Revisiting unplanned extubation in the pediatric intensive care unit: What's new?
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The incidence of cardiac arrest in the intensive care unit (ICU-CA) has not been widely reported. We undertook a systematic review and meta-analysis of studies reporting the incidence of cardiac arrest in adult, general intensive care units. The review was prospectively registered with PROSPERO (CRD42017079717). The search identified 7550 records, which included 20 relevant studies for qualitative analysis and 16 of these were included for quantitative analyses. The reported incidence of ICU-CA was 22.7 per 1000 admissions (95% CI: 17.4–29.6) with survival to hospital discharge of 17% (95% CI: 9.5–28.5%). We estimate that at least 5446 patients in the UK have a cardiac arrest after ICU admission. There are limited data and significant variation in the incidence of ICU-CA and efforts to synthesise these are limited by inconsistent reporting. Further prospective studies with standardised process and incidence measures are required to define this important patient group.
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Abstract Hospitalized adult patients suffer from high rates of acute kidney injury (AKI), which puts them at risk for multiple nutrition problems. The etiology and management strategy of AKI has major implications for the management of the hospitalized patient. The purpose of this review is to understand the incidence and management of AKI in hospitalized adult patients and review the challenges to providing adequate nutrition support.
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Abstract Objective The emergence of coronavirus disease 2019 (COVID-19) required countries to establish COVID-19 surveillance by adapting existing systems, such as mandatory notification and syndromic surveillance systems. We estimated age-specific COVID-19 hospitalization and intensive care unit (ICU) burden from existing severe acute respiratory infections (SARI) surveillance and compared the results to COVID-19 notification data. Methods Using data on SARI cases with ICD-10 diagnosis codes for COVID-19 (COVID-SARI) from the ICD-10 based SARI sentinel, we estimated age-specific incidences for COVID-SARI hospitalization and ICU for the first five COVID-19 waves in Germany and compared these to incidences from notification data on COVID-19 cases using relative change Δ r at the peak of each wave. Findings The COVID-SARI incidence from sentinel data matched the notified COVID-19 hospitalization incidence in the first wave with Δ r =6% but was higher during second to fourth wave (Δ r =20% to 39%). In the fifth wave, the COVID-SARI incidence was lower than the notified COVID-19 hospitalization incidence (Δ r =-39%). For all waves and all age groups, the ICU incidence estimated from COVID-SARI was more than twice the estimation from notification data. Conclusion The use of validated SARI sentinel data adds robust and important information for assessing the true disease burden of severe COVID-19. Mandatory notifications of COVID-19 for hospital and ICU admission may underestimate (work overload in local health authorities) or overestimate (hospital admission for other reasons than the laboratory-confirmed SARS-CoV-2 infection) disease burden. Syndromic ICD-10 based SARI surveillance enables sustainable cross-pathogen surveillance for seasonal epidemics and pandemic preparedness of respiratory viral diseases.
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Abstract INTRODUCTION: Post-transplant diabetes mellitus (PTDM) contributes to the risk for cardiovascular disease and infection, reducing graft and patient survival. This study was conducted to identify incidence and risk factors for development of PTDM. METHODS: We studied 50 non-diabetic adult dialyzed patients awaiting renal transplantation prospectively. Oral glucose tolerance test () was performed pre- and post-transplantation. The relation of age, weight (BMI), dialysis modality, family history of diabetes, duration of dialysis was assessed with occurring PTDM. RESULTS: Based on 1 , 13 patients had unknown Diabetes Mellitus; however after transplantation only 9 of them had same results. Based on 2 6(16.22%) patients had actually PTDM. Age of patients with PTDM were significantly higher than those with normal test (43± 17 versus 31± 11 year old) (P 0.05). CONCLUSION: Risk factors for diabetes in our study were age and duration of dialysis before transplantation. Then identifying them might allow modification of post transplant immunosuppressant with nondibetogenic agents in high risk patients. Keywords: post-transplant diabetes mellitus, oral glucose tolerance test, renal transplantation.
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