Ritmo circadiano em óbitos hospitalares: comparação entre unidade de tratamento intensivo e unidade de tratamento não intensivo

Rocha, Antônio Sérgio Cordeiro da; Araújo, Mônica Peres de; Campos, Augusta; Filho, Rubens Costa; Mesquita, Evandro Tinoco; Santos, Marcus Vinicius Dutra dos

doi:10.1590/s0104-42302011000500010

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…Twenty-seven percent of study patients died in the hospital without prior ICU admission. While this number compares well to publications from North America [ 9 ] and Brazil [ 10 ], a much lower rate was found in a rural Sub-Saharan African setting. Only ~10% of patients dying in an Ugandan hospital did so after ICU admission.…”

Section: Discussionsupporting

confidence: 79%

Potentially Preventable Deaths by Intensive Care Medicine in Mongolian Hospitals

Mendsaikhan

Begzjav

Lundeg

et al. 2016

Critical Care Research and Practice

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Purpose. To evaluate the portion of hospitalized patients dying without prior intensive care unit (ICU) admission and assess whether death could have been prevented by intensive care. Methods. In this prospective, observational, multicenter study, data of adults dying in and outside the ICU in 5 tertiary and 14 secondary hospitals were collected during six months. A group of experts categorized patients dying without prior ICU admission as whether their death was potentially preventable or not. Results. 617 patients died (72.9% in and 27.1% outside the ICU) during the observation period. In 54/113 patients (32.3%) dying in the hospital without prior ICU admission, death was considered potentially preventable. The highest number of these deaths was seen in patients aged 16–30 years and those who suffered from an infection (83.3%), underwent surgery (58.3%), or sustained trauma (52%). Potentially preventable deaths resulted in a total number of 1,078 years of life lost and 709 productive years of life lost. Conclusions. Twenty-seven percent of adults dying in Mongolian secondary and tertiary level hospitals do so without prior ICU admission. One-third, mostly young patients suffering from acute reversible conditions, may have potentially been saved by intensive care medicine.

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Section: Discussionsupporting

confidence: 79%

Potentially Preventable Deaths by Intensive Care Medicine in Mongolian Hospitals

Mendsaikhan

Begzjav

Lundeg

et al. 2016

Critical Care Research and Practice

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“…In one study, the morning peak in mortality was observed in non-ICU patients, but was not observed in patients in the ICU. Furthermore, there was no clear mortality peak observed at any time-of-day in the ICU patients ( 25 ). If ICU patients display a broad distribution of phases and therefore are not well-aligned to the external environment, one would expect that there would be no observable time-of-day peak in mortality.…”

Section: Circadian Rhythms In the Disruptive Icu Environmentmentioning

confidence: 99%

Circadian Disruption in Critical Illness

et al. 2020

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Circadian rhythms play a vital role in metabolic, hormonal, and immunologic function and are often disrupted in patients in the ICU. Circadian rhythms modulate the molecular machinery that responds to injury and illness which can impact recovery. Potential factors contributing to the alteration in circadian rhythmicity in intensive care unit (ICU) patients include abnormal lighting, noise, altered feeding schedules, extensive patient care interactions and medications. These alterations in circadian rhythms in ICU patients may affect outcomes and therefore, normalization of circadian rhythmicity in critically ill patients may be an important part of ICU care.

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“…В этот период фиксируется первый в течение сут. пик и максимальный пик общей и сердечно-сосудистой смертности, повышен риск возникновения инфаркта миокарда, аритмии, инсульта, острого коронарного синдрома [1,2]. Для больных артериальной гипертензией (АГ) утренние цифры артериального давления (АД) являются предикторами смертности, поражения органов мишеней [3][4][5].…”

Section: конфликт интересов: не заявленunclassified

Comparative analysis of several methods for blood pressure measurement in the morning in patients with arterial hypertension

Андреева

Деев

Горбунов

2018

Cardiovasc Ther Prev

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Aim. To compare the known methods of blood pressure (BP) measurement in the morning and a new method for estimating the average morning BP for fixed time intervals, comparing their reproducibility and validity.Material and methods. We analyzed database containing 983 cases of ambulatory blood pressure monitoring (ABPM). Results of ABMP in patients with hypertension without severe associated diseases and weekly cancellation of antihypertensive therapy were analyzed. Blood pressure data per 24-hour period, day and night, level and rate of morning BP surge were assessed. In addition, we proposed new method for estimating the average morning BP level for fixed time intervals, based on calculating the average BP level for the following time windows: from 5:00 to 7:00 a.m., from 7:00 to 9:00 a.m., from 9:00 to 11:00 a.m. To assess the reproducibility of the new method, we determined correlations between the first and second group results calculated by the new method based on two repeated ABPM conducted with 1-2 weeks interval (n=90). To study the validity of the new method for measurement of average morning BP level, we used an objective validation criterion — Left Ventricular Myocardium Mass Index (LVMMI). There were performed 98 echocardiographic tests with the use of Acuson 128XP. LVMMI was calculated using the L. Teichholtz method (1976).Results. The new method for measurement of average morning BP level had good reproducibility while the reproducibility of dynamic showings of ABMP (level and rate of morning BP surge) was low. A new method for assessing morning blood pressure was characterized by a high level of validity: the indicators obtained using this technique reliably correlated with the validation criteria: LVMI and the average daily blood pressure level.Conclusion. The proposed new method for estimating the average morning level of blood pressure has a high level of validity and reproducibility. Time interval from 7 to 9 a. m. seems to be the most optimal. The maximum reproducibility of the showings was noted during this period.

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Ritmo circadiano em óbitos hospitalares: comparação entre unidade de tratamento intensivo e unidade de tratamento não intensivo

Abstract: At the non-ICU, deaths occur more often in the morning period and follow a circadian rhythm, which does not occur at the ICU.

Cited by 5 publications

References 17 publications

Potentially Preventable Deaths by Intensive Care Medicine in Mongolian Hospitals

Potentially Preventable Deaths by Intensive Care Medicine in Mongolian Hospitals

Circadian Disruption in Critical Illness

Comparative analysis of several methods for blood pressure measurement in the morning in patients with arterial hypertension

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