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At least 19 recordsLinked to original sources

PubMed1975

An assessment of the criteria for selection of patients for an obstetric intensive care unit.

Intensive care monitoring of the fetus during labour improves perinatal conditions in 'high-risk" Black women. If the available facilities and staff are to be used with maximal efficiency, a system of priorities is necessary. It would appear that patients with meconium staining of the liquor, with cephalopelvic disproportion, or with two or more indications for monitoring, should have priority for admission to our intensive care unit. Hypertension and antepartum haemorrhage are of less importance, but there are two other problems which need investigation. There is a group of patients in labour who arrive too late to be monitored. They have a considerable perinatal mortality and the reasons for their late arrival need to be ascertained. There is a second group of patients who begin labour before term and deliver babies with a high risk of perinatal death. These problems require further investigation.

Arrhythmias, Cardiac↗

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↗

PubMedDate not supplied

[Noise in an intensive care unit].

An Intensive Care Unit is noisy. These Noises are made by the Machines and the Staff. Nose must be limited and also the patient isolated.

Equipment and Supplies, Hospital↗

PubMed1979

Airway colonization by Flavobacterium in an intensive care unit.

A total of 195 patients admitted to a respiratory-surgical intensive care unit became colonized with species of Flavobacterium during a 70-month prospective study. By biochemical, cultural, and morphological criteria and a comparison of antibiotic susceptibilities, all patient isolates of Flavobacterium were apparently related. The origin of these organisms was sought. Flavobacterium were recovered from different water-associated areas of the hospital and from the hands of respiratory-surgical intensive care care unit staff. The organisms were also found in university dormitory sinks. The isolation of these organisms from tap water led to their recovery from reservoirs supplying drinking water to the city of Boston and surrounding communities. These organisms are resistant to chlorine concentrations found in municipal water. There was no proven case of pneumonia caused by Flavobacterium in 2,329 consecutive patients studied in our respiratory-surgical intensive care unit.

Air Microbiology↗

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↗

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

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↗

PubMed1975

A ceiling module for a newborn intensive care unit.

In a traditional intensive care unit handling of neonates in incubators is usually obstructed by a surrounding clutter of electrical cables and gas tubings used for monitoring care. To solve these problems, an overhead module, provided with electrical and gas supplies and storage facilities for monitoring equipment and apparatus, was developed. The unit is suspended from the ceiling by two columns which serve as conduits for the gas tubing system and electrical wiring separately. The unit described allows for a maximum of flexibility and convenience for care.

Humans↗

PubMed1975

A paediatric respiratory intensive care unit in Lagos.

The respiratory Intensive Care Unit was created at the Lagos University Teaching Hospital in 1963. Experience shows that mortality has been highest in neonates who had congenital anomalies, as well as in children under 2 years of age. The predominant cause of death was preventable respiratory failure. The incidence of mortality was 43 percent. This was related to several factors: (i) the severity of illness, types of illness and antecedent period of neglect; (ii) lack of a critical care medicine programme; (iii) insufficient skilled full-time intensive care personnel, including physicians, nurses, physiotherapists and paramedical specialists; (iv) the high incidence of infection in the Intensive Care Unit.

Age Factors↗

PubMed1979

[Psychosomatic medicine in intensive care units (author's transl)].

Psychosomatic medicine in intensive care units is essentially characterized by problems arising from the emotional involvement of the intensive care unit team. That is why the functions of a psychosomaticist are not only the diagnostics of psychosyndromes and the psychotherapy of dangerously ill patients, but especially the study of psychological interrelations within the unit team. Hypochondriac depressive psychosyndromes caused by the experience of dread, confusion, exhaustion and communication problems, as well as psychosyndromes characterized by a reduction of consciousness and orientation are discussed. Anaclitic psychotherapy, i.e. supporting and encouraging care, and emergency psychotherapy actually required in precarious situations, are described. The specific interrelations within and between the individual groups of the intensive care unit team (physicians, female and male nurses), which are important to the working conditions in the unit, and the possibilities of their psychological activation (e. g. in Balint groups) are outlined. The status and responsibility of a psychosomaticist within the unit team is critically reflected. Finally, the permanent confrontation of the team with death and dying is emphasized, and the psychological aspect of discontinuing intensive care is discussed.

Adjustment Disorders↗

PubMed1979

[Intensive care units in surgery].

The reasons why intensive care units have become essential are examined. The purpose of such units is to modify the organization of hospital assistance according to the concept of progressive treatment in line with the gravity of the disease concerned. Monitoring techniques as a function of the patient's gravity are outlined and the use of electronic processing as a valuable contribution to the surgeon in providing him with a complete and speedy physiological profile of the seriously ill patient is recommended. Finally, the cost of intensive care units is examined and to keep it down careful attention must be paid to the type of pathology admitted to such units. In spite of this by no means negligible factor, institution of such units is still recommended as quickly as possible, their organization being moulded to the situation in question.

