Recognizing the critically ill patient

Bennett, Kathryn; Robertson, Laura C.; Al-Haddad, Mohammed

doi:10.1016/j.mpaic.2015.10.001

Cited by 6 publications

(3 citation statements)

References 5 publications

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“…Additional diseases previously associated with hypocalcemia were also considered, including critical illness, including sepsis and systemic inflammatory response syndrome, diabetes mellitus, including diabetic ketoacidosis (DKA) (2), and feline urethral obstruction (1). In the present study, critical illness was defined as any potentially life-threatening multisystem disorder that, in the absence of medical intervention, would be expected to result in mortality or significant morbidity (16, 17). Primarily this category included patients with evidence of systemic inflammatory response syndrome and sepsis.…”

Section: Methodsmentioning

confidence: 99%

Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats

2019

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Background: Calcium disorders are common in small animals, but few studies have investigated the etiology of ionized hypercalcemia and hypocalcemia in large populations. This study aimed to determine the incidence of ionized calcium disorders in dogs and cats treated at a tertiary referral clinic and to describe the associated diseases. Methods: An electronic database of electrolyte analyses conducted at the Cornell University Hospital for Animals from 2007 to 2017 was searched. Dogs and cats with ionized hypercalcemia or hypocalcemia were identified based on institution reference intervals. Duplicate case entries were removed. Medical records were reviewed to identify the cause of the calcium abnormality. Chi-squared analysis with Bonferroni adjustment was performed to compare frequencies of disease processes between mild and moderate-severe disturbances. Results: The database included 15,277 dogs and 3,715 cats. Hypercalcemia was identified in 1,641 dogs and 119 cats. The incidence of canine and feline hypercalcemia was 10.7 and 3.2%, respectively. Hypocalcemia was identified in 1,467 dogs and 450 cats. The incidence of canine and feline hypocalcemia was 9.6% and 12.1%, respectively. The most common pathologic causes of hypercalcemia in dogs were malignancy-associated (12.9%), parathyroid-dependent (4.6%) and hypoadrenocorticism (1.7%). In cats, malignancy-associated hypercalcemia (22.7%), kidney injury (13.4%) and idiopathic hypercalcemia (12.6%) were most common. Dogs presenting with moderate-severe hypercalcemia vs. mild hypercalcemia were significantly more likely to have hyperparathyroidism, malignancy-associated hypercalcemia or hypervitaminosis D, whereas cats were significantly more likely to have malignancy-associated hypercalcemia or idiopathic hypercalcemia. The most common pathologic causes of hypocalcemia in dogs were critical illness (17.4%), kidney injury (10.4%) and toxicity (7.5%). In cats, kidney injury (21.6%), urethral obstruction (15.1%), and critical illness (14.7%) were most frequent. Dogs presenting with moderate-severe hypocalcemia were significantly more likely to have hypoparathyroidism, kidney injury, eclampsia or critical illness, whereas cats were significantly more likely to have kidney injury, soft tissue trauma or urethral obstruction. Conclusions: Mild calcium disturbances are most commonly associated with non-pathologic or transient conditions. Malignancy-associated hypercalcemia is the most common cause of ionized hypercalcemia in dogs and cats. Critical illness and kidney injury are frequent causes of ionized hypocalcemia in both species.

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Section: Methodsmentioning

confidence: 99%

Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats

2019

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“…They are temporary used as measure until adequate cardiovascular function returns on resolution of the pathological process. Inotropic medications are among the most widely used medications in Critical Care Units, since they help patients to correct hemodynamic instability (1) .…”

Section: Introductionmentioning

confidence: 99%

Effect of Implementing Guidelines Regarding Administering Inotropic Medications for Critically Ill Patients on Nurses’ Practice

2020

IJONE

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Background: There is no teaching guidelines depicted for improving the practice of nurses towards inotropic medication administration, which emphasizes the importance of clinical guidelines in improving nurses' practice, Purpose: To assess the effect of implementing guidelines regarding administering inotropic medications for critically ill patients on nurses' practice, Methods: This single-hospital, Quasi-experimental research design was used in the study. The present study was carried out at Critical Care Units. A convenient sample of all staff nurses (60 nurses), the data were collected using one tool named nurses' observational checklist, Results: 93.3% of studied nurses had satisfactory level of practice regarding inotropic medications post implementing intervention guidelines. The post and follow up-intervention practice mean score was high 48.80, 48 respectively when compared with pre-intervention practice mean score 31.40 with P value<.001*, Conclusion: There was significant difference in the nurses' practice mean scores regarding inotropic medications in post and follow-up implementing guidelines when compared with pre-intervention mean practice score with P value<.001. .

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“…Modern medicine has increased the chances of survival for many patients, which has increased the rate of critical illness [1]. Critical illness can be defined as a life-threatening multisystem process preceded by a period of increased catabolism and physiological deterioration [2]. Increased catabolism and drug-induced adverse effects, which accompany critical illness, reduce appetite, or increase nausea and vomiting making patients unable to achieve nutritional requirements by oral intake [3].…”

Section: Introductionmentioning

confidence: 99%

Evidence on nutritional therapy practice guidelines and implementation in adult critically ill patients: a scoping review protocol

Mooi

Ncama

2019

Syst Rev

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Background: Nutritional therapy practice guidelines are designed to improve nutritional practices and thus the delivery of nutritional therapy in critically ill patients. However, they are not implemented despite the strong recommendation of nutritional therapy in the management of critical illness. The aim of this study is to map evidence on nutritional therapy guidelines and their implementation in critically ill adult patients. Methods: Two independent reviewers will conduct a search of published scholarly and gray literature on the implementation of nutritional therapy guidelines in critically ill adults using Arksey and O'Malley's scoping review framework. The search of studies will be conducted from databases such as PubMed, Google Scholar and EBSCOhost databases,

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Recognizing the critically ill patient

Cited by 6 publications

References 5 publications

Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats

Severity of Ionized Hypercalcemia and Hypocalcemia Is Associated With Etiology in Dogs and Cats

Effect of Implementing Guidelines Regarding Administering Inotropic Medications for Critically Ill Patients on Nurses’ Practice

Evidence on nutritional therapy practice guidelines and implementation in adult critically ill patients: a scoping review protocol

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