View clinical trials related to Critical Care.
Filter by:This research aims to determine the knowledge levels and practices of intensive care nurses regarding the prevention of pressure sores. The main questions it aims to answer are: 1. What is the level of knowledge of intensive care nurses regarding the prevention of pressure sores? 2. What is the impact of sociodemographic characteristics of intensive care nurses on their knowledge level regarding the prevention of pressure sores? 3. What are the experiences of intensive care nurses regarding their practices for the prevention of pressure sores? In this research, a survey and interview technique will be applied to determine the knowledge levels and experiences of nurses working in adult intensive care units regarding the prevention of pressure sores and their practices.
All participants in this clinical trial will be undergoing surgery and will have a central venous catheter (also known as a central line) placed in the large vein in the neck as part of their routine care. The purpose of this clinical trial is to compare different ways of dressing central lines. In current standard care, central lines are stitched in place and covered with a protective transparent dressing. This standard care will be compared with the addition of a haemostatic powder beneath the transparent dressing. This powder product aids clotting at the level of the skin, meaning that it prevents or reduces bleeding while helping to maintain a dry and protected environment. The main questions this clinical trial aims to answer are: - Will the addition of a haemostatic powder increase the durability of central line dressings? - What proportion of dressings required an unplanned change? - The reason(s) for any unplanned change - The incidence of bleeding around central line insertion sites - Were any skin problems observed once the dressings were removed? Once the dressings are applied, all central lines sites will be monitored as part of the participant's routine care. Participation in the clinical trial lasts as long as the first central line dressing remains in place. Central line dressings currently and routinely remain in place for up to, but not more than seven days. After this period, there will be no need for any research-related observations. Routine care will continue and will not be affected by the research. Participants will not be asked to make any extra visits over and above those needed for routine care.
Non-COVID-19 sepsis (Sepsis) has always been one of the common diseases in critically ill patients. The main treatment strategy is to kill pathogens and mitigate hyperinflammation. One study demonstrated that the supplementation with 576,000 IU cholecalciferol (vitamin D3) as a single dose in critically ill adults in the medical intensive care units (MICUs) can improve clinical outcomes, including acute physiology and chronic health evaluation II score (APACHE II), sequential organ failure assessment score (SOFA), and C-reactive protein (CRP). It is a three-year, multi-center, prospective, parallel, double-blind, randomized controlled clinical trial for 240 eligible subjects, with administrations of vitamin D3 576,000 IU or placebo every 24 hours for 3 days (72 hours) within 96 hours after intensive care unit (ICU) admission.
Intra-abdominal pressure (IAP) refers to the stable pressure in a closed cavity. Its magnitude is determined by the compliance of the abdominal wall and the pressure of the abdominal cavity contents, and it increases with inhalation and decreases with exhalation. Due to fluid retention, organ failure, use of ventilators, and other reasons, critically ill patients have higher intra-abdominal pressure, ranging from 5-7mmHg. However, the expansion capacity of the peritoneal cavity is limited. As the internal pressure rises, when the intra-abdominal pressure rises above 12 mmHg, intra-abdominal hypertension (IAH) occurs. Elevated IAP has harmful physiological effects on almost all organ systems, including the central nervous system, cardiovascular, respiratory, kidney, gastrointestinal, and liver systems. When IAP continues to rise and is accompanied by new or progressive organ failure, it develops into abdominal compartment syndrome (ACS), which is the end-stage manifestation of severe IAH. Currently, there are various methods for measuring intra-abdominal pressure, including direct intraperitoneal measurement, transbladder measurement, gastric measurement, superior and inferior vena cava measurement, rectal measurement, and noninvasive measurement. However, the most commonly used clinical method is indirect transbladder measurement. This technique is clinically feasible and accurate, making it the internationally recognized "gold standard" for intra-abdominal pressure monitoring. Nevertheless, it has been reported that the accuracy and reproducibility of intra-bladder pressure measurements can be influenced by many factors, resulting in a large coefficient of variation in intra-abdominal pressure measurements obtained by this method. Additionally, the indirect transbladder measurement technique is cumbersome, discontinuous, and carries a potential risk of infection. Therefore, the development of noninvasive, safe, and reliable IAP monitoring techniques or methods has garnered widespread attention from scholars both domestically and internationally. This study measures IAP using a combination of ultrasound and external pressure application. By comparing it with the gold standard, intra-bladder pressure measurement, we observe the accuracy and reliability of this measurement method. The aim is to provide a noninvasive, fast, accurate, and reliable method for measuring intra-abdominal pressure in critically ill patients.
