Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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Afessa, B., Green, B., Delke, I. & Kock, K. (2001) 112 Maternal Intensive Care in Belgium KCE Reports 94 33 USA 74 obstetric patients admitted to the ICU Tertiary centre based retrospective review of 74 obstetric patients admitted to a multidisciplinary ICU from 1991- 1998 to determine the incidence of SIRS and organ failure and to describe the outcomes of critically ill obstetric patients who have been treated in the medical ICU. Medical records of obstetric patients admitted to the medical ICU were reviewed on age, race, underlying chronic disease, duration of pregnancy on admission to the hospital, reason for medical ICU admission, pregnancy related and other medical diagnoses, use of mechanical ventilation and pulmonary artery catheters, length of medical ICU and hospital stay, development of ARDS, Tertiary centre based retrospective analysis of obstetric ICU admissions (health care survey) reported having capability of full intensive services in labor delivery. Limited lengths of stay from 24h -1week. The other 3 units are identical to the OICU as described in the study CONCLUSION: An Obstetric Intermediate Care Unit allows for the continuation of care by obstetricians and results in fewer transfers to medical/surgical intensive care units. Patient treatment depends on hospital size and available resources. In most tertiary centers, the critically ill pregnant woman is best cared for by obstetricians in an Obstetric Intermediate Care Unit. In smaller hospitals, transfer to a medical or surgical intensive care unit may be preferable. OBJECTIVE: to determine the incidence of systemic inflammatory response syndrome (SIRS) and organ failure and to describe the outcomes in critically ill obstetric patients who have been treated in medical ICU’s. RESULTS: 58% of the patients were admitted to the ICU postpartum, 42% antepartum. Mean age 25,9 years, 64% African American & 34% white. 50% had preexisting medical conditions, APACHE II 14,0 & predicted mortality rate 17,6%. Most common reason for admission respiratory insufficiency. Preeclampsia in 36% of the patients, HELLP in 7%. SIRS developed in 59% of the patients, ARDS in 15%. Invasive mechanical ventilation was required in 45% & pulmonary arterial catheterization in 35%. In hospital mortality was 2,7%. There were 5 spontaneous abortions and 8 perinatal deaths. CONCLUSION: The most common 1+ 2+ 3+ 4?nvt 5? 6+ 7+ 8+ 9+ 10- Score:ok 3
Ryan, M., Hamiltin, V., Bowen, M. & McKenna, P. (2000) Cordingley, J.J., Rubin, A.P. (1997) kCE Reports 94 Maternal Intensive Care in Belgium 113 34 Ireland 123 patients admitted on the HDU of an regional obstetric centre (free standing maternity unit) 34 bis UK 232 consultant obstetric units development of SIRS, development of organ failure, maternal morbidity and pregnancy loss. Acute physiology and chronic health evaluation (APACHE) II scores were calculated. Regional obstetric hospital based retrospective review of on the one hand all records of all obstetric patients admitted to the HDU from 1996 to 1998 and on the other hand a retrospective analysis of medical charts relating to ICU admissions in a tertiary referral hospital from 1994 to 1998. Clinical information: patients’ characteristics, obstetric history, details of current pregnancy and relevant past medical history . HDU data: indication for admission, length of stay, procedures performed and maternal-fetal outcomes ICU-data: indication for transfer to ICU, length of stay, procedures performed and maternal-fetal outcomes (Patient subdivision in ICU transfers before the start of the HDU) Retrospective review between June and November 1994 concerning a postal survey of all units in the UK providing obstetric recovery facilities, high dependency, intensive care and anaesthetic staffing. The questionnaires were addressed to the consultant Regional obstetric hospital based retrospective analysis of all hospital case notes and HDU/ICU registers from HDU admissions and medical charts from the referral ICU (health care survey) Retrospective nationwide health care survey of all UK units providing obstetric recovery facilities, high dependency and intensive care reason for admission to the ICU of critically ill obstetric patients was respiratory failure. Despite the severity of illness and the development of SIRS and organ failure in most patients, the mortality rate was low. OBJECTIVE: The aim of the study was to review a series of critically ill patients admitted to a high-dependency unit(HDU)in a regional obstetric centre, to assess the HDU utilisation rate and to determine the indications for and rate of transfer to an intensive care unit (ICU) in a tertiary referral centre of was performed. RESULTS: One hundred and twenty-three patients were admitted to the HDU in the 2 years following its inception, representing 1.02% of all deliveries. Obstetric complications accounted for 81.3% of admissions. Seventeen patients ere admitted to an ICU during the study period; 12 (0.08%) were transferred before and five (0.04%) after the development of HDU facilities (p . 0.25). CONCLUSIONS: The advantages of a HDU within this setting include the concurrent availability of expert obstetric care and critical care management, the avoidance of the hazards of emergency transport and improved continuity of antenatal and postnatal care. OBJECTIVE: Reports on Confidential Enquiries into Maternal Deaths and the Obstetric Anaesthesits Association have made recommendations about the provision of staff and facilities in consultant obstetric units. This survey aimed to assess postoperative recovery, high dependency and intensive care facilities, monitoring 1+ 2+ 3+ 4+ 5+ 6+/- 7+ 8+ 9+ 10- Score:ok 1+ 2+ 3+ 4+ 5+/- 6+ 7+/- 8+ 3 3
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35. Etude relative aux coûts poten
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Soins maternels intensifs (Maternal Intensive Care) en Belgique - KCE

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