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Troubleshooting venous valve during internal jugular cannulation under ultrasound guidance 超声引导下颈内静脉插管中静脉瓣膜的排除
Pub Date : 2020-07-01 DOI: 10.4103/sccj.sccj_28_20
U. Hariharan, Akash Kanojia, Mohandeep Kaur
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引用次数: 0
A middle adulthood arabic female suffering from Anton–Babinski syndrome 一位中年阿拉伯女性患有安东-巴宾斯基综合症
Pub Date : 2020-07-01 DOI: 10.4103/sccj.sccj_26_20
Alfateh Mohammed Noor, R. Alshaya, A. Alharthy, A. Madi, W. Aletreby, D. Karakitsos
Anton–Babinski (AB) syndrome is a form of cortical blindness in which patients are unaware of their blindness despite the definite signs of vision loss. Moreover, patients insist on their ability to see, repeatedly denying their vision loss. This denial of vision loss is a form of visual anosognosia and a hallmark of this syndrome. Although rare, AB syndrome has been well described in literature; however, to our knowledge, there have been no published case reports of patients with AB syndrome in the Middle East. This could be because of the rarity of the diseases or simply because of underdiagnosis of the condition. Here, we report the case of an Arabic female with AB syndrome in order to highlight the importance of physical examination skills in intensive care unit settings where sophisticated observation technology abounds. This case demonstrates how a thorough clinical history and neurological examination are essential in detecting this critical diagnosis early in the course of disease.
安东-巴宾斯基(AB)综合征是一种皮质性失明,患者不知道自己失明,尽管有明显的视力丧失迹象。此外,患者坚持自己的视力,一再否认自己的视力下降。这种对视力丧失的否认是视觉病感失认症的一种形式,也是该综合征的标志。虽然罕见,但AB综合征在文献中有很好的描述;然而,据我们所知,中东地区还没有发表过AB综合征患者的病例报告。这可能是因为这种疾病的罕见性,或者仅仅是因为这种疾病的诊断不足。在这里,我们报告了一名患有AB综合征的阿拉伯女性的病例,以强调在重症监护病房环境中,复杂的观察技术比比皆是的身体检查技能的重要性。该病例表明,全面的临床病史和神经学检查对于在病程早期发现这一关键诊断至关重要。
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引用次数: 0
Spectrum of postoperative admissions in the intensive care unit of a tertiary care hospital: An Indian update 三级护理医院重症监护室术后住院谱:印度的最新情况
Pub Date : 2020-07-01 DOI: 10.4103/sccj.sccj_24_20
Vijay Singh, R. Datta, S. Sasidharan, Lalit Tomar
Background: The allocation of intensive care unit (ICU) beds for postoperative patients is a difficult task because of expensive and limited resources. Hence, it is imperative that it requires stratification of patients who most deserve ICU admission. With this background, this study was conducted to do a prospective evaluation of postoperative admissions in the ICU over a period of 1 year to analyze the postoperative admissions to the ICU and to formulate recommendations based on limited resources. Aim: To analyze the postoperative admissions to the ICU and to formulate recommendations based on limited resources. Settings and Design: The study was done in a tertiary level teaching hospital in India, over a period of 1 year. All patients meeting the inclusion criteria admitted to the surgical ICU were analyzed in the study as per method designed. Materials and Methods: Postoperative patients were admitted to ICU into three groups: (1) planned, (2) unplanned, and (3) emergency. The study analyzed American Society of Anesthesiologists (ASA) status, preplanned postoperative ventilation, not reversed due to intraoperative complications (which included those patients who developed intraoperative complications and admitted to ICU for postoperative ventilation), postoperative observation (which included those patients who were admitted to ICU only for monitoring and didn't experience any anticipated perioperative complications) and others causes group. Statistical Analysis: All the statistical analyses were performed using SPSS version 20. Results: In 1 year, total patients operated were 18157 and 261 patients were admitted to ICU. In planned group, maximum patients were ASA III and in unplanned/emergency admissions ASA II. The common cause of postoperative ICU admission in the planned group was postoperative observation (58.80%; 124/211) and in unplanned/emergency group, it was other causes. Maximum patients admitted to ICU were of ASA III (59.40%; 155/261) and for postoperative observation 54.80% (85/155). Conclusions: The authors have a valuable consideration into our standards of anesthetic practice to improve the process of allocating ICU beds for postoperative patient.
