Patients discharging the Intensive Care Unit (ICU) still need a high level of care because of the severity of their disease. In fact, they have an increased risk for readmission to the ICU. Moreover, urgent readmissions to the ICU are a widely used tool to assessment the quality of Health Care services. Although a lot of efforts are being made to reduce them, these adverse events still exist. It is noted that readmitted patients to the ICU have a much poorer prognosis, as its mortality rates are six times higher, and also have eleven times higher probability to die in hospital compared with other hospitalized patients.

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We report a rare case of a young woman with anti-N-Methyl-D-Aspartate receptor (NMDAR) encephalitis, who developed psychiatric symptoms, dyskinesias, hypoventilation, hypersalivation and seizures. Serial analysis of antibodies to NR1/NR2B heteromers of the NMDAR was positive on the patient's serum and cerebrospinal fluid (CSF). Removal of an ovarian teratoma after intravenous immunoglobulin and corticosteroid therapy resulted in a prompt neurological response.

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Neurologic complications after liver transplantation are quite common, with central pontine myelinolysis (CPM) being a rare but fatal complication. In this report, we describe the case of female liver transplant recipient who developed CPM after orthotopic liver transplantation (OLT).A 62-year old woman was admitted to the ICU for postoperative recovery after OLT. The procedure was described as uneventful. The patient had a history of decompensated cirrhosis, tension ascites, class I hepatic encephalopathy and chronic hyponatremia which necessitated repeated hospitalizations in the year prior to transplantation.The patient was unable to be weaned from ventilator support and did not show an improvement in mental status (GCS=5) despite the cessation of sedation. After neurologic consultation, a brain MRI was performed which showed evidence of CPM in the pons. Despite supportive therapy, the patient did not show an improvement of mental status and after a 55-day hospitalization in the ICU she died from septic complications.The etiology of CPM is multifactorial, with liver transplant recipients being at an increased risk. Supportive treatment is the standard of care, and there are not enough evidence supporting other types of treatment.

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This study was undertaken to evaluate the immediate postoperative complications in renal transplant recipients requiring Intensive Care Unit (ICU) admission. All renal transplant recipients with immediate post-transplantation complications (<1 week) admitted to our ICU from 1992 to 2012 were studied. Patients’ characteristics, transplant variables and prognosis were evaluated and data were analyzed to identify factors of outcome. Over the study period 13 men and 3 women, (26.2 % of renal transplant recipients requiring ICU admission) aged 45.4±10 years, were included in the study. APACHE II and SOFA scores on ICU admission were 17.8±4.6 and 8.4±3.6 respectively.

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