Inpatients Archives - Critical Care Science (CCS)
Abstract
Rev Bras Ter Intensiva. 2013;25(1):25-31
DOI 10.1590/S0103-507X2013000100006
OBJECTIVE: To calculate the values of the phase angle of septic patients using bioelectrical impedance analysis, correlate the values with clinical and biochemical variables, and compare them to reference values. METHODS: Cohort study conducted with 50 septic patients aged ≥18 years old, admitted to intensive care units, and assessed according to prognostic indexes (APACHE II and SOFA), clinical progression (mortality, severity of sepsis, length of stay in intensive care unit), biochemical parameters (albumin and C-reactive protein), and the phase angle. RESULTS: The average age of the sample was 65.6±16.5 years. Most patients were male (58%) and suffering from septic shock (60%). The average APACHE II and SOFA scores were 22.98±7.1 and 7.5±3.4, respectively. The patients who survived stayed nine days on average (five to 13) in the intensive care unit, and the mortality rate was 30%. The average value of the phase angle was 5.4±2.6° in the total sample and was smaller among the females compared with the males (p=0.01). The phase angle measures did not exhibit an association with the severity of the sepsis, mortality, gender, and age or correlate with the length of hospitalization or the biochemical parameters. The participants' phase angle values adjusted per gender and age were 1.1 to 1.9 times lower compared with the values for a normal population. CONCLUSION: The average value of the phase angle of septic patients was lower compared with the reference values for a healthy population. The phase angle measures did not exhibit association with the clinical and biochemical variables, which might be explained by the sample homogeneity.
Abstract
Rev Bras Ter Intensiva. 2013;25(1):25-31
DOI 10.1590/S0103-507X2013000100006
OBJECTIVE: To calculate the values of the phase angle of septic patients using bioelectrical impedance analysis, correlate the values with clinical and biochemical variables, and compare them to reference values. METHODS: Cohort study conducted with 50 septic patients aged ≥18 years old, admitted to intensive care units, and assessed according to prognostic indexes (APACHE II and SOFA), clinical progression (mortality, severity of sepsis, length of stay in intensive care unit), biochemical parameters (albumin and C-reactive protein), and the phase angle. RESULTS: The average age of the sample was 65.6±16.5 years. Most patients were male (58%) and suffering from septic shock (60%). The average APACHE II and SOFA scores were 22.98±7.1 and 7.5±3.4, respectively. The patients who survived stayed nine days on average (five to 13) in the intensive care unit, and the mortality rate was 30%. The average value of the phase angle was 5.4±2.6° in the total sample and was smaller among the females compared with the males (p=0.01). The phase angle measures did not exhibit an association with the severity of the sepsis, mortality, gender, and age or correlate with the length of hospitalization or the biochemical parameters. The participants' phase angle values adjusted per gender and age were 1.1 to 1.9 times lower compared with the values for a normal population. CONCLUSION: The average value of the phase angle of septic patients was lower compared with the reference values for a healthy population. The phase angle measures did not exhibit association with the clinical and biochemical variables, which might be explained by the sample homogeneity.
Abstract
Rev Bras Ter Intensiva. 2012;24(2):151-156
DOI 10.1590/S0103-507X2012000200009
OBJECTIVE:To characterize drug prescriptions in a university hospital adult intensive care unit. METHODS: Single-center, observational, descriptive, cross-sectional study conducted at an adult general intensive care unit. The study population included all of the unit's inpatients from January to March 2011. The following characteristics for all prescriptions recorded during this period were examined: drug name (generic, brand name or abbreviation), dosage strength, pharmaceutical form, dose, route of administration, patient name, patient registration in the institution, clinic and hospital bed as well as the name, board license number, signature of the prescriber and date of the prescription. It was quantified the percentage of prescribed drugs included in the National List of Essential Drugs, the World Health Organization Model List of Essential Medicines and the University Hospital Center Pharmacotherapy Guide. The prescribed drugs were classified based on the Anatomical Therapeutic Chemical classification system (levels 1 and 2). RESULTS: Eight hundred forty-four prescriptions were reviewed from 72 patients (mean age: 59.04 ± 21.80), 54.92% of whom were female. The mean number of prescriptions per patient was 11.72 ± 11.68. The total number of drugs prescribed was 12,052 and 9,571 (79.41%) of the drugs were prescribed using the generic name. The most frequent absent information in the drug description was the pharmaceutical form of the drug (8,829/73.26%). The dosage strength was indicated in 7,231 (60%) of the prescriptions, and the prescriber and patient information were indicated in over 96% of the prescriptions. The prescribed drugs were classified in 13 therapeutic groups and 55 subgroups. Systemic antibacterials represented one of the most frequently prescribed subgroups. CONCLUSION: Most of the reviewed information was present in the prescriptions. However, the dosage strength and pharmaceutical form were absent in many prescriptions. The characterization of prescriptions at different hospital units is essential for the development of strategies that reduce drug utilization problems.