背景:由于资源有限且价格昂贵,为术后患者分配重症监护病房(ICU)床位是一项艰巨的任务。因此,迫切需要对最值得ICU住院的患者进行分层。在此背景下,本研究对1年的ICU术后入院情况进行前瞻性评估,分析ICU术后入院情况,并在资源有限的情况下提出建议。目的:分析ICU术后住院情况,在资源有限的情况下提出建议。环境和设计:本研究在印度的一家三级教学医院进行,为期1年。按照设计的方法对所有符合纳入标准的外科ICU患者进行分析。材料与方法:将术后入住ICU的患者分为(1)计划组、(2)计划组、(3)急诊组。本研究分析了美国麻醉医师协会(ASA)状态、术后预计划通气、未因术中并发症逆转通气(包括术中出现并发症并入住ICU进行术后通气的患者)、术后观察(包括仅入住ICU进行监护且未出现任何预期围手术期并发症的患者)及其他原因组。统计分析:采用SPSS 20进行统计分析。结果:1年内共手术患者18157例,ICU住院261例。在计划组中,最多的患者为ASA III,而在非计划/急诊入院组中,最多的患者为ASA II。计划组术后住院的常见原因为术后观察(58.80%);124/211),而在计划外/紧急情况组,则是其他原因。入住ICU的患者以ASA III型最多(59.40%);术后观察54.80%(85/155)。结论:作者对我们的麻醉实践标准进行了有价值的考虑,以改善术后患者ICU床位的分配过程。
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引用次数: 0
Management of gestational hypertension disorders in Saudi Arabia by primary care nurses 管理妊娠高血压疾病在沙特阿拉伯由初级保健护士
Pub Date : 2020-07-01 DOI: 10.4103/sccj.sccj_32_20
Maha Alrowaili, Nazik A. Zakari, H. Hamadi, S. Moawed
Objective: Failure of health-care providers to have sufficient knowledge and prevention measures of gestational hypertension leads to an increased rate of complications during pregnancy that may lead to the loss of the fetus. The study aims to determine the level of the nurses' knowledge working in primary health-care (PHC) centers regarding gestational hypertension disorders in Riyadh city. Subjects and Methods: A descriptive correlational, nonexperimental study design was conducted at 6 PHC centers using a self-administered questionnaire for nurses (n = 257). Results: Nurses had inadequate knowledge about the essential key items of gestational hypertension disorders. Almost half of the nurses (44%) lacked knowledge about how to assess the fetal condition in case of gestational hypertension, and 57.98% of the sample had difficulty in identifying the signs and symptoms of mild preeclampsia. The majority of the sample (70.42%) had unsatisfactory knowledge about essential drugs for the treatment of preeclampsia; 54.08% of the nurses experienced insufficient knowledge about their role before the administration of magnesium sulfate drugs. In addition, study results show that there was a lack of knowledge on the appropriate management of preeclampsia among the majority study participants (98.83%) with a total knowledge mean score (19.09, 63.63%). Conclusion: Primary care nurses lacked the needed knowledge to identify and provide preventive care to women experiencing gestational hypertension. Furthermore, there was a lack of knowledge in regard to identifying the complications of preeclampsia. The nurses are accountable for the quality of maternity care, and a maternity training program must be considered.
目的:卫生保健提供者对妊娠期高血压缺乏足够的知识和预防措施,导致妊娠期并发症发生率增加,可能导致胎儿流产。该研究的目的是确定在利雅得市初级保健(PHC)中心工作的护士对妊娠高血压疾病的知识水平。研究对象和方法:在6个初级保健中心进行了描述性、相关性、非实验性的研究设计,采用护士自我管理问卷(n = 257)。结果:护士对妊娠期高血压疾病的基本关键项目认识不足。近一半的护士(44%)缺乏如何评估妊娠期高血压情况下胎儿状况的知识,57.98%的样本难以识别轻度子痫前期的体征和症状。大部分受访患者(70.42%)对治疗子痫前期基本药物的知识不了解;54.08%的护士在给药前对自己的角色认识不足。此外,研究结果显示,大多数研究参与者(98.83%)对子痫前期的适当管理知识缺乏,总知识平均得分为19.09分,63.63%。结论:初级保健护士缺乏必要的知识来识别和提供预防护理的妇女经历妊娠期高血压。此外,在鉴别子痫前期并发症方面缺乏相关知识。护士对产妇护理的质量负责,必须考虑产妇培训计划。
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引用次数: 2
Delayed hydrocephalus secondary to cervical spinal tumor surgery 颈椎肿瘤术后继发迟发性脑积水
Pub Date : 2020-01-01 DOI: 10.4103/sccj.sccj_23_19
I. Ghosh, S. Guha, G. Vijay Kumar, Nikhil Singh
Cerebrospinal fluid (CSF) leakage is a common complication after spinal tumor resection that resolves naturally in many cases. Hydrocephalus with CSF leakage as a complication after spinal surgery is rare. Here, we report a rare case of delayed hydrocephalus due to CSF leakage after cervical cord tumor surgery.
