Background And Objectives: Currently, the reformulation of intensive care goals, often shifting from the search for a cure to offering comfort, has become more and more necessary. The intensivist is frequently confronted with the decision to suspend or not offer a specific therapy, despite its availability. The objective of this study was to estimate the developing risk of probability of death for individual ICU patients with respiratory failure, identify which life-sustaining therapies were administered, time of internment and outcome. Compare the death outcome in relation to UNICAMP II and APACHE II models, as well as verify if the life-sustaining therapies may be limited or suspended.
Methods: It is the observational, prospective cohort study of 150 patients with respiratory failure confined to the intensive care unit. Statistical analysis was carried out using Generalized Linear Models.
Results: Age, sex, race or morbidity did not reveal statistical significance in predicting outcome. This prediction was confirmed more accurately by means of changes in the individual prognostic index of death probability during the first seven days of ICU internment. A 10% worsening prognosis in patients who presented initial death risk of 70% to 80%, utilizing the UNICAMP II Model, showed a specificity of 97.4% - 98.6%.
Conclusions: Prognostic changes in patients during the first seven days of ICU internment are of great aid, from an objective point of view, for ethical decision-making in relation to not-offering new life-sustaining therapies.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Detection of Mycoplasma pneumoniae in hospitalized pediatric patients presenting with acute lower respiratory tract infections utilizing targeted next-generation sequencing.
Infection
January 2025
Department of Pediatric Respiratory Medicine, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, People's Republic of China.
Background: Mycoplasma pneumoniae is a prevalent pathogen in pediatric community-acquired pneumonia. Currently, limited literature exists on the clinical utilization of pathogen-targeted sequencing technologies.
Methods: Targeted next-generation sequencing (tNGS) technology was employed to analyze bronchoalveolar lavage fluid (BALF) from 1,070 hospitalized pediatric patients with acute lower respiratory tract infections.
Diagnosing milk aspiration as a cause of death in sudden unexpected infant death: forensic insights from post-mortem analysis impacting criminal investigations.
Forensic Sci Med Pathol
January 2025
Department of Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
Sudden unexpected infant death (SUID) encompasses both explained and unexplained infant fatalities. When a comprehensive investigation yields inconclusive results, the case is classified as sudden infant death syndrome (SIDS). On the other hand, the most frequent non-SIDS diagnoses may be attributed to specific causes of death including a heterogeneous spectrum of conditions and disorders (e.
View Article and Find Full Text PDFComparison of Six versus Three Doses of Intrapleural Fibrinolytic Therapy in Children with Empyema: A Randomized Controlled Trial.
Indian J Pediatr
January 2025
Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Objectives: To compare six doses of intrapleural streptokinase (SK) vs. the conventional three doses in children with empyema.
Methods: In this randomized controlled trial, children with empyema received intrapleural streptokinase, either twice daily for 3 d (total 6 doses); or once daily for 3 d (total 3 doses).
Microbiological findings in a cohort of patients with coronavirus disease 2019 and venovenous extracorporeal membrane oxygenation.
Med Klin Intensivmed Notfmed
January 2025
Interdisciplinary Medical Intensive Care, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
Background: Venovenous extracorporeal membrane oxygenation (VV ECMO) is an established support option for patients with very severe respiratory failure and played an important role during the coronavirus disease 2019 (COVID-19) pandemic. Bacteria and fungi can lead to severe infectious complications in critically ill patients. The aim of this study was to describe the microbiological spectrum of bacteria and fungi detected in patients with COVID-19-associated respiratory failure supported with VV ECMO in our center.
View Article and Find Full Text PDFA First Case Report of Autoimmune Acquired Factor V Deficiency After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA Vaccination at the Time of Initiating Haemodialysis.
Nephrology (Carlton)
February 2025
Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Oita, Japan.
A 73-year-old Japanese man with chronic kidney disease had no history of abnormal clotting or bleeding. Six days after receiving his third dose of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (BNT162b2; Pfizer/BioNTech), blood tests showed a marked prolongation of the prothrombin time-international normalised ratio and activated partial thromboplastin time, as well as a decrease in factor V (FV) activity. Three months later, he required dialysis owing to worsening heart and renal failure.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!