Background: Effective strategies for managing coronavirus disease 19 (COVID-19) patients suffering from acute respiratory distress are constantly evolving. The timeline and threshold for transitioning from non-invasive ventilation to intermittent mandatory ventilation in critical cases who develop COVID-19-related respiratory distress are undetermined. The present research intends to investigate if emergency room intubations in COVID-19 patients affect mortality.
Methods: Between January 1, 2021 and June 30, 2021, we retrospectively reviewed chart analysis on all patients with confirmed positive COVID-19 screening and who underwent endotracheal intubation. Depending on when the intubation was performed; early in the emergency room or delayed outside the emergency room, patients were separated into two cohorts. In addition to comorbid clinical manifestations, the quick sequential organ failure assessment (qSOFA) score, and in-hospital mortality were all recorded as demographic and clinical information.
Results: Fifty-eight of the 224 corona-positive patients who underwent intubation had their intubations performed in the emergency room. Age, sex, alcohol use, and smoking status did not significantly differ between the two categories at the baseline. The mean qSOFA score was higher in the early intubation cohort (3.5; < 0.000) along with more underlying comorbidities (3.0; < 0.000). When compared to the late intubation cohort (45.78%), patients treated with early intubation had a significantly greater death rate (67.24%).
Conclusion: In summary, we discovered that patients who underwent intubation in the emergency units exhibited a high quick SOFA score as well as maximum co-morbid conditions than patients intubated somewhere else in the hospital. The findings of our investigation imply that intubating patients too early might be risky.
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http://dx.doi.org/10.3389/fmed.2022.1023229 | DOI Listing |
Prehosp Emerg Care
January 2025
Department of Emergency and Transport Medicine, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan.
Objectives: In out-of-hospital cardiac arrest (OHCA), prehospital time is crucial and can be divided into response time, from emergency call to emergency medical service (EMS) contact, and time from EMS contact to hospital arrival. To improve prehospital strategies for pediatric OHCA, it is essential to understand the association between these time intervals and patient outcomes; however, detailed investigations are lacking. The current study aimed to examine the association between response time and time from EMS contact to hospital arrival as well as survival and neurological outcomes in pediatric OHCA.
View Article and Find Full Text PDFAdv Orthop
January 2025
Department of Orthopedics and Trauma Surgery, University of Pisa, Pisa, Italy.
Orthopedic trauma is a significant component of emergency department workloads worldwide. The relationship between weather conditions and injury rates is controversial in modern literature. Even less has been written to investigate bank holidays' influence on contusions, dislocations, fractures, and even polytrauma.
View Article and Find Full Text PDFFront Cardiovasc Med
January 2025
Department of Cardiology, Joan XXIII University Hospital, Tarragona, Spain.
Introduction: Cardiac troponin levels below the 99th percentile improve the predictive efficacy for cardiovascular events when associated with relevant clinical variables. However, whether ultra-sensitive analytical methods improve this predictive efficacy over less sensitive or contemporary analytical methods remains unknown.
Methods: This retrospective observational study involved consecutive patients who presented to the emergency department for suspected acute coronary syndrome and underwent measurement of ultra-sensitive cardiac troponin I (Singulex) and contemporary cardiac troponin I (Siemens) with levels below the 99th percentile.
J Intensive Med
January 2025
Department of Pneumology, Institut Clinic del Tórax, Hospital Clinic of Barcelona - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona - SGR 911- Ciber de Enfermedades Respiratorias (Ciberes), Barcelona, Spain.
Aminoglycosides are concentration-dependent antibiotics exerting a bactericidal effect when concentrations at the site of infection are equal to or greater than 5 times the minimum inhibitory concentrations (MIC). When administered intravenously, they exhibit poor lung penetration and high systemic renal and ototoxicity, imposing to restrict their administration to 5 days. Experimental studies conducted in anesthetized and mechanically ventilated sheep and pigs provide evidence that high doses of nebulized aminoglycosides induce a rapid and potent bacterial killing in the infected lung parenchyma.
View Article and Find Full Text PDFWorld J Gastrointest Surg
January 2025
Department of General Surgery, Tianjin Xiqing Hospital, Tianjin 300100, China.
Background: Petersen's hernia occurring through the epiploic foramen of the greater omentum, is an uncommon type of internal hernia. When it presents with complications such as chylous ascites, which is the lymphatic fluid accumulation in the abdominal cavity, it is particularly rare. Following laparoscopic total gastrectomy and Roux-en-Y anastomosis, the incidence of this condition is exceedingly low.
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