Background: Acute respiratory failure (ARF) is an important presentation in emergency department (ED). Intubation and mechanical ventilation (MV) are sometimes the ultimate decisions in such emergent situations. Many of these patients are unfortunately managed in an ED. This may endanger their outcome. This study was aimed to compare the outcome of critically ill patients with ARF under MV admitted to ED with patients admitted to ICU. Methods: All critically ill patients with ARF who were Intubated and placed under MV were enrolled in this study. Cases were either admitted to ED or ICU. Demographic data, initial diagnosis, final diagnosis, length of hospital stay, one-month mortality rate, number of times patient was Intubated and number of times patient was resuscitated were all recorded and compared between the 2 groups. Results: Out of all 172 patients admitted to ED and ICU, 74 (43%) were females and 98 (57%) were males. patients had a mean±, SD age of 64. 2±, 18. 1 years. ICU patients (85 patients (49. 4%)) had a significantly longer hospital stay (p=0. 048). ICU patients had significantly more resuscitation process (p=0. 006). Mortality rate in ICU was significantly higher than ED. In the meanwhile, more patients in ED finally survived (p=0. 004). Conclusion: In the present study, ICU patients were admitted longer to the ward than ED patients. Overall, ED mortality rate was lower than ICU. More patients finally survived in ED in comparison to ICU.

Background & Aims: Endotracheal intubation is commonly performed in the intensive care unit. Many international guidelines for difficult intubation management are available and the intensivists think that any endotracheal intubation in ICU is potentially difficult with several complications.Materials & Methods: After obtaining ethical approval, this descriptive and analytical study was conducted from 2014 to 2015 in the Urmia Emam hospital GICU. Demographic characteristic (Age, Sex), underlying diseases, mean of intubation, mechanical ventilation, ICU and hospital length of stay, frequency of difficult intubation, drugs used for intubation, mortality of patients were extracted from the medical information unit and entered to check lists. The data were analyzed with SPSS software ver.20.. P<0.05 was considered significant.Results: The mean of variables were as follows: intubation period 14.56±4.71, mechanical ventilation 13.24±5.54, ICU length of stay 18.11±10.16 and hospital 21.04±13.09 days. Frequency of difficult intubation was 9.31%. Mean number of attempts was 1.31 times for intubation and frequency of mortality was 35.17%. The Mean of intubation, mechanical ventilation, ICU and hospital length of stay period between 2 groups (difficult and non difficult intubation) were significantly different (P<0.05), although mortality frequency was not significant.Conclusion: This study, like previous studies showed that difficult intubation had a negative influence on patients’ outcome in the intensive care unit.

Background: The role of caffeine as a brain stimulant in improving the respiratory characteristics of patients under mechanical ventilation is unclear. This study aimed at determining the effect of oral caffeine in helping to release (Liberation) from the ventilator in Intubated patients under mechanical ventilation admitted to the intensive care unit. Materials and Methods: General ICU patients with more than 48 hours of dependency on a ventilator were randomly divided into two groups. The intervention group received 200mg caffeine tablets twice a day through a gastric tube, while the control group received a placebo of the same amount. Every day, patients were assessed for the likelihood of being disconnected from the device. If their clinical condition was deemed suitable, the device mode was switched to spontaneous, and their Rapid Shallow Breathing Index (RSBI) was calculated. Based on this information, a decision was made regarding whether to proceed with weaning. Results: Caffeine use in ICU patients significantly reduced the airway resistance index of patients (P <0.05). However, although this drug reduced the length of hospital stay in the ICU and the duration of intubation of patients, these changes were not statistically significant (P> 0.05). Conclusion: Caffeine may improve respiratory status and reduce the duration of intubation and hospitalization in the ICU.

Background: Recently, a novel coronavirus was reported fromWuhan, Hubei Province, China. The novel coronavirus infection was spread from China to other countries, including Iran. Objectives: We report the clinical characteristics, laboratory findings, and chest exams of infected patients. Methods: All patients suspected to the novel coronavirus were hospitalized in a special airborne protection room. We collected and analyzed the characteristics of confirmed patients by data extraction from electronic medical records. Results: The Computerized Tomography (CT) scan and radiography results showed ground glass in the lung of patients, and realtime PCR confirmed the infection. The myocardial and liver function tests showed abnormalities in infected patients. Conclusions: Most patients admitted to the Intensive Care Unit (ICU) showed respiratory problems, and their infection was confirmed by virological tests and chest images. The main reason for the patient’ s death was the signs of acute heart failure, such as hypotension and cardiac arrhythmia.