
Surgical Intensive Care ◽  
Liver Transplant Recipients

Background:The role of rectal carriage ofStaphylococcus aureusas a risk factor for nosocomialS. aureusinfections in critically ill patients has not been fully discerned.Methods:Nasal and rectal swabs forS. aureuswere obtained on admission and weekly thereafter until discharge or death from 204 consecutive patients admitted to the surgical intensive care unit and liver transplant unit.Results:Overall, 49.5% (101 of 204) of the patients never harboredS. aureus, 21.6% (44 of 204) were nasal carriers only, 3.4% (7 of 204) were rectal carriers only, and 25.5% (52 of 204) were both nasal and rectal carriers. Infections due toS. aureusdeveloped in 15.7% (32 of 204) of the patients; these included 3% (3 of 101) of the non-carriers, 18.2% (8 of 44) of the nasal carriers only, 0% (0 of 7) of the rectal carriers only, and 40.4% (21 of 52) of the patients who were both nasal and rectal carriers (P= .001). Patients with both rectal and nasal carriage were significantly more likely to developS. aureusinfection than were those with nasal carriage only (odds ratio, 3.9; 95% confidence interval, 1.18 to 7.85;P= .025). By pulsed-field gel electrophoresis, the infecting rectal and nasal isolates were clonally identical in 82% (14 of 17) of the patients withS. aureusinfections.Conclusions:Rectal carriage represents an underappreciated reservoir forS. aureusin patients in the intensive care unit and liver transplant recipients. Rectal plus nasal carriage may portend a greater risk forS. aureusinfections in these patients than currently realized.

Scoring Systems for Outcome Prediction in a Cardiac Surgical Intensive Care Unit: A Comparative Study

2015 ◽  
Vol 24 (4) ◽  
pp. 327-334 ◽  
Author(s):  
Themistocles Exarchopoulos ◽  
Efstratia Charitidou ◽  
Panagiotis Dedeilias ◽  
Christos Charitos ◽  
Christina Routsi
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Clinical Outcome ◽  
Area Under Curve ◽  
Outcome Prediction ◽  
Scoring Systems ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Saps Ii

Background Most scoring systems used to predict clinical outcome in critical care were not designed for application in cardiac surgery patients. Objectives To compare the predictive ability of the most widely used scoring systems (Acute Physiology and Chronic Health Evaluation [APACHE] II, Simplified Acute Physiology Score [SAPS] II, and Sequential Organ Failure Assessment [SOFA]) and of 2 specialized systems (European System for Cardiac Operative Risk Evaluation [EuroSCORE] II and the cardiac surgery score [CASUS]) for clinical outcome in patients after cardiac surgery. Methods Consecutive patients admitted to a cardiac surgical intensive care unit (CSICU) were prospectively studied. Data on the preoperative condition, intraoperative parameters, and postoperative course were collected. EuroSCORE II, CASUS, and scores from 3 general severity-scoring systems (APACHE II, SAPS II, and SOFA) were calculated on the first postoperative day. Clinical outcome was defined as 30-day mortality and in-hospital morbidity. Results A total of 150 patients were included. Thirty-day mortality was 6%. CASUS was superior in outcome prediction, both in relation to discrimination (area under curve, 0.89) and calibration (Brier score = 0.043, χ2 = 2.2, P = .89), followed by EuroSCORE II for 30-day mortality (area under curve, 0.87) and SOFA for morbidity (Spearman ρ= 0.37 and 0.35 for the CSICU length of stay and duration of mechanical ventilation, respectively; Wilcoxon W = 367.5, P = .03 for probability of readmission to CSICU). Conclusions CASUS can be recommended as the most reliable and beneficial option for benchmarking and risk stratification in cardiac surgery patients.

Infectious Complications and Cost-Effectiveness of Open Resuscitation in the Surgical Intensive Care Unit after Cardiac Surgery

1985 ◽  
Vol 40 (4) ◽  
pp. 388-392 ◽  
Author(s):  
Robert L. McKowen ◽  
George J. Magovern ◽  
George A. Liebler ◽  
Sang B. Park ◽  
John A. Burkholder ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cost Effectiveness ◽  
Infectious Complications ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care
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