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At least 19 recordsLinked to original sources
PubMed1978

Metabolic changes during prolonged total parenteral nutrition in intensive care.

Intensive care patients receiving prolonged total parenteral nutrition (TPN) developed alterations of liver function tests, seen in the activity of certain serum enzymes. Hepatomegaly and jaundice sometimes appeared. The changes in chemical pathology were in serum transaminases activity (GOT, GPT, GDH); alkaline phosphatase and gamma-glutamyltranspeptidase as indices of cholestasis; lactate dehydrogenase, hydroxybutyrate dehydrogenase and creatine phosphokinase, as enzymes related to energy metabolism; pseudocholinesterase, as a protein metabolism-related enzyme. The possible causes of these alterations in critically ill patients undergoing TPN are considered and a functional final metabolic interpretation is proposed.

Alanine Transaminase↗
PubMed1979

[Interaction between intensive care patients; a comparison of different intensive care units (author's transl)].

A study was made of the extent and type of contact which patients of an intensive care unit established with each other. The information was obtained by interviewing 92 patients in 4 different types of intensive care units. In evaluating and interpreting the results special attention was paid to the possible influence of 10 patient-specific and disease-specific parameters. 81 per cent of the interviewed persons had established contact, mostly of a verbal nature, with their fellow patients. The majority appreciated the companionship and attached a positive value to the contacts made: communication with the other patients relieved the mental stress arising from their condition and detracted from their anxiety and tendency to brooding; on the other hand, they were also, to some extent, worried that too much excitement might adversely affect their condition. Encouraging talks by the medical team greatly helped towards reducing stress. Even severely ill persons who could no longer actively communicate felt happier in a multi-bed ward: they felt less isolated and more involved and therefore, psychically supported. The fact that the great majority of patients preferred multi-bed units to single rooms suggests that the former have a stabilizing effect, both physically and psychically - an aspect of intensive care that has so far been ignored.

Bed Occupancy↗
PubMed1979

Intensive care for sick neonates, the earlier the better: improved survival rate of IRDS children, referred by means of a mobile neonatal intensive care unit.

A mobile intensive care unit has been used since september 1976 in the region referring sick neonates to the two University Hospital NICU's of Amsterdam. The present study compares two groups of neonates (suffering from the I.R.D.S.) i.e. a group that had been referred by non specialized transport teams (N S T-group) and a group admitted after institution of the neonatal-transport service (S. T.-group). Significant difference is found in the temperature on admission (S T group greater than N S T group). In the N S T-and the S T-group the need for ventilatory assistance was not significantly different but in the S T-group it was started significantly earlier. Survival after institution of ventilatory assistance and overall-survival are significantly better in the S T-group. These conclusions point to the fact that administering intensive care to sick neonates as early as possible and transportation of this group by means of special "neonatal"-transport services increases their survival rates.

Humans↗
PubMed1976

Controlled trial of fetal intensive care.

A fetal intensive care unit was formed at the Queen Victoria Memorial Hospital in 1972. Because of some doubt concerning the value of fetal intensive care, a controlled clinical trial including all high-risk patients was performed. The trial clearly showed that intensive care is associated with improved neurologic and biochemical status of the neonate; however, it is possible that this improvement results from the use of fetal diagnostic tests or some other factor associated with intensive care. Sufficient evidence was gathered to warrant the continuation of fetal intensive care in this hospital, but in other contries, where funding is difficult to obtain, a controlled trial would appear justified.

Blood↗
PubMed1979

[Acute hypoxia and internal intensive care. IV. Results of respirator therapy in an internal intensive care unit].

In the fourth information on the topic acute hypoxia and internal intensive medicine the results of an internal intensive unit in the respiration of internal emergencies during one year are described. Issuing from this, questions of the respiration in insufficiency of the left heart, acute and chronic obstruction of the respiratory tract, restrictive disturbances of the lung, of neurological pictures of the disease, intoxications and shock lung are in the centre of the treatise.

Adult↗
PubMed1978

Symposium on intensive care: 3. Upper gastrointestinal bleeding in the intensive care unit.

Bleeding from hemorrhagic erosions in the stomach or duodenum of seriously ill patients is associated with a high mortality. While the pathogenesis of such lesions is by no means certain, it is known that they are universal after shock, sepsis or severe burns. Fiberoptic endoscopy has become the most valuable means of diagnosis. This should be preceded by gastric irrigaiton, which usually sufficies to control bleeding caused by acetylsalicylic acid or alcohol, or both. Neutralization of gastric acidity is essential. The histamine HI-receptor antagonist, cimetidine, was used in 27 patients with erosive gastritis, and bleeding ceased in 24. There is a prospect that sugh agents will obviate the necessity of total gastrectomy in the occasional resistant cases in favour of conservative surgery.

Antacids↗
PubMed1979

[Comparative analysis of the situation of intensive care (author's transl)].

