Browsing by Subject "length of stay"

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    Adjusting ventilator settings to avoid air trapping in extremely premature infants reduces the need for tracheostomy and length of stay
    (Frontiers, 2022-12-30) Sammour, Ibrahim; Conlon, Steven M.; Bauer, Sarah E.; Montgomery, Gregory S.; Cristea, A. Ioana; Rose, Rebecca S.; Pediatrics, School of Medicine
    Despite the improving understanding of how lung mechanics and tidal volume requirements evolve during the evolution of bronchopulmonary dysplasia (BPD), clinical management continues to be heterogeneous and inconsistent at many institutions. Recent reports have examined the use of high tidal-volume low respiratory rate strategies in these patients once disease has been well established to help facilitate their eventual extubation and improve their long-term neurodevelopmental outcomes. In this retrospective observational research study, we describe how intentional adjustment of ventilator settings based on patient lung mechanics by an interdisciplinary BPD team improved the care of the at-risk population of infants, reduced the need for tracheostomies, as well as length of stay over a period of over 3 years. The team aimed to establish consistency in the management of these children using a high tidal volume, low-rate approach, and titrating PEEP to address the autoPEEP and bronchomalacia that is frequently observed in this patient population.
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    Hypothyroidism Prolongs Hospitalization Following Surgery
    (Scientific Research, 2019-12) Villavicencio, Raquel; Mariash, Cary N.; Medicine, School of Medicine
    Objective: Each year 45 million surgical procedures are performed in the United States, and a significant number of these are performed on hypothyroid patients. Little guidance is available to determine the postoperative risk to these subjects. We hypothesized that new surgical techniques and modern anesthesia would lead to no differences in outcome between hypothyroid patients and euthyroid controls. Methods: We queried surgical databases in our health system for patients who underwent an operative procedure between January 1, 2010 and December 31, 2015 with a TSH > 10 mcU/mL or a FT4 < 0.6 ng/dL. Identified patients were matched to euthyroid controls selected for age, sex, surgical procedure, and search interval. Predicted length of hospital stay (LOS) was determined using the American College of Surgeons National Surgical Quality Improvement Program surgical risk calculator. Results: We identified 29 hypothyroid patients. The LOS was significantly longer for the hypothyroid patients compared to the predicted LOS (14.4 vs 6.7 days, P < 0.001). The LOS in the matched controls was not significantly different than their predicted LOS (9.6 vs 7.1 days, P = 0.11). Other complications were not different between the hypothyroid and control patients. Conclusions: In contrast to our initial hypothesis, hypothyroidism is associated with a 2-fold longer LOS following surgery. Hypothyroidism continues to place patients at increased surgical risk.