Browsing by Author "Taljaard, Jantjie J."
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- ItemSepsis : at-risk patients, clinical manifestations and management(Health and Medical Publishing Group (HMPG), 2010-06) Taljaard, Jantjie J.Sepsis is a major clinical challenge, especially to clinicians working in emergency and critical care units. Research over the last decade into a better understanding of the pathophysiology and management of sepsis has resulted in a remarkable increase of new knowledge on the subject. Some findings translate into improved outcomes, while others lack reproducibility in large clinical trials.
- ItemThe utility of high-flow nasal cannula oxygen therapy in the management of respiratory failure secondary to COVID-19 pneumonia(Health & Medical Publishing Group, 2020-05-07) Lalla, Usha; Allwood, Brian W.; Louw, Elizabeth H.; Nortje, Andre; Parker, Arifa; Taljaard, Jantjie J.; Moodley, Desiree; Koegelenberg, Coenraad F. N.COVID-19 is a potentially fatal infection caused by SARS-CoV-2. As of 4 May 2020, more than 6 000 cases had been confirmed in South Africa (SA) with numbers rising steadily, a situation that will place a major strain on the country’s health resources, including its ability to provide intensive care and ventilatory support to patients with severe disease.
- ItemValidation of a severity-of-illness score in patients with tuberculosis requiring intensive care unit admission(Health & Medical Publication Group, 2015-05-27) Koegelenberg, Coenraad Frederik N.; Balkema, Cecile A.; Jooste, Ynishia; Taljaard, Jantjie J.; Irusen, Elvis M.Background. There is a paucity of data on the determinants of mortality due to tuberculosis (TB) in the intensive care unit (ICU). Objective. To develop a simple severity-of-illness score for use in patients with TB admitted to an ICU. Methods. A scoring system was generated by retrospectively identifying the four most significant and clinically unrelated predictors of mortality from an existing prospectively collected dataset (January 2012 - May 2013), and combining these with known predictors of poor outcome. Results. Of 83 patients admitted with TB, 38 (45.8%) died in the ICU. The four parameters identified from the retrospective analysis were: (i) HIV co-infection with a CD4 cell count <200/μL; (ii) a raised creatinine level: (iii) a chest radiograph showing diffuse parenchymal infiltrates/miliary pattern; and (iv) absence of TB treatment on admission. These were combined with septic shock and a low arterial partial pressure of oxygen/fractional inspired oxygen (P:F) ratio to generate a six-point severity-of-illness score (one point for each parameter). The scores for survivors were significantly lower than those for non-survivors (mean (standard deviation) 2.27 (1.47) v. 3.58 (1.08); p<0.01). A score of ≥2 was associated with significantly higher mortality than a score of <2 (7.1% v. 46.4%; odds ratio (OR) 15.03; 95% confidence interval (CI) 1.86 - 121.32; p<0.01), whereas a score of ≥3 was associated with a significantly higher mortality than a score of <3 (64.6% v. 20.0%; OR 7.29; 95% CI 2.64 - 20.18; p<0.01). Conclusion. The proposed scoring system identified patients at increased risk of dying from TB in the ICU. Further prospective studies are indicated to validate its use.