Unlabelled: Early rehabilitation in the intensive care unit is a promising component of post-intensive care syndrome (PICS) treatment and prevention. However, the optimal time to start mobilizing critically ill patients is still to be determined.
Objective: To evaluate the effect of rehabilitation initiation timing on outcomes in patients with pneumonia.
Material And Methods: The study included 106 patients with pneumonia (27 patients with community-acquired pneumonia and 79 patients with early-onset healthcare associated pneumonia) who received daily rehabilitation treatment for at least 7 days in the intensive care unit. All patients were retrospectively assigned to the early rehabilitation (ER) group if rehabilitation treatment was started within the first 48 hours of admission to the intensive care unit or the delayed rehabilitation (DR) group if mobilization was not initiated within this time frame.
Results: The baseline clinical and demographic characteristics of the patients did not differ between the groups. During rehabilitation, rates of catecholamine use and the psychiatric signs of PICS frequency were also comparable. The duration of mechanical ventilation was 1.5 times shorter in ER group patients than in DR group (8 vs. 6 days and 13 vs. 9 days, respectively; =0.003). The ICU and hospital stay were also significantly shorter in ER group compared with the DR group (12 (9-16) vs. 19 (13-30), respectively; <0.001; 23 (12) vs. 31 (13) as inpatients, respectively; =0.005). Mortality and severe complications rate were comparable between the groups.
Conclusions: The earliest possible start of rehabilitation provided the patient's condition is stable, can reduce the duration of respiratory support and hospital stay for patients with pneumonia.
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http://dx.doi.org/10.17116/kurort20219806211 | DOI Listing |
Surg Infect (Larchmt)
January 2025
Division of Trauma, Surgical Critical Care, Burns, and Acute Care Surgery, Department of Surgery, UC San Diego, San Diego, California, USA.
Cholecystectomy is the recommended treatment for acute cholecystitis in pregnancy, leading to fewer pregnancy-related complications than non-operative management. However, past research demonstrated high rates of non-operative management despite these recommendations. Rates of cholecystostomy tube usage and outcomes in pregnancy are not well described.
View Article and Find Full Text PDFAliment Pharmacol Ther
January 2025
Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Friedrich-Schiller-University, Jena, Germany.
Background: Transjugular intrahepatic portosystemic shunt (TIPS) placement leads to a reduction in portal pressure and an improvement in survival in patients with recurrent and refractory ascites and variceal haemorrhage. Prediction of post-TIPS survival is primarily determined by factors identified before the TIPS procedure, as data collected during or after TIPS implantation are limited. The aim of the study was to evaluate the influence of early hemodynamic changes after TIPS placement on survival, in order to refine post TIPS management.
View Article and Find Full Text PDFEur J Clin Invest
January 2025
URC PNVS, CIC-EC 1425, INSERM, Bichat - Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Background: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a potentially fatal disease with a multifactorial nature, impacting different medical and surgical specialties. Recently, new guidelines and direct oral anticoagulants facilitated early discharge for most DVT patients and non-severe PE patients.
Objective: The aim of this study is to illustrate the distribution of VTE patients throughout the hospital and map their care pathway from Emergency Department (ED) to hospital discharge.
Cureus
January 2025
Anesthesiology and Reanimation, Military Hospital of Avicenne, Marrakech, MAR.
Infectious myocarditis (IM) and infective endocarditis (IE), sometimes associated with infection of the surrounding mediastinal tissue or embolic complications caused by residual implantable cardioverter defibrillator (ICD) lead material embedded in the ventricle, present a significant challenge for cardiac surgeons due to the difficulty of precisely locating the old intracardiac pacing lead remnants because of the heart's continuous movement. We present the case of successful two-stage elective sternotomy extraction of two residual defibrillator leads, one trapped in the left innominate vein, easily removed after veinotomy without cardiopulmonary bypass (CPB), and the other embedded intramyocardially in the inferior wall of the right ventricle, successfully removed under CPB after fluoroscopic guidance. The patient was discharged four weeks post-operation without complications.
View Article and Find Full Text PDFAnn Transl Med
December 2024
Division of Advanced Gastrointestinal and Bariatric Surgery, Mayo Clinic, Jacksonville, FL, USA.
Background: Addressing language barriers through accurate interpretation is crucial for providing quality care and establishing trust. While the ability of artificial intelligence (AI) to translate medical documentation has been studied, its role for patient-provider communication is less explored. This review evaluates AI's effectiveness in clinical translation by assessing accuracy, usability, satisfaction, and feedback on its use.
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