ABSTRACT
INTRODUCTION: Little information exists on the burden of intensive care unit (ICU) to the posttransplant rehospitalizations of kidney allograft recipients. We do not clearly know the extent of the need for ICU during rehospitalizations and causes of readmissions. In this study, we aimed to assess ICU admissions of kidney transplant recipients, to determine the risk factors of ICU admissions in rehospitalized patients, and to evaluate the additional burden of ICU admission. MATERIALS AND METHODS: A total of 581 posttransplant rehospitalizations of kidney transplant recipients were assessed for ICU admission. Clinical characteristics of the patients and the length of hospital stay, transplantation-admission interval, hospitalization costs, and mortality rate were reviewed. RESULTS: Twenty-five rehospitalized kidney transplant recipients (4.3%) had been admitted to ICU with kidney dysfunction (36.0%), cerebrovascular accident (24.0%), sepsis (16.0%), brain tumor (8.0%), brain abscess (4.0%), diabetic ketoacidosis (4.0%), trauma (4.0%), and hemodynamic shock (4.0%). The risk factors of referral to ICU were higher age (P = .001) and hospitalization for cerebrovascular accident (P = .001) and malignancy (P = .004). Additional burdens were 1.8, 3.3, and 11.4 times as high as the rehospitalization burden for the length of hospital stay, hospitalization costs, and mortality rate, respectively. CONCLUSIONS: Age and some special causes of hospitalizations are risk factors of ICU admission of kidney transplant recipients, and this occurs in about 5% of rehospitalizations. Admission to ICU adds considerably to the burden of rehospitalizations, warranting measures to prevent conditions that lead to the need for intensive care in these patients.
Subject(s)
Intensive Care Units/statistics & numerical data , Kidney Transplantation/adverse effects , Patient Readmission/statistics & numerical data , Adult , Age Factors , Female , Health Care Costs , Humans , Intensive Care Units/economics , Iran/epidemiology , Kaplan-Meier Estimate , Kidney Transplantation/economics , Length of Stay , Male , Middle Aged , Patient Readmission/economics , Retrospective Studies , Risk FactorsABSTRACT
OBJECTIVE: Percutaneous trans-tracheal jet ventilation (PTJV) is an alternative ventilatory approach in airway surgery. We evaluated the effects of body mass index (BMI) on ventilation during low-frequency jet ventilation. STUDY DESIGN AND SETTING: Forty-two patients undergoing micro-laryngeal surgery under total anesthesia were studied. Low-frequency jet ventilation was applied through an injector inserted into the trachea via cricothyroid membrane; ventilation was assessed during the operation by arterial blood gas sampling. RESULT: The age range of the patients was 43.54 +/- 12.04 years, weight was 69.97 +/- 11.66 kg, and BMI 24.80 +/- 2.78 (mean +/- SD). There was a strong correlation (P < 0.05) and a good correspondence between the BMI and mean PaCO(2), and arterial pH. CONCLUSION AND SIGNIFICANCE: This method was effective in maintaining gas exchange in the presence of micro-laryngeal surgery for low-BMI patients. It provided a nice visible surgical field, avoiding the use of combustible material inside the larynx or trachea.
