AI Article Synopsis
- Patients with severe respiratory failure due to COVID-19 may require extracorporeal membrane oxygenation (ECMO), but this treatment is linked to high mortality rates and lengthy hospital stays.
- A study analyzed 48 COVID patients on ECMO and found that palliative care consultations (PCC) — particularly automatic ones — led to more family meetings and potential changes in end-of-life care plans.
- The results suggest that automatic PCC might help shift patients to "Do Not Attempt Resuscitation" (DNAR) status, which could impact the duration of ECMO treatment and overall hospital stay, although further research is needed to confirm these trends.
Article Abstract
Context: Patients with severe respiratory failure from COVID-19 refractory to conventional therapies may be treated with extracorporeal membrane oxygenation (ECMO). ECMO requirement is associated with high mortality and prolonged hospital course. ECMO is a high-resource intervention with significant burdens placed on caregivers and families with limited data on the integration of palliative care consultation (PCC).
Objectives: To explore the role of standard vs. automatic PCC in the management of COVID patients on ECMO.
Methods: Retrospective chart review of all COVID patients on ECMO admitted from March 2020 to May 2021 at a large volume academic medical center with subsequent analysis.
Results: Forty-eight patients were included in the analysis. Twenty-six (54.2%) received PCC of which 42% of consults were automatically initiated. PCC at any point in admission was associated with longer duration on ECMO (24.5 vs. 37 days; P < 0.05). Automatic PCC resulted in more family meetings than standard PCC (0 vs. 3; P < 0.05) and appears to trend with reduced time on ECMO, shorter length of stay, and higher DNAR rates at death, though results were not significant. Decedents not receiving PCC had higher rates of no de-escalation of interventions at time of death (31% vs. 11%), indicating full intensive care measures continued through death.
Conclusions: Among patients with COVID-19 receiving ECMO, PCC may be associated with a shift to DNAR status particularly with automatic PCC. There may be a further impact on length of stay, duration of time on ECMO and care plan at end of life.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9233556 | PMC |
| http://dx.doi.org/10.1016/j.jpainsymman.2022.06.013 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Unexpected pheochromocytoma leading to cardiac arrest during the perioperative period: a case report and literature review.
BMC Anesthesiol
December 2024
Department of Anaesthesiology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, Zhejiang, 322000, China.
Background: Pheochromocytomas (PCCs) are rare neuroendocrine catecholamine (CA)-secreting tumours that originate from chromaffin tissue and can produce and store CAs. Unexpected PCCs pose a serious threat to the perioperative safety of patients and a considerable challenge to anaesthesiologists because of the risks of fatal hypertensive crises and other stresses.
Case Presentation: A 37-year-old woman who was scheduled for tonsillectomy and palatopharyngoplasty under general anaesthesia experienced a malignant cardiovascular event after induction, which was characterized mainly by a sharp increase in heart rate and blood pressure, ultimately leading to cardiac arrest and the occurrence of secondary long QT syndrome.
Application of deep learning in wound size measurement using fingernail as the reference.
BMC Med Inform Decis Mak
December 2024
Department of Information Management, Yuan Ze University, Taoyuan, Taiwan.
Objective: Most current wound size measurement devices or applications require manual wound tracing and reference markers. Chronic wound care usually relies on patients or caregivers who might have difficulties using these devices. Considering a more human-centered design, we propose an automatic wound size measurement system by combining three deep learning (DL) models and using fingernails as a reference.
View Article and Find Full Text PDFEffective connectivity of default mode network subsystems and automatic smoking behaviour among males.
J Psychiatry Neurosci
December 2024
From the Department of Magnetic Resonance Imaging, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
Background: The default mode network (DMN) is not a single system, but rather is composed of smaller and distinct functional subsystems that interact with each other. The functional relevance of these subsystems in tobacco use disorder (TUD) and the neurobiological features associated with smoking motivation are still unclear; thus, we sought to assess causal or direct connectivity alterations within 3 subsystems of the DMN among people with TUD.
Methods: We recruited male smokers and nonsmokers.
CT-Based Lung Size Matching in Delayed Chest Closure for Systemic Sclerosis Lung Transplantation.
Clin Transplant
December 2024
Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Purpose: Delayed chest closure (DCC) during lung transplantation (LTx) is a controversial surgical approach that lacks research in systemic sclerosis (SSc) patients. We investigated outcomes, clinical risk factors, and CT-based lung size-matching parameters associated with DCC in SSc recipients.
Methods: This retrospective study included 92 SSc recipients (age 51 years ± 10, 56/92 (61.
A fuzzy-predictive current control with real-time hardware for PEM fuel cell systems.
Sci Rep
November 2024
Department of Theoretical Electrical Engineering and Diagnostics of Electrical Equipment, Institute of Electrodynamics, National Academy of Sciences of Ukraine, Beresteyskiy, 56, Kyiv-57, Kyiv, 03680, Ukraine.
This research study presents the application of the FC-PCC (Fuzzy Logic Predictive Current Control) algorithm in the context of maximum power point tracking (MPPT) for a proton exchange membrane fuel cell system employing a three-level boost converter (TLBC). The proposed approach involves the integration of an intelligent fuzzy controller with a predictive current control strategy in order to improve the performance of MPP tracking. Initially, the utilization of fuzzy logic involves the utilization of data values obtained from the PEMFC.
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!