Browsing by Subject "Mechanical Ventilation"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    “Clinical Characteristics, Outcomes and Prognosticators in Adult Patients Hospitalized with COVID-19”
    (Elsevier, 2020-07-08) Gavin, Warren; Campbell, Elliott; Zaidi, Adeel; Gavin, Neha; Dbeibo, Lana; Beeler, Cole; Kuebler, Kari; Abdel-Rahman, Ahmed; Luetkemeyer, Mark; Kara, Areeba; Medicine, School of Medicine
    Background: COVID-19 is a novel disease caused by SARS-CoV-2. Methods: We conducted a retrospective evaluation of patients admitted with COVID-19 to one site in March 2020. Patients were stratified into three groups: survivors who did not receive mechanical ventilation (MV), survivors who received MV and those who received MV and died during hospitalization. Results: There were 140 hospitalizations; 22 deaths (mortality rate 15.7%), 83 (59%) survived and did not receive MV, 35 (25%) received MV and survived; 18 (12.9%) received MV and died. Thee mean age of each group was 57.8 , 55.8 and 72.7 years respectively (p=.0001). Of those who received MV and died, 61% were male (p=.01). More than half the patients ( n=90, 64%) were African American. First measured d-dimer >575.5 ng/mL, procalcitonin > 0.24 ng/mL, LDH > 445.6 units/L and BNP > 104.75 pg/mL had odds ratios of 10.5, 5 , 4.5 and 2.9 respectively forMV (p < .05 for all). Peak BNP > 167.5 pg/mL had an odds ratio of 6.7 for inpatient mortalitywhen mechanically ventilated (p= .02).Conclusions: Age and gender may impact outcomes in COVID-19. D-dimer, procalcitonin, LDH and BNP may serve as early indicators of disease trajectory.
  • Thumbnail Image
    Item
    Delirium Incidence, Duration and Severity in Critically Ill Patients with COVID-19
    (Indiana Medical Student Program for Research and Scholarship (IMPRS), 2020-12-15) Hammes, Jessica; Khan, Sikandar; Lindroth, Heidi; Khan, Babar; Department of Medicine, IU School of Medicine
    Background: COVID-19 is associated with severe respiratory failure and high mortality in critically ill patients. Neurologic manifestations of the disease, including delirium and coma, may also be associated with poor clinical outcomes. Delirium is associated with prolonged mechanical ventilation and mortality. This study sought to describe the rates, duration, and severity of delirium in patients admitted to the ICU with COVID-19. Methods: A retrospective, observational study was conducted from March 1st to April 27th, 2020, at Indiana University Health Methodist and Eskenazi Health Hospitals. The delirium measurements were extracted in the first 14 days of the ICU stay, using the Richmond Agitation and Sedation Scale (RASS) and the CAM-ICU and CAM-ICU7, for those with a positive COVID-19 diagnosis. The primary outcomes were delirium rates and duration; the secondary outcome was delirium severity. Descriptive statistics and median group comparisons were done using SAS v9.4. Results: Of 144 patients in the study, 73.6% experienced delirium and 76.4% experienced delirium or coma. The median delirium or coma duration was 7 days (IQR: 3-10), and the median delirium duration was 5 days (IQR: 2-7). The median CAM-ICU-7 score was 6 (IQR: 2-7) signifying severe delirium. Mechanical ventilation was associated increased risk of developing delirium (OR: 22.65, 95% CL: 5.24-97.82). Mortality was also more likely in patients experiencing delirium: 26.4% compared to 15.8% in patients without delirium. Conclusion: Of the 144 patients included, 73.6% experienced delirium lasting on average 5 days: the median delirium score being severe. Mechanical ventilation was also associated with greater odds of developing delirium. Because Covid-19 is associated with high rates of delirium, leading to increased rates of functionality disability, more resources and attention are needed to prevent and manage delirium in patients.
  • Thumbnail Image
    Item
    Fat Embolism Syndrome in Duchenne Muscular Dystrophy Patients: Early Recognition and Aggressive Therapy
    (Hindawi, 2018-06-04) Murphy, Lee D.; Yabrodi, Mouhammad; Lutfi, Riad; Pediatrics, School of Medicine
    We describe two pediatric patients with Duchenne muscular dystrophy that presented with acute neurologic deterioration and hypoxic respiratory failure requiring mechanical ventilation. These cases fulfill the clinical criteria for Fat Embolism Syndrome. Early recognition and aggressive supportive therapy with mechanical ventilation, right ventricular afterload reduction, and blood transfusion led to survival without any residual effects from the event. Fat Embolism Syndrome needs to be considered early in the course of patients with Duchenne muscular dystrophy who present with respiratory and neurological symptoms.