Introduction. We sought to identify possible risk factors associated with mortality in patients with high-risk pulmonary embolism (PE) after intensive care unit (ICU) admission. Patients and Methods. PE patients, diagnosed with computer tomography pulmonary angiography, were included from two ICUs and were categorized into groups: group 1 high-risk patients and group 2 intermediate/low-risk patients. Results. Fifty-six patients were included. Of them, 41 (73.2%) were group 1 and 15 (26.7%) were group 2. When compared to group 2, need for vasopressor therapy (0 vs 68.3%; p < 0.001) and need for invasive mechanical ventilation (6.7 vs 36.6%; p = 0.043) were more frequent in group 1. The treatment of choice for group 1 was thrombolytic therapy in 29 (70.7%) and anticoagulation in 12 (29.3%) patients. ICU mortality for group 1 was 31.7% (n = 13). In multivariate logistic regression analysis, APACHE II score >18 (OR 42.47 95% CI 1.50–1201.1), invasive mechanical ventilation (OR 30.10 95% CI 1.96–463.31), and thrombolytic therapy (OR 0.03 95% CI 0.01–0.98) were found as independent predictors of mortality. Conclusion. In high-risk PE, admission APACHE II score and need for invasive mechanical ventilation may predict death in ICU. Thrombolytic therapy seems to be beneficial in these patients.
Elderly patients with low EF were more likely to predispose to higher sensorial block level and hypotension was more common during spinal anaesthesia with supine position compared to lateral decubitus position.
Two patients experiencing cancer pain with neuropathic components were treated with epidural administration of a mixture of ketamine (1 mg/mL) + morphine (1 mg/mL) + bupivacaine (1 mg/mL) injected daily by epidural port. No serious adverse effect was observed throughout the therapy. The patients were mostly pain-free and have gotten better quality of life during 110- and 48-day follow-up when the therapy was given by epidural route. Low doses of epidural ketamine added to morphine and bupivacaine increase the mean duration of satisfactory analgesia without severe adverse effects and restore quality of life when traditional therapy fails.
Objective: Evaluation of needs and satisfaction of families of patients admitted to intensive care unit (ICU) is an important concern. The aim of this study was to determine relatives' perception and satisfaction about ICU in our hospital. Material and Methods:For evaluation, a questionnaire study was conducted in medical ICU. During study period, families of ICU patients were included into the study and a face-to-face survey was administered by the ICU physician to those who wish to participate.Results: A total of 50 family members were included into the study. Of them all reported to know the exact diagnosis for ICU admission however only 32% of them had the correct diagnosis, whereas others stated previous comorbidities as the main admission reason. Even though all the patients admitted to the ICU were critically ill, 23% of relatives classified their patient's status as mild or moderate. Seventy two percent of study participants stated that the information given about their patients was adequate, and 70% of them reported that the content of the procedures described sufficiently. The overall satisfaction was good or very good in 88% of participants. It was observed that longer stay in the ICU was associated with better satisfaction (p<0.05). Conclusion:Detailed information about patient's status, including admission diagnosis, and all interventions should be given to ICU patients' relatives continuously from the first day of ICU admission.Keywords: Intensive care unit, perception, satisfaction, patients' relatives Received: 28.07.2016 Accepted: 09.09.2016Amaç: Yoğun bakım üniteleri (YBÜ)'nde yatan hastaların ailelerinin ihtiyaç ve memnuniyetinin değerlendirilmesi önemli bir noktadır. Bu çalışmada, merkezimizde YBÜ'de yatan hastaların yakınlarının yoğun bakım algısının ve memnuniyetinin değerlendirilmesi amaçlanmıştır.Gereç ve Yöntemler: Dahili YBÜ'de yatmakta olan hastaların yakınlarının yoğun bakım algısı ve memnuniyetini ölçmek üzere anket çalışması yapıldı. Çalışma süresi boyunca tüm hasta yakın-ları hastalarını ziyaret öncesinde anket konusunda bilgilendirildi, çalışmaya katılmak isteyenlere ilgili yoğun bakım hekimi (yoğun bakım yan dal asistanı) tarafından yüz yüze anket uygulandı.Bulgular: Çalışma süresince toplam 50 hasta yakını ile anket dolduruldu. Tüm hasta yakınları YBÜ yatış tanısını bildiklerini bildirmelerine rağmen cevaplar değerlendirildi-ğinde %32'sinin doğru tanıyı bildiği, geri kalan %68'inin ise hastanın daha önceki komorbiditesini yatış tanısı olarak belirttiği görülmüştür. Tüm hastalar kritik hasta olarak YBÜ'ye kabul edildiği halde hastalık şiddetini hasta yakınlarının %8'i hafif, %15'i orta olarak bildirmiştir. YBÜ memnuniyeti için yapılan değerlendirmede hasta yakınlarının %72'si yeterli bilgilendirme yapıldığını, %70'i yapılan işlemlerin içeriğinin yeterli anlatıl-dığını bildirmişlerdir. YBÜ için genel memnuniyet değerlendirmesinde hasta yakınları-nın %88'i memnuniyetlerini çok iyi-iyi olarak değerlendirmişlerdir. YBÜ'de kalış süresi uzadıkça hasta yakınlarının memnuniyetinin arttığ...
This study was presented as an oral presentation in 19 th National Intensive Care Congress.
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