Intensive care units clinical studies

SSIs negatively affect patient outcomes and increase health care costs. Patients who develop SSIs are five times more likely to be readmitted to the hospital and have twice the mortality of patients who do not develop an SSI.1 A patient infected with an SSI is also 60% more likely to be admitted to an intensive care unit.1 Clinical studies have shown that SSIs increase lengths of hospital stay and costs.1,3,4 The type of SSI can also affect outcome. Deep SSIs, involving organs or spaces, result in longer durations of hospital stay and higher costs compared to SSIs that are limited to the incision.5... 

Many patients in intensive care units receive intravenous nutrition, which is a mixture of various amino acids, sorbitol, and ethanol. In a study of 30 patients with normal preoperative folate levels who were operated on for gastrointestinal disease, the serum folate fell within 48 hours by 60-95% in 20 patients receiving intravenous nutrition (W24). Seven patients had a megaloblastic bone marrow. Daily treatment with 0.5 mg of folic acid given intravenously prevented any clinical signs of folate deficiency. These patients received between 100 and 150 g of ethanol daily as part of their parenteral nutrition, and this may have played a significant role in the development of folate deficiency. However, Tennant (T12) examined this possibility and found that acute depression of the serum folate concentration occurred with both alcohol-firee and alcohol-containing preparations used for parenteral nutrition. It was also noted that only one particular brand of... 

All infants, on admission to the neonatal intensive care unit, were established on parenteral fluids within the first hour of day 1 at 80 ml/kg/day with a solution of electrolytes, dextrose 10%, amino acids (Vaminolact, Fresenius Kabi, Cheshire, UK) and a phosphate supplement (Addiphos, Fresenius Kabi, Cheshire, UK). Fluid intakes were thereafter managed on the basis of clinical requirements. On day 2 of life, and thereafter, the solution was further supplemented with water-soluble vitamins (Solvito N, Fresenius Kabi, Cheshire, UK) and trace elements (Peditrace, Fresenius Kabi, Cheshire, UK), to the levels recommended by the manufacmrer. In tandem, a fat emulsion solution (Intralipid 20%, Fresenius Kabi, Cheshire, UK) with added fat-soluble vitamins (Vitfipid, Fresenius Kabi, Cheshire, UK) was infused, initially at 8ml/kg/ day, increasing maximally to 18 ml/kg/day by posma-tal day 5. Enteral feeds were started, when the condition of the infant was stable, as hourly boluses of 0.5—1 ml/h. Thereafter enteral feed volumes were gradually increased as determined by the infants clinical condition, with reciprocal reductions in the volume of parenteral nutrition infused. No infant progressed beyond hourly bolus feeds for the duration of the study. 

Studies have also found that preventable adverse events occur across sites and locations and are not concentrated in what are often perceived as higher-risk settings (such as surgeries or intensive care units). Therefore, attention can be focused on the system as a whole the hospital, the clinic, the emergency depart-... 

Friedrich JO, Wilson G, Chant C. Long-term outcomes and clinical predictors of hospital mortality in very long stay intensive care unit patients a cohort study. Crit Care 2006 10(2) R59. 

Although infant botulism was not recognized until a large outbreak occurred in Califomia in 1976 (Pickett et ah, 1976), it is currently the most prevalent form of botulism in the United States, accounting for approximately 70% of all cases (Shapiro et al., 1998). Because infant botulism results from a continual production of BoNT, it appears to be more effectively treated by antitoxin than is foodborne botulism. In a recently concluded 5 year randomized clinical trial carried out with a human botulinum immune globulin (BIG-IV), it was found that administration of BIG-IV within 3 days of hospitalization resulted in a 3 week reduction in the mean hospital stay, as well as substantial reductions in the time needed for intensive care and mechanical ventilation (Amon et al., 2006). In a nationwide open label study, BlG-lV was found to be effective even when administered 4—7 days after hospital admission, although to a somewhat lesser extent than when infusion was initiated at 3 days (Arnon et al., 2006). 

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