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4 results on '"Intensyviosios terapijos skyrius"'

1. Evaluation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for the patients in the intensive care unit.

Author

Linkaitė, Gabrielė, Riauka, Mantas, Bunevičiūtė, Ignė, and Vosylius, Saulius

Subjects
*DELIRIUM, *ARTIFICIAL respiration, *HOSPITAL admission & discharge, *INTENSIVE care units, *COGNITION disorders, *HALOPERIDOL, *PROGNOSIS, *THERAPEUTICS
Abstract

Introduction. Delirium not only compromises patient care, but is also associated with poorer outcomes: increased duration of mechanical ventilation, higher mortality, and greater long-term cognitive dysfunction. The PRE-DELIRIC model is a tool used to calculate the risk of the development of delirium. The classification of the patients into groups by risk allows efficient initiation of preventive measures. The goal of this study was to validate the PRE-DELIRIC model using the CAM-ICU (The Confusion Assessment Method for the Intensive Care Unit) method for the diagnosis of delirium. Materials and methods. Patients admitted to the University Hospital of Vilnius during February 2015 were enrolled. Every day, data were collected for APACHE-II and PRE-DELIRIC scores. Out of 167 patients, 38 (23%) were included and screened using the CAM-ICU method within 24 hours of admission to the ICU. We defined patients as having delirium when they had at least one positive CAM-ICU screening or haloperidol administration due to sedation. To validate the PRE-DELIRIC model, we calculated the area under receiver operating characteristic curve. Results. The mean age of the patients was 69.2 ± 17.2 years, 19 (50%) were male, APACHE-II mean score 18.0 ± 7.4 points. Delirium was diagnosed in 22 (58%) of 38 patients. Data used for validation of the PRE-DELIRIC model resulted in an area under the curve of 0.713 (p < 0.05, 95% CI 0.539-0.887); sensitivity and specificity for the patients with 20% risk were, accordingly, 77.3% and 50%; 40% risk - 45.5% and 81.3%, 60% - 36.4%, and 87.5%. Conclusions. The PRE-DELIRIC model predicted delirium in the patients within 24 hours of admission to the ICU. Preventive therapy could be efficiently targeted at high-risk patients if both of the methods are to be implemented. [ABSTRACT FROM AUTHOR]

Published
2018

2. Complications of thrombolysis in an intensive care unit.

Author

Deimantavičienė, Živilė, Klimas, Nerijus, Pečkauskas, Aurimas, Bakšytė, Giedrė, Macas, Andrius, Pieteris, Linas, and Repšienė, Aurelija

Subjects
*THROMBOLYTIC therapy, *INTENSIVE care units, *DISEASE complications, *TREATMENT effectiveness, *CLINICAL trials, *QUALITY of life
Abstract

Background. Thrombolysis is often the only way in treating people with life-threatening conditions, like acute myocardial infarction (AMI), pulmonary embolism (PE) and acute ischemic stroke (AIS). Complications of thrombolytic therapy are not rare and have clear influence in the quality of life, hospital stay, outcomes and mortality. Most common complications are intracranial hemorrhage, severe injection site, nose, vaginal bleeding and peripheral hematomas. Methods and materials. A retrospective study took place in the Department of Intensive Care, Hospital of Lithuanian University of Health Sciences Kaunas Clinics. Medical data of 83 patients, who underwent treatment with thrombolytic drugs in the period of 2007-2011, were analyzed. All patients were treated with intravenous infusion of Alteplase. Inclusion criteria were as follows: · AMI, AIS or PE treatable with thrombolytic therapy. Results. 72.3% (n = 60) of patients experienced massive PE, 13.3% (n = 11) AMI and 14.4% (n = 12) AIS. There were 8.43% (n = 7) of patients who had bleeding complications - 2.4% (n = 2) experienced nose bleed during or shortly after thrombolytic therapy, 3.6% (n = 3) had injection site bleeding and 1.2% (n = 1) experienced multiple skin hemorrhages. 11.7% (n = 7) of patients in the group of massive PE were thrombolised during CPR and only one of them experienced bleeding to the pleural cavity. There were no internal or external bleeding observed neither in AMI nor in AIS groups. In-hospital mortality after thrombolytic therapy was 20.5% (n = 17). Conclusions. Thrombolytic therapy very often is the only way in treating acute, life-threatening diseases, like acute myocardial infarction, pulmonary embolism or acute ischemic stroke. Intracranial hemorrhage, injection site, nose, vaginal bleeding and peripheral hematomas are the most common complications of thrombolysis. Risk factors should be evaluated before starting the thrombolytic therapy. Data of our hospital experience do not dramatically differ from worldwide data. [ABSTRACT FROM AUTHOR]