Intensive care in Hungary in most of the medium size and major hospitals is provided on a proper level thanks for a great effort. The areal distribution of intensive care units is satisfactory. In case that a special intervention cannot be realized in one of the departments lack of instruments or expert personal, usually there is a possibility within 50--70 km distance in another unit to carry out this intervention. As a result of controlled development at the end of the sixth five year plan the units will come up quantitatively as well as qualitatively with all the needs for intensive care. In the present--let us hope transitory--situation the lack of expert personal, out of date hospital constructions and the great variety in types of instruments are meaning serious problems. The difficulties are exaggerrated by the fact that the work on an intensive care unit puts on an increased physical and psychological burden. As a result, in spite of all their interest and beauty the intensive care and its counter pair the anaesthesiology are among the less inviting professions with high incidence of migration and fluctuation of the personal.

Critical Care↗
PubMed2024

Value of a secretomic approach for distinguishing patients with COVID-19 viral pneumonia among patients with respiratory distress admitted to intensive care unit.

In intensive care units, COVID-19 viral pneumonia patients (VPP) present symptoms similar to those of other patients with Nonviral infection (NV-ICU). To better manage VPP, it is therefore interesting to better understand the molecular pathophysiology of viral pneumonia and to search for biomarkers that may clarify the diagnosis. The secretome being a set of proteins secreted by cells in response to stimuli represents an opportunity to discover new biomarkers. The objective of this study is to identify the secretomic signatures of VPP with those of NV-ICU. Plasma samples and clinical data from NV-ICU (n = 104), VPP (n = 30) or healthy donors (HD, n = 20) were collected at Nantes Hospital (France) upon admission. Samples were enriched for the low-abundant proteins and analyzed using nontarget mass spectrometry. Specifically deregulated proteins (DEP) in VPP versus NV-ICU were selected. Combinations of 2 to 4 DEPs were established. The differences in secretome profiles of the VPP and NV-ICU groups were highlighted. Forty-one DEPs were specifically identified in VPP compared to NV-ICU. We describe five of the best combinations of 3 proteins (complement component C9, Ficolin-3, Galectin-3-binding protein, Fibrinogen alpha, gamma and beta chain, Proteoglycan 4, Coagulation factor IX and Cdc42 effector protein 4) that show a characteristic receptor function curve with an area under the curve of 95.0%. This study identifies five combinations of candidate biomarkers in VPP compared to NV-ICU that may help distinguish the underlying causal molecular alterations.

Humans↗
PubMed1978

Intrapartum maternal and fetal monitoring: the obstetric intensive care unit.

The Obstetric Intensive Care Unit (OBICU) at Bellevue Hospital in New York City has adapted intensive care and coronary care models to the care of patients in labor. During the past 3 years, 519 of the most serious of 2 250 high-risk obstetric patients treated at the hospital were monitored in the OBICU. There were two maternal and six perinatal deaths. The perinatal mortality rate of the very high risk population of the OBICU was 11.6/1 000, compared to 14.7/1 000 for all deliveries performed at the hospital. Our findings indicate that the OBICU system provides the ideal mechanism for the rapid and continuous control of symptoms in very high risk gravidas which is essential for stabilizing the patient, both for prompt delivery and for optimal maternal and fetal survival.

Adolescent↗
PubMed1979

[The role of respiratory physiotherapy in an intensive care unit].

In an intensive care unit an important role is assigned to respiratory physiotherapy. Its principal task is efficacious toilet of the bronchi by fluidifying the secretions, promoting their ungluing from the respiratory tree and facilitating their evacuation by cough or by aspiration with a catheter or bronchoscope. The technique comprises the inhalation of a secretolytic (e.g. Bisolvon, NaCl 9%) and, in the case of asthma, bronchospasmolytic (e.g. Ventoline) aerosol followed by breathing exercises. The other objectives of physiotherapy are to ensure a better distribution of inspired air, increase failing ventilation, ameliorate disturbed gas exchange, relax the contracted respiratory muscles and prevent bronchiolar collapse in emphysema during expiration. The field of application of respiratory physiotherapy is large; its purpose is prophylactic and therapeutic. The method is prophylactic in all patients confined to bed, where there is a risk of bronchial obstruction or ventilatory failure, especially in those with severe operation, traumatism or consciousness disorder. Physiotherapy has a therapeutic role in several, principally broncho-pulmonary diseases, such as asthma, obstructive emphysema, pneumonia, bronchiectasis, pulmonary abscess, atelectasis, and pulmonary and pleural fibrosis. Myocardial infarction and pulmonary embolism in the acute state, acute pulmonary edema, pneumothorax and pulmonary hemorrhage are contraindications for physiotherapy. If the method is to be effective the intensive care unit should have a specialized physiotherapist attached to it working there on a daily basis.

Bronchodilator Agents↗