Normal saline (0.9% sodium chloride), a classical crystalloid solution, is widely used to maintain fluid balance, volume resuscitation and dilute drugs during clinical practice. However, the chloride concentration of normal saline (154mmol/L) is much higher than human plasma, and a large amount of infusion may lead to iatrogenic hyperchloremia in ICU patients. In contrast, the concentrations of Multiple electrolytes II is more similar to those of plasma and is considered to be a better fluid choice than normal saline.
To assess the association between early multimodal therapy and the duration of invasive mechanical ventilation in the Intensive Care Unit at Fundación Santa Fe de Bogotá.
The objective of this study is to assess whether an intervention package via telemedicine consisting of daily multidisciplinary rounds with a specialist in intensive care medicine, an intervention package provided by a specialized multiprofessional team (nursing, physical therapy and clinical pharmacy) and a management intervention package, focused on quality and safety, reduces the length of stay in ICU patients in Brazil. Our hypothesis is that the intervention package via telemedicine has the potential to decrease the length of stay in ICU patients in Brazil. The study provides for the implementation of three interventions in association via telemedicine. - Daily multidisciplinary rounds conducted by a physician specialized in intensive care medicine - Intervention package by specialized multidisciplinary team (nursing, physiotherapy and clinical pharmacy). - Management intervention package (quality and safety). The main questions it aims to answer are: - Length of stay in ICU, measured in days, considering the time interval between admission to the ICU and the moment of physical transfer of the patient to another hospital admission area or external transfer. - ICU mortality. - Mechanical ventilation free time at 28 days. - Ventilator-associated events. - Patient Mobilization Density. - Standard resource use. - Standardized mortality rate.
Spontaneous cerebral hemorrhage (SICH) is a hemorrhage caused by the rupture of a blood vessel within the brain parenchyma that is non-traumatic. Its rapid onset and dangerous condition seriously threaten human health; it accounts for about 15% of strokes and 50% of stroke-related mortality. Hunan Province is recognized as one of the high incidence areas of cerebral hemorrhage in the world; according to statistics, the direct economic loss caused by cerebral hemorrhage in Hunan Province is more than 1 billion yuan per year, which should be paid great attention. A 30-day follow-up study of large-volume cerebral hemorrhage (defined as supratentorial hemorrhage greater than 30 ml, infratentorial greater than 5 ml, and thalamus and cerebellum greater than 15 ml) found that the morbidity and mortality rate of ICH with hemorrhage of 30-60 ml was as high as 44-74%, while the morbidity and mortality rate of ICH with hemorrhage of <30 ml was 19% and that of >60 ml was 91%. According to studies, the occurrence of hematoma occupancy and malignant cerebral edema in large-volume cerebral hemorrhage can lead to secondary malignant intracranial pressure elevation and subsequent secondary brain injury, which are the main factors of high morbidity and mortality and poor prognosis in patients with large-volume cerebral hemorrhage. Clinical monitoring and management is the key to treatment, and despite aggressive surgical treatment and anti-brain edema therapy, a large number of patients progress to malignant brain edema disease, leading to poor outcomes. Therefore, this project intends to conduct a multicenter clinical trial of non-invasive monitoring of large volume cerebral hemorrhage on the curtain in the Hunan region to explore the impact of non-invasive brain edema monitoring management based on bioelectrical impedance technology on patient prognosis; and to explore early biomarkers of malignant brain edema through metabolomic analysis and the mechanism of malignant brain edema occurrence through multi-omic analysis to provide data support for the clinical treatment application of malignant brain edema.
The aim of this study is to assess the diagnostic ability of quantitative pupillometry for the early detection of hydrocephalus during the weaning process of the external ventricular drain.
This study will be a cluster randomized controlled trial to assess the impact of telemedicine in Pediatric Intensive Care Units (PICU), through daily tele-rounds with a board certified physician and educational activities, in improving clinical-assistance indicators, as well as reducing the length of stay in the PICU.