ABSTRACT
It is summarized the Critical Care Medicine Institute's long-term experience that will make critical care medicine service operation more effective. The retrospective analysis of patients data was conducted. Currently admission rate amounts to 5939 patients (100%) and mortality rate is equal to 35,6%. Maximum admission occurs per season in spring-27%, per month in May - 10% , per week in first week of the month - 27% and per hour during 18-24 hr - 35%. Maximum mortality takes place per season in spring - 28%, per month in April and December - 12%. Among critical patients nervous system pathology is leading - 24%; rate of polytrauma is also high - 22%. Maximum mortality equal to 36% occurs at nervous system pathology. Mortality at polytrauma is about 20%.
Subject(s)
Critical Care/statistics & numerical data , Critical Illness/epidemiology , Critical Illness/mortality , Organization and Administration/statistics & numerical data , Patient Admission/statistics & numerical data , Georgia (Republic) , Health Services Research , Humans , Nervous System Diseases/mortality , Retrospective Studies , Wounds and Injuries/mortalityABSTRACT
On the material, based on the experimental treatment of broncho-pulmonary derangements, including ventilator-associated pneumonias, at 105 critically ill patients, the authors recommend methods of prophylaxis and treatment of these types of pathologies, which are based on the suction fibrobronchoscopy with the use of different suction mixtures. The more satisfying evolvement of pathological processes, decrease of the expressing of the degree of clinical appearance and intoxication, the indisputable improvement of dynamics of the condition of the patient and subsidence of the average continuation of treatment prove the advantage of this method. The important economical effect is also achieved with the subsidence of the price of daybeds, decrease of the expenses of the diagnostics and cures. The achieved results give us the permission to recommend the widespread use of the treating suction fibrobronchoscopy when treating patients with acute diseases of lungs, advantages at VAP. The expressed efficiency, reliability and the important economical effect are the base priorities of this method.
Subject(s)
Bronchoscopy/methods , Pneumonia, Ventilator-Associated/surgery , Aged , Aged, 80 and over , Critical Illness , Female , Humans , Male , Middle Aged , Treatment OutcomeABSTRACT
The goal of the current research was to ascertain the optimal methods of an endoscopic haemostasis in critical care patients with GDB. The research was conducted on critically ill patients. The different endoscopic methods of treatment: injectional hemostasis, irrigation with local hemostatics, thermo coagulation, and combined method were used. Treatment with injectional hemostasis resulted in hemostasis in 75% of patients. Irrigation with local hemostatics was conducted using the local hemostatic agent caprofer and (or) 10% solution of epsylonaminocapronal acid. The final hemostasis was achieved in the 90% of the cases; bleeding was stopped in 85% of the cases when the hemorrhages occurred from chronic ulcers. The effect of thermo coagulation method was 80-85%. Combined method of treatment (combination of the irrigation with caprofer and thermo coagulation) helped to achieve 95% of the final hemostasis in critically ill patients. The achieved results certify that the combined use of caprofer and method of electro coagulation in critical care patients with GDB is very perspective. Simultaneously with this, it is also recommended to use anti-segregation therapy with blockers of proton pomp and boosting the defense of the mucous tissue with high doses of mucogen.
Subject(s)
Gastrointestinal Hemorrhage/therapy , Hemostasis, Endoscopic/methods , Adult , Aged , Aged, 80 and over , Combined Modality Therapy , Critical Illness , Electrocoagulation , Female , Humans , Male , Middle AgedABSTRACT
The treatment of the critical patients by a combination of the external electrical pacing and traditional methods in comparison with only traditional methods of treatment within first two weeks promote to stable, besides statistically significant growth of the bone marrow and peripheral blood cells quantity, including precursor and immunocompetent cells, erythrocytes, leucocytes, especially its young forms and thrombocytes, normalizes the respiratory and metabolic components of the acid-base balance, increases surviving of the patients, reduces frequency of complications and category of the invalidity and the cost and duration of the treatment.
Subject(s)
Bone Marrow Cells/physiology , Critical Care/methods , Critical Illness/therapy , Electric Stimulation Therapy/methods , Stem Cells/physiology , Aged , Cell Differentiation , Female , Humans , Male , Middle AgedABSTRACT
Research aims to find out best medical therapy in treatment of critical patients. The treatment of the critical patients by a combination of the skin surface plasma radiation, external electrical pacing and i.v. infusion of adequate dozes of nitroglycerine in comparison with traditional methods of treatment within first two weeks promote to stable, besides statistically significant growth of the bone marrow and peripheral blood cells quantity, including precursor and immunocompetent cells, erythrocytes, leucocytes, especially its young forms and thrombocytes, normalizes the respiratory and metabolic components of the acid-base balance, increases surviving of the patients, reduces frequency of complications and category of the invalidity and the cost and duration of the treatment.
Subject(s)
Critical Illness , Electric Stimulation/methods , Nitroglycerin/therapeutic use , Plasma/radiation effects , Precursor Cells, B-Lymphoid/physiology , Precursor Cells, T-Lymphoid/physiology , Vasodilator Agents/therapeutic use , Acid-Base Equilibrium/physiology , Adult , Aged , Blood Platelets/physiology , Bone Marrow/metabolism , Erythrocytes/physiology , Female , Health Care Costs , Humans , Injections, Intravenous , Leukocytes/metabolism , Male , Middle Aged , Nitroglycerin/administration & dosage , Vasodilator Agents/administration & dosage , Young AdultABSTRACT
The task of the study was the comparison of 2 scoring systems SOFA and PIM for mortality risk assessment in intensive care units. SOFA score is evaluated on admission and thereafter 72 and 120 h until ICU discharge in Children's Central Clinical Hospital from 2001 to 2005 years. Total 200 patients were studied. Mean age was 234.5+/-14.5. Mortality rate was 54 (27%). 89 (44.5%) were females and 111 (55.5%) were mails. Mechanical ventilation was performed in 72 (36%) patients. Septic shock was developed in 39 (19.5%) cases. Diagnose was confirmed by bacteriology in 68 (34%) cases. Higher score was in 93 (46.5%) cases, middle scores in 94 (47%) cases and low in 13 (6.5%) cases at the first day of admission. After 72 h. higher score was in 33 (16.5%) cases, middle in 113 (56.5%) cases and low in 54 (27.5%) cases. By evaluation with PIM--Higher score was in 58 (29%) cases, middle scores in 51 (25.5%) cases and low in 91 (45.5%) cases at the first day of admission. There is a correlation between the SOFA and PIM scores and paediatric mortality. Sofa scores predict mortality in ICU better then PIM scoring system. Kendall's tau of SOFA 0.64+/-0.3. Kendall's tau of PIM 0.45+/-0.2. Sofa scores is an excellent tool to describe the extent of organ dysfunction in critically ill patients.
