Harrison Troelsen (temperplate56)

Indian J Crit Care Med 2020;24(1)49-54. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Background This study was designed to evaluate the patient characteristics and outcomes of in-hospital cardiac arrest (IHCA). Materials and methods We carried out a single-center, 5-year, retrospective chart review and analysis of resuscitation data for age, gender, body mass index (BMI), length of stay (LOS) until cardiac arrest, survival of initial IHCA, survival to hospital discharge, primary medical service, and determination of the etiology of cardiac arrest. Results A total of 500 cases occurred with a mean LOS of 8.5 days until the initial IHCA. Overall, 79.5% survived the initial IHCA and 32.4% survived to discharge. As LOS increased, there was an increase in the proportion of pulmonary and metabolic etiologies. Logistic regression analysis adjusting for BMI, gender, age, LOS, and primary medical service were on a surgical service significant for survival to discharge (p = 0.0007) and LOS less then 9 days significant for survival of IHCA (p = 0.018). Conclusion There are a number of causes of IHCA, and the incidence of death and respiratory related IHCA etiologies increase with LOS. Length of stay carries the highest weight when predicting survival of IHCA. Also, there is a higher rate of survival to discharge when on a primary surgical service. How to cite this article Riley LE, Mehta HJ, Lascano J. Single-center In-hospital Cardiac Arrest Outcomes. Indian J Crit Care Med 2020;24(1)44-48. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Objective The study aimed to evaluate the effect of a single after-hours rapid response team (RRT) calls on patient outcome. Design A retrospective cohort study of RRT-call data over a 3-year period. Setting A 600-bedded, tertiary referral, public university hospital. Participants All adult patients who had a single RRT-call during their hospital stay. Intervention None. Main outcomes measures The primary outcome was to compare all-cause in-hospital mortality. The secondary outcomes were to study the hourly variation of RRT-calls and the mortality rate. Results Of the total 5,108 RRT-calls recorded, 1,916 patients had a single RRT-call. Eight hundred and sixty-one RRT-calls occurred during work-hours (0800-1759 hours) and 1,055 during after-hours (1800-759). The all-cause in-hospital mortality was higher (15.07% vs 9.75%, OR 1.64, 95% CI 1.24-2.17, p value 0.001) in patients who had an after-hours RRT-call. This difference remained statistically significant after multivariate regression analysis (OR 1.50, 95% CI 1.11-2.01, p value 0.001). We noted a lower frequency of hourly RRT-calls after-hours but were associated with higher hourly mortality rates. There was no difference in outcomes for patients who were admitted to ICU post-RRT-call. Conclusion Patients having an after-hour RRT-call appear to have a higher risk for hospital mortality. No causal mechanism could be identified other than a decrease in hourly RRT usage during after-hours. How to cite this article Singh MY, Vegunta R, Karpe K, Rai S. Does the Time of Solitary Rapid Response Team Call Affect Patient Outcome? Indian J Crit Care Med 2020;24(1)38-43. Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.Aims and objectives Sleep deprivation in the intensive care unit (ICU) has been linked to numerous complications. Light levels might impact the sleep of patients in the ICU. The aim of the study was to measure light levels during sleep-protected time in the ICU and to assess the impact of light intensity on sleep quantity/quality. Materials and methods This prospective, observational study was conducted in a 10-bed, mixed surgical/medical ICU. For measuring light levels, a commercially available smartphone application was used. The measurements were performed between 2330 and 0615 hours at 15-minute intervals. ALK inhibitor To assess sleep quantity, we used Patient's Sleep Observation Behavioral Tool a