Catheterization↗

PubMed1977

[Hospital infections with pseudomonas aeruginosa: I. Technical devices and wet areas as sources of infection in intensive care units (author's transl)].

In an intensive care unit system comprising three surgical intensive care wards bacteriologic investigations on the presence of Pseudomonas aeruginosa were carried out over a period of 7 months (as an example for the aetiology of hospital infections). Centers of contaminations were found to exist in wet areas and in technical devices (ultrasonic nebulizers, respirators etc.). In many cases, the bacterial strains isolated from patients were found by means of phage-typing to be identical with strains isolated from devices and wet areas. Additional experimental investigations showed the predominant role of ultrasonic nebulizers for germ dissemination. On the basis of the results obtained a patient oriented scheme of probable infection chains was tried to establish. Hereby the wet areas play a central role as reservoirs of germs and therapeutical devices as vectors. The results obtained were evaluated in order to define a catalogue of practical measures for interruption of infection chains.

Bacteriophage Typing↗

PubMed1979

Staff nurse turnover in neonatal intensive care units.

The turnover rate and patterns in Neonatal Intensive Care Units (NICUs) were assessed and compared with adult Intensive Care Units (ICUs) and General Infant Care Units at the same hospitals for the year 1976. Thirty-five hospitals with NICUs participated in the study. The findings of this study disagree with the previous literature in three major ways: 1 The turnover rate of staff nurses was less than half that estimated by The National Commission on Nursing for 1970. 2 The turnover rates in ICUs and NICUs were not significantly higher than that for staff nurses in Non-Intensive Care Units. In addition, the pattern of turnover among leavers is identical for all three major types of unit. The variability pattern for neonatal units, however, is statistically significant; this is not so with the other units studied. 3 There is no evidence for a stabilization of turnover following the usual 'induction crisis period' (the first 3 to 6 months).

Evaluation Studies as Topic↗

PubMed1975

Patient material in multidisciplinary intensive care units.

The patient material in the multidisciplinary intensive care unit of Uppsala University Hospital is compared with the material from a recently performed nation-wide study on different intensive care units. A registration chart to record intensive care work and a time and motion study of nursing personnel are presented. It is concluded that such records are necessary to allow valid comparisons of the need for intensive care beds and personnel in hospitals of different sizes and degrees of specialization.

Critical Care↗

PubMedDate not supplied

Experience with an intensive care unit in a developing country.

In September 1963 an intensive care unit was established at the Lagos University Teaching Hospital in Nigeria. The incidence of mortality was significantly high (38%). This was attributed to several factors: (1) severity of illnesses, types of illness and antecedent period of neglect; (2) lack of a critical care medicine program; (3) limited numbers of skilled, full-time intensive care unit personnel, including physicians, nurses, inhalation therapists and paramedics, and (4) the high incidence of sepsis in the intensive care unit.

Developing Countries↗

PubMed1976

The role of intensive care units.

The indications for intensive care are discussed. Selection of patients should be based upon the apparent reversibility of disease processes and the likelihood of producing worthwhile relief of suffering. Admission statistics for one II-bed unit are also presented, and survival rates exceeding 90% of three "model" conditions-namely, fat embolism, tetanus and Gullain-Barré syndrome-are reported. The hospital costs for treating critically ill patients are approximately three times those for treating the "average" patient.

Adolescent↗

PubMed1979

[Mortality factors in infectious diseases in a surgical intensive care unit].

Among 350 patients admitted to a surgical intensive care unit between 1.1.77 and 31.9.77, their profile and septic course being defined, two populations were studied: -- the first involved 49 patients dying of infection during their stay in the department; -- the second involved 132 patients developing a non lethal infectious syndrome. Comparative study of these two patients groups made it easier to understand why, in the same department and apparently with the same kind of care, certain patients die of infection and others do not. It was thus attempted to demonstrate certain difference between the two groups in terms of biometric data, predictable risk factors, the type of underlying pathology and the nature and course of the infectious process. Finally, the role played by the intensive care unit in the onset of these deaths of infectious cause is considered.

Adolescent↗

PubMed1978

[Hygienic requirements for the architectural-functional design of intensive care units (author's transl)].

Three standard variants of intensive care units are described. The hygienic-microbiological examinations of the patients' surrounding show in how fat architectural factors influence the propagation of germs responsible for nosocomial infections. The results are hygienic requirements concerning the architectural functional structure of intensive care units to facilitate the maintenance of anti- and asepsis for the nursing personal.

Facility Design and Construction↗