Articles: outcome.
-
Pediatric drug intoxication is a significant public health issue worldwide. The present study aimed to delineate the epidemiology, exposure-related conditions, and outcome severity of pediatric drug intoxication cases in Taiwan for over a 36-year period. ⋯ This analysis of data obtained from Taiwan's National PCC database for over 36 years reveals bimodal trends in pediatric drug intoxication, showing high rates in young children due to unintentional exposures and peaks in intentional poisoning among adolescent girls. Pharmaceuticals were the predominant toxic agents. Future efforts should focus on age- and sex-targeted preventions, public education on medication safety, and age-specific interventions.
-
Thoracic injuries are directly responsible for 20-30% of deaths in severe trauma patients and represent one of the main regions involved in preventable or potentially preventable deaths. Controlling bleeding in thoracic trauma is a major challenge because intrathoracic hemorrhagic lesions can lead to hemodynamic instability and respiratory failure. ⋯ Thoracic bleeding can result from the diaphragm, intrathoracic vessels (aorta, but also inferior or superior vena cava, and suprahepatic veins), lung, cardiac, or chest wall injuries. Depending on thoracic lesions (such as hemothorax or hemopericardium), hemodynamic instability, and respiratory failure, a pericardial window approach, sternotomy, thoracotomy, or emergency resuscitation thoracotomy may be considered after discussion with the surgeon. Alongside treatment of injuries, managing oxygenation, ventilation, hemodynamic, and coagulopathy are essential for the patient's outcome.
-
Curr Opin Anaesthesiol · Feb 2025
Outcomes, cost-effectiveness, and ethics in patient blood management.
In this narrative review, we evaluate the recent evidence for benefits, cost-effectiveness, and ethical considerations of patient blood management (PBM) programs. ⋯ PBM is an important concept as it promotes the rational use of allogeneic blood products and reduces transfusion and wastage of precious and limited blood products.
-
To investigate the association between glycemic control, measured by glycated hemoglobin (HbA1c) levels, and post-operative complications across various procedures, identify the prevalence of patients with undiagnosed prediabetes or diabetes undergoing surgery, and explore whether better glycemic management is associated with reduced short-term postoperative complications. ⋯ Glycemic control significantly impacts morbidity and mortality in surgical patients. A total of 23% of patients were patients with undiagnosed prediabetes or diabetes, underscoring the importance of preoperative HbA1c screening for all patients. Both very low and very high HbA1c levels should be preoperatively addressed, with moderate control (HbA1c 7-8%, 53-64 mmol/mol) identified as optimal. Overall, these findings emphasize the need for personalized diabetes management plans tailored to each patient's needs and should inform clinical guidelines.
-
This review aims to summarize recent developments for the management of severe traumatic brain injury (TBI) in the ICU. Recent advancements in TBI ICU management emphasize a progression toward more multimodal approaches and mitigating secondary brain injury by increased focus on careful systemic management. ⋯ ICP monitoring remains a key component of severe TBI management in ICU. Emerging evidence is slowly changing and improving intensive care and patient outcomes and include both brain-targeted therapies and careful systemic intensive care management.