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Treatment – Acute Illness-Related Malnutrition
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Critically ill patients are a heterogeneous population, with each individual displaying unique needs. The nutrition intervention is dependent on the clinical situation and nutrition status, and an individualized nutritional support regimen improves outcomes40 and can improve mortality.41 The following sections highlight common clinical conditions encountered in the ICU setting.
Basics of flexible bronchoscopy and equipment
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
Antoinette Wannes Daou, Carolyn Wallace, Joshua Shannon, Cherie A. Torres-Silva
The ideal venue for bronchoscopic procedures is an endoscopy suite or an operating room with continuous cardiopulmonary monitoring, that is fully equipped to manage any foreseeable emergencies, including pulmonary hemorrhage or cardiac arrest.9 Alternatively, emergency bronchoscopic procedures can be performed at the bedside in the intensive care units (ICUs) with appropriate support from the ICU staff.13
Cervical Chordoma
Published in Kelechi Eseonu, Nicolas Beresford-Cleary, Spine Surgery Vivas for the FRCS (Tr & Orth), 2022
Kelechi Eseonu, Nicolas Beresford-Cleary
The procedure would need to involve a posterior and then anterior procedure and then possibly a return to the back to insert instrumentation. Sacrifice of nerve roots at this level may have a deleterious effect on diaphragmatic function. The imaging suggests that the vertebral artery is included on the left side and may need to be sacrificed and thorough assessment of the contralateral artery would need to be undertaken. Following surgery, the patient would need to stay in intensive care unit (ICU) and may need a tracheostomy.
Perceptions and ideas of critically ill patients, their family and staff members regarding family participation in the physiotherapy-related care of critically ill patients: a qualitative study
Published in Physiotherapy Theory and Practice, 2022
Lotte van Delft, Karin Valkenet, Arjen Slooter, Cindy Veenhof
For this study, critically ill patients, family members, and ICU staff members were included for semi-structured interviews. Overall inclusion criteria for participation were the ability to speak Dutch and an age of 18 years or older. Patients had to be admitted to the ICU for more than 72 hours and be both verbally and cognitively capable to talk for 30 minutes, as assessed by the treating physicians. Regarding family members, only first-degree relatives and spouses (partners) of patients admitted at the ICU for more than 72 hours were included. Involved staff members were as follows: ICU nurses (formal relevant postgraduate training completed), ICU physicians (formal relevant postgraduate training completed), physiotherapists, occupational therapists, and managers working in the ICU for at least 4 months. Staff members were purposively sampled for semistructured interviews, based on discipline and years of work experience. The inclusion of patients, family and/or staff members continued until nothing new was heard in two consecutive interviews and theoretical saturation, described as the point where no new themes other than the one already existing obtained from the data, was reached.
Update on the diagnosis and management of pediatric laryngotracheal stenosis
Published in Expert Review of Respiratory Medicine, 2022
Matthew M Smith, Lauren S Buck
Operations can be single staged or double staged. Single stage operations involve not performing a tracheostomy or closing a previous tracheostomy during the procedure. Double staged procedures involve the patient having a tracheostomy or T-tube at the end of the procedure. The decision of which stage to perform remains a complex decision with many factors. Single stage operations can require prolonged stays in the intensive care unit (ICU) with or without sedation. The role of the intensivist and ICU care team is significant and multidisciplinary care is critical. For patients undergoing single stage laryngotracheoplasty, Mehta et al found that implementing an ICU protocol and multidisciplinary approach for sedation led to timelier extubation and decreased ICU stay [23].
The Prospective Association of Patient Hospitalization with Spouse Depressive Symptoms and Self-Reported Heath
Published in Behavioral Medicine, 2022
Talea Cornelius, Jeffrey L. Birk, Ari Shechter
Despite evidence that hospitalization can adversely affect patients’ partners, quantitative research has been primarily limited to adverse psychological outcomes in family members exposed to the ICU (e.g., post-intensive care syndrome [PICS] in families16–18). This work suggests some benefit to family members in terms of psychological distress (e.g., allowing family to be present can reduce complicated grief following bereavement19), but experiences in the ICU differ markedly from the more common experience of inpatient hospitalization. Furthermore, although family members often report that they prefer 24-hour ICU visitation policies, more visitation time has not been shown to benefit partners; in fact, family members’ anxiety may be positively associated with the time families spent visiting patients in the ICU.20–22