Published
2012

3. Skirtumų analizė padidinto inkstų klirenso atveju ir jų svarba farmakokinetiniu požiūriu

Author

Moser, Elvina, Janulis, Valdimaras, Ivanauskas, Liudas, Savickienė, Nijolė, Rodovičius, Hiliaras, Digilytė, Audronė, Savickas, Arūnas, Briedis, Vitalis, Ramanauskienė, Kristina, Inkėnienė, Asta, Jakštas, Valdas, Drakšienė, Gailutė, Radžiūnas, Raimundas, Skyrius, Vaidas, Brusokas, Valdemaras, Barsteigienė, Zita, Marksienė, Rūta, Ževžikovas, Andrejus, Vitkevičius, Konradas, Gumbrevičius, Gintautas, Ragažinskienė, Onutė, Maruška, Audrius, Martinėnas, Žydrūnas, Kuncaitė, Giedrė, Zulanienė, Eglė Audronė, Jakubauskas, Mindaugas, Budrikienė, Aušra, Švarcaitė, Jūratė, Balanaškienė, Rima, Marcinkevičienė, Rasa, Mačiulaitis, Romaldas, and Lithuanian University of Health Sciences

Subjects
Pharmakokinetics, IFG, Subterapinės dozės, ICU, Augmented renal clearance, pharmakokinetics, GFR, subtherapeutic dosing, Padidintas inkstų klirensas, Farmakokinetika, Pharmacy, Intensyviosios terapijos skyrius, Subtherapeutic dosing
Abstract

Objective of the work: The purpose of this quantitative retrospective comparative study was to register possible cases of augmentedted renal clearance (ARC) in patients of Hospital of Lithuanian University of Health Sciences and analyse the differences in assessments of cases of Augmented Renal Clearance and the drug therapy problems related to ARC. Tasks: To achieve the objective, several tasks were performed: 1) to register possible ARC patients cases as assessed by Cocroft-Gault and their possible associated reasons; 2) to analyse differences in three equations used for GFR estimation: Cocroft-Gault, MDRD simplified, and CKD-EPI. 3) compare the therapies of the patients and determine the drugs that are in risk of being underdosed when ARC is present. Methodology: An ARC survey (appendix 1) was filled about patients from various departments of Clinics during the period of 2013 03 04 – 2014 08 15. All patients were selected according serum creatinine values that were 50 µmol/l. or less. Two goups of patients were assigned for analysis: patients were grouped according Cocroft - Gault creatinine clearance values: (1) ARC group A CrCl >130 ml./min and (2) comparative Non-ARC group B CrCl 90-130 ml./min. Data were analyzed by using descriptive and comparative statistical analysis, considering statistically significant difference between the groups if p value was 130 ml./min. ir (2) palyginamąją B grupę – CrCl 90-130 ml./min. Duomenys buvo analizuojami naudojant palyginamąją ir aprašomąją statistiką. Skirtumai tarp grupių buvo laikomi statistiškai reikšmingi, kai p reikšmė buvo

Published
2014

4. ANALYSIS OF DIFFERENCES IN AUGMENTED RENAL CLEARANCE CASES AND THEIR RELEVANCE TO PHARMACOKINETICS

Author

Moser, Elvina, Milvydaitė, Irena, Mačiulaitis, Romaldas, Digilytė, Audronė, Savickienė, Nijolė, Janulis, Valdimaras, Ivanauskas, Liudas, Savickas, Arūnas, Briedis, Vitalis, Ramanauskienė, Kristina, Inkėnienė, Asta Marija, Jakštas, Valdas, Drakšienė, Gailutė, Radžiūnas, Raimundas, Skyrius, Vaidas, Barsteigienė, Zita, Brusokas, Valdemaras, Marksienė, Rūta, Ževžikovas, Andrejus, Vitkevičius, Konradas, Gumbrevičius, Gintaras, Ragažinskienė, Onutė, Maruška, Audrius, Martinėnas, Žydrūnas, Kuncaitė, Giedrė, Zulanienė, Eglė Audronė, Jakubauskas, Mindaugas, Budrikienė, Aušra, Balanaškienė, Rima, Marcinkevičienė, Rasa, and Lithuanian University of Health Sciences