Abstract
Rev Bras Ter Intensiva. 2012;24(2):151-156
DOI 10.1590/S0103-507X2012000200009
OBJECTIVE:To characterize drug prescriptions in a university hospital adult intensive care unit. METHODS: Single-center, observational, descriptive, cross-sectional study conducted at an adult general intensive care unit. The study population included all of the unit's inpatients from January to March 2011. The following characteristics for all prescriptions recorded during this period were examined: drug name (generic, brand name or abbreviation), dosage strength, pharmaceutical form, dose, route of administration, patient name, patient registration in the institution, clinic and hospital bed as well as the name, board license number, signature of the prescriber and date of the prescription. It was quantified the percentage of prescribed drugs included in the National List of Essential Drugs, the World Health Organization Model List of Essential Medicines and the University Hospital Center Pharmacotherapy Guide. The prescribed drugs were classified based on the Anatomical Therapeutic Chemical classification system (levels 1 and 2). RESULTS: Eight hundred forty-four prescriptions were reviewed from 72 patients (mean age: 59.04 ± 21.80), 54.92% of whom were female. The mean number of prescriptions per patient was 11.72 ± 11.68. The total number of drugs prescribed was 12,052 and 9,571 (79.41%) of the drugs were prescribed using the generic name. The most frequent absent information in the drug description was the pharmaceutical form of the drug (8,829/73.26%). The dosage strength was indicated in 7,231 (60%) of the prescriptions, and the prescriber and patient information were indicated in over 96% of the prescriptions. The prescribed drugs were classified in 13 therapeutic groups and 55 subgroups. Systemic antibacterials represented one of the most frequently prescribed subgroups. CONCLUSION: Most of the reviewed information was present in the prescriptions. However, the dosage strength and pharmaceutical form were absent in many prescriptions. The characterization of prescriptions at different hospital units is essential for the development of strategies that reduce drug utilization problems.
Abstract
Rev Bras Ter Intensiva. 2008;20(3):220-225
DOI 10.1590/S0103-507X2008000300003
OBJECTIVES: Correct cuff inflation allows appropriate ventilation, and prevents aspiration pneumonia as well as several tracheal complications. The objective of this study was to evaluate endotracheal cuff pressure and/or tracheotomy tubes at zero, 30 and 60 degrees inclination of the patient's bed head section in adult intensive care units. METHODS: A cross sectional study was carried out evaluating the cuff pressure, the expiratory tidal volume (VT) and the peak airway pressure (PP) at inclinations zero, 30 and 60 degree of the head section of the patients' bed. The 30 degree inclination was considered the standard position used as control to analyze values in the zero and 60 degree positions, which were randomly ordered. The Student's t test was used and was considered significant when p < 0.05. RESULTS: A sample of 12 women and 12 men with a mean age of 51.29 ± 19.55 years was surveyed. When inclination of the bed head section was changed from 30 to zero degrees, there was a 16.9% mean reduction of the cuff pressure and 11.8% mean increase of the PP. On the other hand, changing the position from 30 to 60 degrees caused a mean reduction of 18.8% in the cuff pressure and a mean increase of 13.3% in the PP. Findings were significant when p < 0.05. CONCLUSIONS: To prevent air leak and risk of aspiration pneumonia, adequate adjustments and monitoring of the patients cuff pressure are necessary when inclination of the bed head section is changed.
Abstract
Rev Bras Ter Intensiva. 2008;20(3):220-225
DOI 10.1590/S0103-507X2008000300003
OBJECTIVES: Correct cuff inflation allows appropriate ventilation, and prevents aspiration pneumonia as well as several tracheal complications. The objective of this study was to evaluate endotracheal cuff pressure and/or tracheotomy tubes at zero, 30 and 60 degrees inclination of the patient's bed head section in adult intensive care units. METHODS: A cross sectional study was carried out evaluating the cuff pressure, the expiratory tidal volume (VT) and the peak airway pressure (PP) at inclinations zero, 30 and 60 degree of the head section of the patients' bed. The 30 degree inclination was considered the standard position used as control to analyze values in the zero and 60 degree positions, which were randomly ordered. The Student's t test was used and was considered significant when p < 0.05. RESULTS: A sample of 12 women and 12 men with a mean age of 51.29 ± 19.55 years was surveyed. When inclination of the bed head section was changed from 30 to zero degrees, there was a 16.9% mean reduction of the cuff pressure and 11.8% mean increase of the PP. On the other hand, changing the position from 30 to 60 degrees caused a mean reduction of 18.8% in the cuff pressure and a mean increase of 13.3% in the PP. Findings were significant when p < 0.05. CONCLUSIONS: To prevent air leak and risk of aspiration pneumonia, adequate adjustments and monitoring of the patients cuff pressure are necessary when inclination of the bed head section is changed.