脑脊液漏是脊柱肿瘤切除术后常见的并发症,在许多病例中自然消失。脑积水合并脑脊液漏作为脊柱手术后的并发症是罕见的。在此,我们报告一例罕见的颈脊髓肿瘤手术后因脑脊液漏而导致的迟发性脑积水。
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引用次数: 0
Fall assessment in older adult 老年人跌倒评估
Pub Date : 2020-01-01 DOI: 10.4103/sccj.sccj_5_20
Sarah AlGhadeer, Q. AlJabr
Falls are caused by many factors. For an individual, the cause may be a complex interaction between these factors. For this case, fall assessment is mandatory because the patient has hypovitaminosis D, stroke, arthritis, urinary incontinence, cognitive impairment, “dementia,” and osteoporosis. This patient in the past 12 months, he experienced tow falls. The fall assessment was done; it showed gait instability. As the patient complained of back pain, lumbar X-ray was positive for L4 compression fracture; however, his DEXA-scan showed osteoporosis. Osteoporosis magnetic resonance imaging was done to the patient: The result showed normal pressure hydrocephalus and vascular component. lumbar puncture (LP) was done, after the LP, his motor function improved, so the final diagnosis of normal-pressure hydrocephalus was reached. As a clinical guideline, when we face a case of fall, we should perform “a multifactorial falls risk assessment by taking the history, doing the physical examination, some test, and review the medications.”
跌倒是由许多因素引起的。对于个人来说,原因可能是这些因素之间复杂的相互作用。对于这种情况,跌倒评估是强制性的,因为患者有维生素D缺乏症、中风、关节炎、尿失禁、认知障碍、“痴呆”和骨质疏松症。这个病人在过去的12个月里,他经历了两次跌倒。完成了坠落评估;它显示步态不稳定。由于患者主诉背部疼痛,腰椎x线片显示腰4压迫性骨折阳性;然而,dexa扫描显示骨质疏松。对患者进行骨质疏松磁共振成像:结果显示正常的压力脑积水和血管成分。行腰椎穿刺,术后运动功能明显改善,最终诊断为常压脑积水。作为一项临床指导方针,当我们面对一个跌倒病例时,我们应该“通过了解病史、做身体检查、一些测试和回顾药物来进行多因素跌倒风险评估。”
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引用次数: 0
Adjunctive continuous ketamine infusion to conventional sedation in mechanically ventilated patients: It is time for a randomized trial 机械通气患者辅助持续氯胺酮输注至常规镇静:是时候进行随机试验了
Pub Date : 2020-01-01 DOI: 10.4103/sccj.sccj_9_20
M. Bawazeer, M. Amer, K. Maghrabi, Kamel Al-Sheikh, R. Amin, M. Rizwan, M. Shaban, M. Altewerki, F. Alkhaldi, S. Alenazi, Mehreen Bao, E. De Vol, M. Hijazi
Managing sedative and analgesic medications is an essential part of critical care medicine. There is a shift toward favoring the use of nonbenzodiazepine agents because of their side effects. There is an increasing interest in using ketamine as an analgo-sedative in the intensive care unit because of its unique pharmacologic properties. A comprehensive literature search was performed to capture all the studies involving ketamine use in critical care. We searched PubMed, EMBASE, and Cochrane databases. We also extracted the references from major review articles and recent guidelines. In this review, we present the most up-to-date studies done on this topic. We also present the proposal for a future multicenter randomized trial through the Saudi Critical Care Trials Group.
镇静和镇痛药物的管理是重症监护医学的重要组成部分。由于非苯二氮卓类药物的副作用,人们开始倾向于使用它们。由于氯胺酮独特的药理学特性,在重症监护病房使用氯胺酮作为镇痛镇静剂的兴趣越来越大。我们进行了全面的文献检索,以获取所有涉及氯胺酮在重症监护中使用的研究。我们检索了PubMed、EMBASE和Cochrane数据库。我们还从主要综述文章和最新指南中提取了参考文献。在这篇综述中,我们介绍了关于这一主题的最新研究。我们还提出了通过沙特重症监护试验组进行未来多中心随机试验的建议。
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引用次数: 2
Point prevalence of delirium among critically ill patients in Saudi Arabia: A multicenter study 沙特阿拉伯危重病人谵妄的点患病率:一项多中心研究
Pub Date : 2020-01-01 DOI: 10.4103/sccj.sccj_7_20
Nada S. Al-Qadheeb, Mai Hashhoush, K. Maghrabi, Asia Rugaan, F. Eltatar, H. Algethamy, A. Abudayah, N. Ismail, Almubarak, K. Alkhatib, Mohammed Amaani, Ala’a Ghabashi, M. Almaani, R. Amin, A. Alharthy, Nasir Nasim, Galal ElRakaiby, Farhan Alonazi, Israa Alnajdi, Mariam A. Alansari, M. al ahmed, Ahmed O Alenazi, Abdulrahman R. Alruwaili, O. Almuslim
Delirium is commonly recognized among critically ill patients; previous work suggests that delirium prevalence is up to 80% in intensive care unit (ICU) patients and is associated with a variety of adverse outcomes. While several tools have been validated for the detection of ICU delirium, the confusion assessment method -ICU and the intensive care delirium screening checklist are the most widely studied and used. Several risk factors are known to influence delirium occurrence such as benzodiazepines use, drug-induced coma, sleep alterations, metabolic disturbances, and sepsis. In Saudi Arabia, few studies have discussed delirium burden and associated risk factors among critically ill patients. Therefore, the aim of this study is to determine the prevalence of ICU delirium and to study the risk factors associated with the development of delirium in patients in the intensive care setting in Saudi Arabia. This is a 1-day cross-sectional study performed on January 28, 2020, in the medical-surgical ICUs at 14 hospitals in Saudi Arabia. Patients are excluded from the study if they have traumatic brain injury, documented dementia in patient's medical chart, and the inability to conduct valid delirium assessment.
