1
Hip hemiarthroplasty after displaced femoral neck
fracture: a survivorship analysis
Femoral neck fracture – broken knee joint
• Total Hip Arthroplasty – Yes….better results for
patients than internal fixation and hemiarthroplasty.
• Some Results for age group 60 + differ from this:
“0-35 % dislocation cases” – quite high
 REASON ? Major one is comorbidities!
•
2
Biomarkers as a Tool for Management of
Immunosuppression in Transplant Patients
•
•
•
•
Immuno-suppressive drugs
Without immunosuppression therapy,
transplatation surgery could be fatal.
Therapeutic drug monitoring –
DOES NOT reflect adverse effects to immune cells.
Pharmacodynamic monitoring (biomarkers)
3
Problem of infection in the ICU
•
•
Infections possible - ventilator-associated
pneumonia, catheter-associated urinary
tract infection, catheter-related
bloodstream infection
Need to be attentive to horizontal infection
and use proper antibiotics for multiresistant bacteria like MRSA.
4

Managing infection in the critical care unit:
how can infection control make the ICU safe?

Infection Control in the ICU

Device Related Nosocomial Infection In ICU
5
Antibiotic Resistance
Pathogens
Ventilator Associated
Pneumonia
Catheter-related
Infections
6
Risk Factors

Modifiable
◦ Frequency of ventilator
circuit changes
◦ Antibiotic usage

Prevention


Nonmodifiable
◦ Patient age and gender
◦ Severity of illness
◦ Coma

Bronchoscopic
techniques
Nonbronchoscopic
techniques
Balance between
initial antibiotic and
overuse
7
Decrease Infection in
Neonatal Intensive Care Unit
8
Long-Term Acute Care Hospital
Hand
Hygiene
Active
Surveillance
Culture
9
Pursuing perfection in fighting with
VAP and CR-BSIs in ICU
Bundle Methodology
VAP rate per 1,000
device days
CR-BSI rate per 1,000
device days
1997
2004
2002
2004
Medical ICU
29
18
8.2
3.4
Surgical ICU
Similar declines
10.5
4.5
Burn Center
Similar declines
9.5
1.85
Year
VAP: Ventilator-Associated Pneumonia
CR-BSIs: Catheter-Related Bloodstream Infections
10
11