Background
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection.
Objective
To assess the prevalence and outcome of sepsis in RICU
Patients and methods
The study was conducted upon 403 patients admitted at RICU of the Abbassia Chest Hospital, Cairo, Egypt; 100 of them had sepsis either on admission or acquired in the RICU during the period from May 2019 to November 2019. Severity of illness was assessed by Acute Physiology and Chronic Health Evaluation II (APACHE II score), which was recorded within 24 h from patient admission. Quick sepsis-related organ failure assessment (qSOFA) score was recorded in emergency room, and sepsis-related organ failure assessment (SOFA) score was recorded on ICU admission and on the 3rd and 7th day of ICU stay. Type of infection (community or hospital acquired), infection site, and pathogenic organisms, all were recorded. Assessment was done also regarding mechanical ventilation, length of RICU stay, the presence of comorbidities, survived patients, and dead ones, as regards causes of death and risk factors.
Results
The study included 100 cases with sepsis out of 403 admitted cases in the same duration with frequency 24%. Among sepsis patients, 72% were males and 28%were females, with mean age 51.62 ± 18.62 years. The main diagnosis was pneumonia (62%), and the main comorbidity was diabetes mellitus (23%). There was significant increase in age among non-survivors when compared with survivors. There was significant increase in number of mechanically ventilated patients and a highly significant incidence of complications and need for vasoactive drugs among non-survivors when compared with survivors. There was a highly significant higher APACHE II score on the 1st day of admission among non-survivor patients. The SOFA score was significantly higher on the 1st day of admission and significantly higher on the 3rd and 7th day of admission among non-survivor patients when compared to survived patients.
Conclusion
The current study showed that sepsis affects nearly one quarter of cases admitted at RICU, and it is usually associated with higher mortality rate in those patients.
Trial registration
ClinicalTrials.gov NCT05240157. Registered February 15, 2022. Retrospectively registered.
Background: Although conventional chest radiography remains the first routine radiologic examination in mechanically ventilated patients, chest ultrasound provides more accurate information, with less ionizing radiation and less time delay.Objective: To compare between sensitivity of chest ultrasound and routine daily chest X-ray in diagnosis and follow up of diseases in mechanically ventilated patients admitted at Respiratory ICU of the Ain Shams University Hospital.Design:The study was carried out as a prospective analytical study.Patients and methods: The study was conducted upon twenty-five mechanically ventilated patients (16 male patients and 9 female patients), with a mean age of 58.8 years (SD ± 15.64) who were admitted at the Respiratory Intensive Care Unit of the Ain Shams University Hospital during the period from October 2012 to May 2013. Chest ultrasound examination was done for patients on mechanical ventilation on the first day of enrollment prior to seeing their chest Xray, then follow up daily chest ultrasound examination was done over the entire period of mechanical ventilation with comparison of examination results with that of chest X-ray.Results: Initial chest ultrasound was more sensitive in the detection of pleural effusion (40% of cases) than chest X-ray (8% of cases). This superiority of chest ultrasound over chest X-ray persisted in follow up studies (44%, 8% respectively). As regards consolidation, there was no statistically significant difference between chest ultrasound (consolidation was detected in 16 out of 25 cases) and chest X-ray (consolidation was detected in 15 out of 25 cases) in the initial studies, and also along the follow up period, chest ultrasound detected consolidation in 17/25 patients, while CXR detected consolidation in 18/25 patients.
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