谵妄常见于危重病人;先前的研究表明,重症监护病房(ICU)患者谵妄患病率高达80%,并与各种不良后果相关。虽然有几种工具已被证实用于检测ICU谵妄,但混淆评估方法-ICU和重症监护谵妄筛查清单是最广泛研究和使用的。一些已知的危险因素会影响谵妄的发生,如苯二氮卓类药物的使用、药物性昏迷、睡眠改变、代谢紊乱和败血症。在沙特阿拉伯,很少有研究讨论危重病人的谵妄负担和相关危险因素。因此,本研究的目的是确定ICU谵妄的患病率,并研究与沙特阿拉伯重症监护患者谵妄发展相关的危险因素。这是一项为期1天的横断面研究,于2020年1月28日在沙特阿拉伯14家医院的内科外科icu中进行。如果患者有创伤性脑损伤,在患者病历中记录痴呆,并且无法进行有效的谵妄评估,则排除在研究之外。
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引用次数: 1
One-year progress oa a large-scale collaborative project for improving the care of mechanically ventilated patients 改善机械通气患者护理的大型合作项目一年进展
Pub Date : 2020-01-01 DOI: 10.4103/sccj.sccj_11_20
Y. Arabi, Z. A. Al Aseri, T. Alaama, Abdulrhman Alharthy, F. Al-Hameed, Y. Mandourah, A. Elhazmi, H. Sallam, G. Almekhlafi, A. Mady, K. Alghamdi, M. Alshahrani, Adnan Ghamdi, E. Al Qasim, Sheryl I Abdukahil, Abdullah A. Alzahrani, Mohammed Al Qarni, Basheer El-Rahman, Mufareh Alkatheri, A. Alsaawi, Asad Latif, S. Berenholtz
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引用次数: 1
Timing and dose of pharmacological thromboprophylaxis in adult trauma patients 成人创伤患者血栓预防药物的时机和剂量
Pub Date : 2020-01-01 DOI: 10.1101/2021.01.26.21250366
M. Bawazeer, M. Amer, K. Maghrabi, R. Amin, E. De Vol, M. Hijazi
Pharmacological venous thromboembolism prophylaxis in the trauma population is considered a real challenge. Issues like the ideal time to start therapy, type and dose of the medication, and how to monitor these patients are controversial. We searched PUBMED, EMBASE, and COCHRANE Databases. We also extracted the references from major review articles and recent guidelines. The timing to start thromboembolic prophylaxis in patients with traumatic brain injuries, Spinal Cord Injuries (SCI), and solid organ injuries is not very well defined in the literature. This is because of the associated bleeding risk. At the same time, the type of chemical prophylaxis and dose are not well defined as well. In this review, we present the most up to date studies done on this topic. We discuss the areas of controversy and the challenges behind starting chemical prophylaxis. We also discuss areas of future research potentials to do multicenter studies through the Saudi Critical Care Trials Group.
药物静脉血栓栓塞预防在创伤人群被认为是一个真正的挑战。诸如开始治疗的理想时间、药物的类型和剂量以及如何监测这些患者等问题都存在争议。我们检索了PUBMED, EMBASE和COCHRANE数据库。我们还从主要综述文章和最新指南中提取了参考文献。在创伤性脑损伤、脊髓损伤(SCI)和实体器官损伤患者中,开始血栓栓塞预防的时机在文献中没有很好的定义。这是因为相关的出血风险。同时,化学预防的种类和剂量也没有很好地界定。在这篇综述中,我们介绍了关于这一主题的最新研究。我们讨论了争议的领域和开始化学预防背后的挑战。我们还讨论了通过沙特重症监护试验组进行多中心研究的未来研究潜力领域。
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引用次数: 1
期刊
Saudi Critical Care Journal
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