Articles: chronic.
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Critical care medicine · Apr 2017
Impact of Acute Kidney Injury in Patients Hospitalized With Pneumonia.
Pneumonia is a common cause of hospitalization and can be complicated by the development of acute kidney injury. Acute kidney injury is associated with major adverse kidney events (death, dialysis, and durable loss of renal function [chronic kidney disease]). Because pneumonia and acute kidney injury are in part mediated by inflammation, we hypothesized that when acute kidney injury complicates pneumonia, major adverse kidney events outcomes would be exacerbated. We sought to assess the frequency of major adverse kidney events after a hospitalization for either pneumonia, acute kidney injury, or the combination of both. ⋯ When acute kidney injury accompanies pneumonia, postdischarge outcomes are worse than either diagnosis alone. Patients who survive a pneumonia hospitalization and develop acute kidney injury are at high risk for major adverse kidney events including death and should receive careful follow-up.
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Critical care medicine · Apr 2017
Opening the Door: The Experience of Chronic Critical Illness in a Long-Term Acute Care Hospital.
Chronically critically ill patients have recurrent infections, organ dysfunction, and at least half die within 1 year. They are frequently cared for in long-term acute care hospitals, yet little is known about their experience in this setting. Our objective was to explore the understanding and expectations and goals of these patients and surrogates. ⋯ Our study describes the experience of chronically critically ill patients and surrogates in an long-term acute care hospital and the feasibility of patient-focused research in this setting. Our findings indicate overly optimistic expectations about return home and unmet palliative care needs, suggesting the need for integration of palliative care within the long-term acute care hospital. Further research is also needed to more fully understand the challenges of this growing population of ICU survivors.
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A 28-year-old female patient presented through her primary care physician with symptoms of atypical chest pain and chronic cough. Her pain was described as pleuritic and intermittently radiating to the right arm. Her medical history was significant for recurrent respiratory infections, gastritis, and a left ovarian cyst treated with ipsilateral salpingo-oophorectomy. She denied any history of smoking, known lung disease, or extrapulmonary infections.