2篇
您的检索式：作者名="Thambu David"
|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Attributable cost of a nosocomial infection in the intensive care unit: A prospective cohort study显示文摘AIM To study the impact of hospital-acquired infections(HAIs) on cost and outcome from intensive care units(ICU) in India. METHODS Adult patients(> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included. The impact of HAI on treatment cost and mortality was assessed. RESULTS The mean(± SD) age of the cohort(n = 499) was42.3 ± 16.5 years. Acute physiology and chronic health evaluation-Ⅱ score was 13.9(95%CI: 13.3-14.5); 86% were ventilated. ICU and hospital length of stay were 7.8 ± 5.5 and 13.9 ± 10 d respectively. Hospital mortality was 27.9%. During ICU stay, 76(15.3%) patients developed an infection(ventilator-associated pneumonia 50; bloodstream infection 35; urinary tract infections 3), translating to 19.7 infections/1000 ICU days. When compared with those who did not develop an infection, an infection occurring during ICU stay was associated with significantly higher treatment cost [median(inter-quartile range, IQR) INR 92893(USD 1523)(IQR 57168-140286) vs INR 180469(USD 2958)(IQR 140030-237525); P < 0.001 and longer duration of ICU(6.7 ± 4.5 d vs 13.4 ± 7.0 d; P < 0.01) and hospital stay(12.4 ± 8.2 d vs 21.8 ± 13.9 d; P < 0.001)]. However ICU acquired infections did not impact hospital mortality(31.6% vs 27.2%; P = 0.49).CONCLUSION An infection acquired during ICU stay was associated with doubling of treatment cost and prolonged hospitalization but did not significantly increase mortality. | Binila Chacko Kurien Thomas Thambu David Hema Paul Lakshmanan Jeyaseelan John Victor Peter | 2017 | World Journal of Critical Care Medicine2017，6，1： | 11 |
| 2 | Intravenous Mannitol reduces intracompartmental pressure following tibia fractures: A randomized controlled trial显示文摘Purpose:Impending compartment syndrome is a common event following closed tibia fractures,which can progress to sinister compartment syndrome.Fasciotomy is the only definitive treatment available,though it has its own drawbacks and complications.Medical management at present consists of limb elevation and adequate hydration.This study aims at determining whether intravenous administration of Mannitol reduced the intracompartmental pressure in patients with closed tibial fractures.Methods:This is a double blinded,randomized control trial done in a single tertiary care center in India.Forty-five patients were recruited between February 2012 and October 2012.Forty patients who presented to the emergency department with isolated,closed,high velocity,and proximal 2/3 tibia fractures were included in this study.Patients with contraindication to Mannitol were excluded.They were allocated into 2 groups by the investigator using computer generated randomization.The pressure in the anterior compartment of the leg was measured with a handheld Stryker pressure monitor.Then either 20%Mannitol or 0.9%normal saline as given intravenously in a blinded manner,based on the randomization.The intracompartmental pressure was measured at 0,1 and 3 h after the infusion.The participant,investigator and statistician were masked to the group assessment.Results:There was no difference in intracompartmental pressures at 1 or 3 h,between the groups.However,in patients with the baseline of compartmental pressures30 mmHg,Mannitol showed a marked reduction in pressure of 8.5 mmHg at 1 h compared to almost no change in pressure in the saline group.There were no adverse events with the use of Mannitol.Conclusions:This preliminary study appears to show that Mannitol is useful in the management of the increased compartment pressure.The limitations of this study were that it only involved a small group of patients and the baseline pressures in both the groups were not comparable.More studies are required before the use of Mannitol as a standard of care in the management of compartment syndrome can be established. | Jerry Nesaraj Viju Daniel Varghese P.R.Boopalan Manasseh Nithyananth Thambu David Sudarsanam Thilak Samuel Jepegnanam | 2021 | Chinese Journal of Traumatology2021，24，2： | 2 |
您所在的机构暂未开通此部分的功能，请联系管理员