Articles: intensive-care-units.
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J Clin Monit Comput · Jul 2024
Comparison of continuous temperature measurement methods in the intensive care unit: standard bladder catheter measurements versus non-invasive transcutaneous sensors.
The purpose of this study was to compare a wearable system for body core temperature measurement versus bladder and tympanic thermometers in an intensive care setting. The question was, if continuous non-invasive sensors in the intensive care unit represent an alternative to current standard methods of invasive continuous bladder temperature measurement methods?Between May and September 2023, a comparative investigation involving 112 patients was conducted in a 20-bed surgical intensive care unit to assess various temperature probes, including those placed in the tympanic tube, bladder, and skin. To achieve this, a wireless non-invasive sensor system provided by greenTEG AG, Switzerland, was affixed to different body locations (clavicular and lateral chest) of each catheterized patient (equipped with a temperature probe) admitted to the intensive care unit. ⋯ This makes it a potential alternative to intermittent tympanic measurement devices. In this study we were able to show, that in at least one subset of patients, the non-invasive and continuous device demonstrated a precision comparable to tympanic measurements. The accuracy of all non-invasive methods was lower than in previous studies, suggesting that the use of bladder temperature as reference and user related variations may have introduced additional errors.
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Multicenter Study Observational Study
Risk factors for COVID-19 and their association with mortality in Ecuadorian patients admitted to the ICU: A retrospective cohort multicentric study.
Several risk factors were associated with mortality in patients with coronavirus disease 2019 (COVID-19) infection in intensive care units (ICU). We assessed the effect of risk factors related to the characteristics and clinical history of the population, laboratory test results, drug management, and type of ventilation on the probability of survival/discharge from the ICU. A retrospective cohort multicentric study of adults with COVID-19 admitted to the ICU between March 2020 and December 2021. ⋯ After adjusting for confounders, Cox regression analysis showed that patients were less likely to be discharged alive from the ICU if they met the following conditions: arterial hypertension (hazard ratio [HR] = 0.83 95% CI 0.723-0.964), diabetes mellitus (HR = 0.80 95% CI 0.696-0.938), older than 62 years (HR = 0.86 95% CI 0.790-0.956), obese (body mass index ≥ 30) (HR = 0.78 95% CI 0.697-0.887), 1 unit increase in SOFA score (HR = 0.94 95% CI 0.937-0.961), PaO2/FiO2 ratio <100 mm Hg (HR = 0.84 95% CI 0.786-0.914), and the use of invasive mechanical ventilation (HR = 0.68 95% CI 0.614-0.769). Risk factors associated with increased mortality were older age, obesity, arterial hypertension, and diabetes. Factors such as male gender, chronic obstructive pulmonary disease, acute kidney injury, and cancer reported in other investigations did not have the same effect on mortality in our study.
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This study aims to develop and validate a machine learning (ML) predictive model for assessing mortality in patients with malignant tumors and hyperkalemia (MTH). We extracted data on patients with MTH from the Medical Information Mart for Intensive Care-IV, version 2.2 (MIMIC-IV v2.2) database. The dataset was split into a training set (75%) and a validation set (25%). ⋯ This study demonstrates the effectiveness of ML methods in predicting mortality risk in ICU patients with MTH. It highlights the importance of predictors like urine output and mean heart rate. SHAP and LIME significantly enhanced the model's interpretability.
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Multicenter Study
Changes in quality of life 1 year after intensive care: a multicenter prospective cohort of ICU survivors.
With survival rates of critical illness increasing, quality of life measures are becoming an important outcome of ICU treatment. Therefore, to study the impact of critical illness on quality of life, we explored quality of life before and 1 year after ICU admission in different subgroups of ICU survivors. ⋯ This large prospective multicenter cohort study demonstrated the diversity in long-term quality of life between, and even within, subgroups of ICU survivors. These findings emphasize the need for personalized information and post-ICU care.
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Metagenomic next-generation sequencing (mNGS) was previously established as a method that can increase the pathogen identification rate in patients with severe community-acquired pneumonia (SCAP). ⋯ ChiCTR2000037894.