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Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial

Historically, the admission of hematological patients in the ICU shortly after the start of a critical illness is associated with better survival rates. Early intensive interventions administered by MET could play a role in the management of hematological critically ill patients, eventually reducing...

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Autores principales: Vergnano, Beatrice, Signori, Davide, Benini, Annalisa, Calcinati, Serena, Bettini, Francesca, Verga, Luisa, Borin, Lorenza Maria, Cavalca, Fabrizio, Gambacorti-Passerini, Carlo, Bellani, Giacomo, Foti, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573388/
https://www.ncbi.nlm.nih.gov/pubmed/37834926
http://dx.doi.org/10.3390/jcm12196281
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author Vergnano, Beatrice
Signori, Davide
Benini, Annalisa
Calcinati, Serena
Bettini, Francesca
Verga, Luisa
Borin, Lorenza Maria
Cavalca, Fabrizio
Gambacorti-Passerini, Carlo
Bellani, Giacomo
Foti, Giuseppe
author_facet Vergnano, Beatrice
Signori, Davide
Benini, Annalisa
Calcinati, Serena
Bettini, Francesca
Verga, Luisa
Borin, Lorenza Maria
Cavalca, Fabrizio
Gambacorti-Passerini, Carlo
Bellani, Giacomo
Foti, Giuseppe
author_sort Vergnano, Beatrice
collection PubMed
description Historically, the admission of hematological patients in the ICU shortly after the start of a critical illness is associated with better survival rates. Early intensive interventions administered by MET could play a role in the management of hematological critically ill patients, eventually reducing the ICU admission rate. In this retrospective and monocentric study, we evaluate the safety and effectiveness of intensive treatments administered by the MET in a medical ward frame. The administered interventions were mainly helmet CPAP and pharmacological cardiovascular support. Frequent reassessment by the MET at least every 8 to 12 h was guaranteed. We analyzed data from 133 hematological patients who required MET intervention. In-hospital mortality was 38%; mortality does not increase in patients not immediately transferred to the ICU. Only three patients died without a former admission to the ICU; in these cases, mortality was not related to the acute illness. Moreover, 37% of patients overcame the critical episode in the hematological ward. Higher SOFA and MEWS scores were associated with a worse survival rate, while neutropenia and pharmacological immunosuppression were not. The MET approach seems to be safe and effective. SOFA and MEWS were confirmed to be effective tools for prognostication.
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spelling pubmed-105733882023-10-14 Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial Vergnano, Beatrice Signori, Davide Benini, Annalisa Calcinati, Serena Bettini, Francesca Verga, Luisa Borin, Lorenza Maria Cavalca, Fabrizio Gambacorti-Passerini, Carlo Bellani, Giacomo Foti, Giuseppe J Clin Med Article Historically, the admission of hematological patients in the ICU shortly after the start of a critical illness is associated with better survival rates. Early intensive interventions administered by MET could play a role in the management of hematological critically ill patients, eventually reducing the ICU admission rate. In this retrospective and monocentric study, we evaluate the safety and effectiveness of intensive treatments administered by the MET in a medical ward frame. The administered interventions were mainly helmet CPAP and pharmacological cardiovascular support. Frequent reassessment by the MET at least every 8 to 12 h was guaranteed. We analyzed data from 133 hematological patients who required MET intervention. In-hospital mortality was 38%; mortality does not increase in patients not immediately transferred to the ICU. Only three patients died without a former admission to the ICU; in these cases, mortality was not related to the acute illness. Moreover, 37% of patients overcame the critical episode in the hematological ward. Higher SOFA and MEWS scores were associated with a worse survival rate, while neutropenia and pharmacological immunosuppression were not. The MET approach seems to be safe and effective. SOFA and MEWS were confirmed to be effective tools for prognostication. MDPI 2023-09-29 /pmc/articles/PMC10573388/ /pubmed/37834926 http://dx.doi.org/10.3390/jcm12196281 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Vergnano, Beatrice
Signori, Davide
Benini, Annalisa
Calcinati, Serena
Bettini, Francesca
Verga, Luisa
Borin, Lorenza Maria
Cavalca, Fabrizio
Gambacorti-Passerini, Carlo
Bellani, Giacomo
Foti, Giuseppe
Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial
title Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial
title_full Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial
title_fullStr Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial
title_full_unstemmed Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial
title_short Safety and Effectiveness of Intensive Treatments Administered Outside the Intensive Care Unit to Hematological Critically Ill Patients: An Intensive Care without Walls Trial
title_sort safety and effectiveness of intensive treatments administered outside the intensive care unit to hematological critically ill patients: an intensive care without walls trial
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10573388/
https://www.ncbi.nlm.nih.gov/pubmed/37834926
http://dx.doi.org/10.3390/jcm12196281
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