Active clinical trials for "Critical Illness"

Chronic Critical Illness (CCI) is a condition associated to patients surviving an acute phase of disease and respiratory failure (ARF) although remaining dependent on mechanical ventilation (MV). The prevalence and the underlying mechanisms of CCI have not been elucidated in this population.An observational prospective cohort study was undertaken at the Respiratory Intensive Care Unit (RICU) of the University Hospital of Modena (Italy) from January 2016 to January 2018. Patients mechanically ventilated with ARF in this unit were enrolled. Demographics, diagnosis, severity scores (APACHEII, SOFA, SAPSII) and clinical conditions (septic shock, infections, acute respiratory distress syndrome [ARDS]) were recorded on admission. Respiratory mechanics and inflammatory-metabolic blood parameters were recorded on admission and within the first seven days of stay. All these variables were tested as potential predictors of CCI through appropriate univariate and multivariate analysis.

Sedation is used for 30 to 70 % of all intensive care unit (ICU) patients. Deep sedation can be used for lot of disease like acute respiratory distress syndrome, septic shock. Deep sedation was defined by RASS (Richmond Assessment Sedation Scale) below -3. Deep sedation can be associated with increased mortality, length stay, duration of mechanical ventilation, acute brain dysfunction. The french exploration neurologic group in ICU developed a score used Brainstem response patterns in patient deeply sedated by midazolam and showed that a high BRASS score is associated with high mortality at day 28. The investigators think that BRASS score isn't associated with the medication used for sedation. In this study the investigators included all patients sedated independently of medication used for sedation, we also excluded patient with neurologic disorder. The main objective is to shown that high BRASS score at admission of patient without neurologic disorder sedated is predictive of 28-day mortality.

Several evidences in the literature suggest sleep interruption in critical care patients. Nowadays, the amount and the quality of sleep phases during the length of stay in the intensive care unit are largely unknown. In this study, the amount of time spent by the patients in N1, N2 N3 and REM phases during sleep is quantified.

PK of Caspofungin in ICU septic patients might be changed as compared to healthy volunteers due to sepsis-related pathophysiology. Sub-optimal plasma and tissue concentrations might be achieved in these patients when drugs are administered at the same dosage/regimen suggested for healthy volunteers.

Nutritional support is an important component of modern critical care. The practice of vitamin and micronutrient supplementation is variable and official guidelines are not consistent. The primary objective of this observational study is to investigate the clinical practice of micronutrient supplementation during critical illness and to explore the factors underpinning clinical decisions.

This is a single-center, multi-ICU prospective observational trial evaluating current nutritional practice and its influence of the physical function of critically ill patients.

Sepsis is the body-wide response to infection. People who develop sepsis have an increased risk of dying. One of the greatest challenges in sepsis is determining what is the pathogen (bacteria or virus for example) in a timely manner so the most specific antibiotics can be given to treat the infection. Patients presenting to the hospital and the intensive care unit often have lung infections. In this study the investigators plan to develop new techniques to rapidly (less than 6 hours) identify bacteria growing in the airways of patients on ventilators. The investigators will obtain these samples by suctioning the airways (a routine procedure) and comparing the bacterial cultures grown by novel culture media with the usual techniques in the hospital microbiology laboratory. At the same time the investigators will collect a blood sample. This blood sample will be used to isolate the bacterial genetic material and use this to compare with bacteria grown on the culture media from the clinical and the research laboratory. The investigators will also collect information on the patient's course in hospital. These pilot study results will allow us to integrate this new technique into routine patient care.

It is known that the number of Chronic Critical İllnes, an iatrogenic condition, increases all over the world. The prevalence of Chronic Critical Illness in Turkey is unknown. The investigators aimed to evaluate the etiology, comorbid conditions, demographic data, prevalence, mortality and costs of these patient in intensive care units in Turkey. In this multi-centered study, The investigators will retrospectively review the last 1 year of patients receiving treatment at the Adult Intensive Care Unit.

Esophageal atresia is a rare but severe malformation, and it requires early surgery. Coloesophagoplasty is surgical repair of the esophageal with an isoperistaltic transverse colon graft. In the postoperative period after coloesophagoplasty children require careful monitoring of fluid balance, because clinically significant fluid overload can lead to dysfunction of various organs and systems.

The purpose of the study is to characterize various healthcare practitioners' perspectives on implementation of beta-lactam therapeutic drug monitoring in critical care practice.