Subjects
Pharmakokinetics, IFG, Subterapinės dozės, ICU, Augmented renal clearance, Padidintas inkstų klirensas, Farmakokinetika, Pharmacy, Intensyviosios terapijos skyrius, Subtherapeutic dosing, GFR
Abstract

In recent years, the focus on augmented renal clearance increased as it was found by other researchers to result in subtherapeutic drug dosing concentrations. Accurate assessment of renal function is important for prescribing optimal dosis of pharmaceuticals for ARC patients. Objective of the work: The purpose of this quantitative retrospective comparative study was to register possible cases of Accelerated renal clearance in patients of Hospital of Lithuanian University of Health Sciences Kaunas Clinics and analyse the differences in assessments of cases of Augmented Renal Clearance and the possible risks of ARC for therapy. Tasks: To achieve the objective several tasks were raised: 1) to register possible ARC patients cases as assessed by Cocroft-Gault and their possible associated reasons; 2) to analyse differences in three for GFR estimation used equations (Cocroft-Gault, MDRD simplified, and CKD-EPI). 3) determine the risk drugs for changed renal elimination. Methodology: ARC survey (appendix 1) was filled about patients from various departments of Clinics during the period of 2013 03-04 – 2013 12-20. All patients were selected according serum creatinine values that were 50 µmol/l. or less. Two goups of patients were assigned for analysis: patients were grouped according Cocroft - Gault creatinine clearance values: (1) ARC group A CrCl >130 ml./min and (2) comparative Non-ARC group B CrCl 90-130 ml./min. In the group A were 31 and in the group B - 5 patients... [to full text] Pastaraisiais metais labai išaugo tyrimų apie padidintą inkstų klirensą (PIK), nes pagal keleto tyrejų duomenis šios būklės pasekmė yra subterapinės vaistų koncentracijos. Tikslus inkstų funkcijos nustatymas yra labai svarbus norint parinkti optimalias terapines vaistų dozes padidinto inkstų klirenso pacientams. Darbo tikslas: Šio kiekybinio retrospektyvaus palyginamojo darbo tikslas buvo surinkti duomenis apie padidinto inkstų klirenso PIK atvejus Lietuvos sveikatos mokslų universiteto ligonines Kauno klinikose. Buvo siekiama išanalizuoti sirtumus tarp skirtingų PIK įvertinimo būdų ir įvertinti galimas PIK rizikas terapijai Uždaviniai: norint pasiekti užsibrėžtus tikslus šie uždaviniai buvo iškelti: 1) užregistruoti PIK atvejus ir nustatyti jų galimas priežastis. 2) apskaičiuoti GFG trimis skirtingomis formulėmis (Cocroft-Gault, MDRD, CKD-EPI) ir išanalizuoti skirtumus. 3) nustatyti vaistus, kurie gali būti pakitusios inksų eliminacijos rizikoje. Metodika: PIK anketa ( 1 priedas) buvo pildoma apie pacientus iš skirtingų Kauno klinikų skyrių, laikotarpiu nuo 2013 04 03 iki 2013 12 20. Visi pacientai buvo parinkti pagal kreatinino kiekį serume – 50 µmol/l.. ir mažiau. Dvi pacientų grupės buvo parinktos analizei: pacientai buvo sugrupuoti pagal kreatinino klirensą į (1) PIK A grupę – CrCl > 130 ml./min. ir (2) palyginamąją B grupę – CrCl 90-130 ml./min. A grupėje buvo parinktas 31 pacientas ir B grupėje 5 pacientai. Rezultatai: Vidutinės GFG reikšmės tiriamojoje... [toliau žr. visą tekstą]

Published
2014

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