PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “intensive care units”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
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↗
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↗
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↗
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

[Hospital infections with pseudomonas aeruginosa. II. Intensive care units (author's transl)].

72 newly admitted patients of three surgical intensive care units of the Medical School Hannover were examined bacteriologically for pseudomonas aeruginosa for a period of 7 months. A total of 810 specimens was examined during therapy. 95 strains of pseudomonas aeruginosa were isolated in 32 of 72 patients, taken either at the time of admission or during the stay of the patients in the hospital. The frequency of contamination increased with the duration of the stay of the patients in the hospital as follows: 20 per cent at the time of admission, 71 per cent after 8 to 10-day stay and up to 100 per cent for a duration of stay exceeding 14 days. The germs were mainly localized in the nose-throat region and in the respiratory tract. The results of phage typing suggested a hospital infection in about 50 per cent of the patients. The relationship between infection and infectious disease was discussed with respect to the epidemiologic characteristics of intensive care units. Furthermore, it was attempted to formulate recommendations for interrupting or abolishing the infection chains.

Cross Infection↗
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↗
PubMed1978

Bacterial contamination of telephones in an intensive care unit.

Pathogenic and potentially pathogenic bacteria were found on telephones of an intensive care unit. Direct contamination by microorganisms from throats, hands, and noses of the staff members is real although airborne contamination would also play a role. The awareness of environmental risk in intensive care units is underlined.

Asepsis↗
PubMed1977

Respiratory infection in an intensive care unit.

A postmortem bacteriological study of Black children in a respiratory intensive care unit showed that Pseudomonas aeruginosa was the most common opportunistic pathogen and that it usually complicated a viral infection. In a parallel study of non-debilitated patients in general hospital wards Klebsiella aerogenes and Escherichia coli were the most frequently isolated organisms. Counter-immuno-electrophoresis was used for the identification of Pseudomonas-precipitating antibody in serum and tracheal secretions, and also of Pseudomonas antigen in the latter.

Antigens, Bacterial↗
PubMedDate not supplied

Nurse turnover in the newborn intensive care unit.

Nurse retention has become a significant issue in the newborn intensive care units for two main reasons: 1) the quality of care declines as it is delivered by inexperienced nurses, and 2) the cost of orienting new nurses is exorbitant. "Stress" has been implicated as one of the important factors in nurse retention; it appears that a paradox exists in that the stress/excitement that attracts a nurse to the newborn ICU in the first place may ultimately drive her away. We attempted to define stress factors in the Turner Newborn Intensive Care Unit at Hermann Hospital in Houston, Texas, and to develop management methods to decrease stress. Over a three-year period, during the implementing of new programs, nurse termination rates decreased significantly, as did turnover.

Humans↗
PubMed1977

Aspergillus pneumonia--a cluster of four cases in an intensive care unit.

Four cases of Aspergillus pneumonia occurred in an intensive care unit within a short period. Clusters of cases of invasive aspergillosis are rare and have usually been attributed to excessive contamination of the environment. Extensive environmental studies were, however, negative. Three of the cases were diagnosed ante mortem. One patient survived after early initiation of treatment with amphotericin B.

Adult↗