Informacja

Drogi użytkowniku, aplikacja do prawidłowego działania wymaga obsługi JavaScript. Proszę włącz obsługę JavaScript w Twojej przeglądarce.

English (EN)·Polski (PL)·Yкраїнський (UK)
Przejdź do strony domowej biblioteki Pedagogiczna Biblioteka Wojewódzka im. Komisji Edukacji Narodowej w Lublinie Link otwiera się w nowym oknie Logo biblioteki Prolib Integro - strona głównaPedagogiczna Biblioteka Wojewódzka im. Komisji Edukacji Narodowej w Lublinie
Zmień bibliotekę

Wyszukujesz frazę "Flaatten, Hans" wg kryterium: Autor

  Lista filtrów
Wyrównaj
Wyświetlanie 1-10 z 66
Tytuł:
The impact of age-related syndromes on ICU process and outcomes in very old patients
Autorzy:
Guidet, Bertrand
Szczeklik, Wojciech
Boumendil, Ariane
Leaver, Susannah
Flaatten, Hans
Beil, Michael
Vallet, Helene
Sviri, Sigal
Jung, Christian
De Lange, Dylan W.
Opis:
In this narrative review, we describe the most important age-related “syndromes” found in the old ICU patients. The syndromes are frailty, comorbidity, cognitive decline, malnutrition, sarcopenia, loss of functional autonomy, immunosenescence and inflam-ageing. The underlying geriatric condition, together with the admission diagnosis and the acute severity contribute to the short-term, but also to the long-term prognosis. Besides mortality, functional status and quality of life are major outcome variables. The geriatric assessment is a key tool for long-term qualitative outcome, while immediate severity accounts for acute mortality. A poor functional baseline reduces the chances of a successful outcome following ICU. This review emphasises the importance of using a geriatric assessment and considering the older patient as a whole, rather than the acute illness in isolation, when making decisions regarding intensive care treatment.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Autorzy:
Guidet, Bertrand
Szczeklik, Wojciech
Leaver, Susannah
Fjolner, Jesper
Flaatten, Hans
Beil, Michael
Sviri, Sigal
van Heerden, Peter Vernon
de Lange, Dylan
Jung, Christian
Opis:
There is ongoing demographic ageing and increasing longevity of the population, with previously devastating and often-fatal diseases now transformed into chronic conditions. This is turning multi-morbidity into a major challenge in the world of critical care. After many years of research and innovation, mainly in geriatric care, the concept of multi-morbidity now requires fine-tuning to support decision-making for patients along their whole trajectory in healthcare, including in the intensive care unit (ICU). This article will discuss current challenges and present approaches to adapt critical care services to the needs of these patients.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Contribution of information about acute and geriatric characteristics to decisions about life-sustaining treatment for old patients in intensive care
Autorzy:
Leaver, Susannah
Beil, Michael
Sviri, Sigal
Joskowicz, Leo
Jung, Christian
de Lange, Dylan W.
van Heerden, P. Vernon
Flaatten, Hans
Szczeklik, Wojciech
Guidet, Bertrand
Opis:
Background Life-sustaining treatment (LST) in the intensive care unit (ICU) is withheld or withdrawn when there is no reasonable expectation of beneficial outcome. This is especially relevant in old patients where further functional decline might be detrimental for the self-perceived quality of life. However, there still is substantial uncertainty involved in decisions about LST. We used the framework of information theory to assess that uncertainty by measuring information processed during decision-making. Methods Datasets from two multicentre studies (VIP1, VIP2) with a total of 7488 ICU patients aged 80 years or older were analysed concerning the contribution of information about the acute illness, age, gender, frailty and other geriatric characteristics to decisions about LST. The role of these characteristics in the decision-making process was quantified by the entropy of likelihood distributions and the Kullback–Leibler divergence with regard to withholding or withdrawing decisions. Results Decisions to withhold or withdraw LST were made in 2186 and 1110 patients, respectively. Both in VIP1 and VIP2, information about the acute illness had the lowest entropy and largest Kullback–Leibler divergence with respect to decisions about withdrawing LST. Age, gender and geriatric characteristics contributed to that decision only to a smaller degree. Conclusions Information about the severity of the acute illness and, thereby, short-term prognosis dominated decisions about LST in old ICU patients. The smaller contribution of geriatric features suggests persistent uncertainty about the importance of functional outcome. There still remains a gap to fully explain decision-making about LST and further research involving contextual information is required.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Autorzy:
Beil, Michael
Guidet, Bertrand
Rahamim, Ana
de Lange, Dylan
Leaver, Susannah K.
Sviri, Sigal
Flaatten, Hans
Jacobs, Jeremy M.
Jung, Christian
Vallet, Helene
Szczeklik, Wojciech
Opis:
Very old critically ill patients pose a growing challenge for intensive care. Critical illness and the burden of treatment in the intensive care unit (ICU) can lead to a long-lasting decline of functional and cognitive abilities, especially in very old patients. Multi-complexity and increased vulnerability to stress in these patients may lead to new and worsening disabilities, requiring careful assessment, prevention and rehabilitation. The potential for rehabilitation, which is crucial for optimal functional outcomes, requires a systematic, multi-disciplinary approach and careful long-term planning during and following ICU care. We describe this process and provide recommendations and checklists for comprehensive and timely assessments in the context of transitioning patients from ICU to post-ICU and acute hospital care, and review the barriers to the provision of good functional outcomes.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Tytuł:
Reporting SOFA in research : we should always present each of the SOFA subscores
Autorzy:
Polok, Kamil
Bruno, Raphael Romano
Guidet, Bertrand
de Lange, Dylan
Leaver, Susannah
Wernly, Bernhard
Flaatten, Hans
Czok, Marcelina
Jung, Christian
Moreno, Rui
Putowski, Zbigniew
Szczeklik, Wojciech
Opis:
Background: The Sequential Organ Failure Assessment (SOFA) score is the sum of 6 components, each representing one organ system with dysfunction classified on a 4-point scale. In research, usually by default, the total SOFA score is taken into account, but it may not reflect the severity of the condition of the individual organs. Often, these values are expected to predict mortality. Methods: In this study, we reanalysed 2 cohorts of critically ill elderly patients to explore the distribution of SOFA subscores and to assess the between-group differences. Both cohorts were adjusted to maintain similarity in terms of age and the primary cause of admission (respiratory cause). Results: In total, 910 (non-COVID-19 cohort) and 551 patients (COVID-19 cohort) were included in the analysis. Both cohorts were similar in terms of the total SOFA score (median 5 vs. 5 points); however, the groups differed significantly in 4/6 SOFA subscores (respiratory, neurological, cardiovascular, and coagulation subscores). Moreover, the cohorts had different fractions of organ failures (defined as a SOFA subscore ≥ 3). Conclusions: This analysis revealed significant differences in SOFA subscores between the COVID-19 and non-COVID-19 respiratory cohorts, highlighting the importance of considering individual organ dysfunction rather than relying solely on the total SOFA score when reporting organ dysfunction in clinical research.
Dostawca treści:
Repozytorium Uniwersytetu Jagiellońskiego
Artykuł
Wyświetlanie 1-10 z 66

Ta witryna wykorzystuje pliki cookies do przechowywania informacji na Twoim komputerze. Pliki cookies stosujemy w celu świadczenia usług na najwyższym poziomie, w tym w sposób dostosowany do indywidualnych potrzeb. Korzystanie z witryny bez zmiany ustawień dotyczących cookies oznacza, że będą one zamieszczane w Twoim komputerze. W każdym momencie możesz dokonać zmiany ustawień dotyczących cookies