scholarly journals RELATIONSHIP OF LIVER ENZYME LEVELS WITH THE CLINICAL COURSE OF COVID-19

2021 ◽  
Author(s):  
ulku ince ◽  
harun tolga duran
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Liver Enzyme ◽  
Alanine Aminotransferase ◽  
Invasive Mechanical Ventilation ◽  
Gamma Glutamyl Transferase ◽  
Predictive Values ◽  
Gamma Glutamyl ◽  
Glutamyl Transferase

Introduction: Covid 19 infection, which can affect many systems in the human body, can cause organ dysfunction. High liver serum enzymes can be found in covid-19 patients, and many factors cause this stop. Patients with high levels of liver enzymes that require invasive mechanical ventilation during their follow-up were examined, and it was aimed to determine whether it was among the predictive indicators of mortality. MATERIAL AND METHODS: Patients infected with covid 19 who were hospitalized in the intensive care unit between March 30 and December 1, 2020 according to the criteria of hospitalization in the intensive care unit, clinical trials such as age, gender, length of stay, additional diseases, liver enzyme levels and whether invasive mechanical ventilation is required their characteristics were recorded and analyzed retrospectively and compared. RESULTS: Data were collected from 111 patients whose liver enzyme levels were measured from 131 patients included in the study. It was found that aspartate transaminase, alanine aminotransferase, and gamma-glutamyl transferase levels were statistically higher in the invasive mechanical ventilation group compared to the patients who did not undergo invasive mechanical ventilation. CONCLUSION: Alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase levels were statistically higher in COVID19-infected patients who were treated in intensive care and undergoing invasive mechanical ventilation. These enzymes are easily accessible and are shown among predictive values in mortality.

scholarly journals Gamma Glutamyl Transferase and Uric Acid Levels Can Be Associated with the Prognosis of Patients in the Pediatric Intensive Care Unit

Children ◽  
2018 ◽  
Vol 5 (11) ◽  
pp. 147
Author(s):  
Fatih Aygun ◽  
Ruhsar Kirkoc ◽  
Deniz Aygun ◽  
Halit Cam
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Uric Acid ◽  
Intensive Care ◽  
Drug Use ◽  
Significant Relationship ◽  
Pediatric Intensive Care ◽  
Gamma Glutamyl Transferase ◽  
Inotropic Drug ◽  
Glutamyl Transferase

Introduction: Gamma glutamyl transferase (GGT) and uric acid (UA) are reported to be predictive markers in various disorders. It has been reported that these biomarkers can be used to indicate increased risk of mortality in critically ill patients. Herein, we aimed to evaluate the effects of the initial serum GGT and UA levels on the outcomes of patients in the pediatric intensive care unit (PICU) and to investigate if these biomarkers can be used to predict pediatric mortality. Materials and Methods: The relationship between the initial GGT and UA levels and invasive mechanical ventilation (IMV) and noninvasive mechanical ventilation (NIV) support, inotropic drug need, acute renal kidney injury (AKI), continuous renal replacement therapy (CRRT), presence of sepsis, mortality, and hospitalization period were investigated retrospectively. Results: In all, 236 patients (117 males and 119 females) were included in the study. The age distribution of the patients was 1–12 years. There was a statistically significant relationship between GGT levels in the first biochemical analysis performed during admission and inotropic drug use, AKI, duration of hospitalization in intensive care unit, and sepsis. There was a statistically significant relationship between initial UA levels and inotropic drug use, AKI, CCRT, and sepsis. Conclusion: We suggest that initial GGT and UA levels during admission could be used to predict the outcomes of patients in PICU.

Bước đầu khảo sát sự ổn định của một số chỉ số xét nghiệm sinh hóa trong máu toàn phần và huyết tương theo thời gian bảo quản mẫu bệnh phẩm

2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Đinh Thị Thảo ◽  
Trần Thái Hà ◽  
Nguyễn Viết Tân ◽  
Vi Thị Nhung ◽  
Nguyễn Cẩm Thạch
Keyword(s):  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Ldl Cholesterol ◽  
Hdl Cholesterol ◽  
Gamma Glutamyl Transferase ◽  
Gamma Glutamyl ◽  
Mau Mau ◽  
Glutamyl Transferase

Mục tiêu: Đánh giá ảnh hưởng của thời gian bảo quản đến kết quả phân tích các chỉ số urea, creatinine, triglycerid, cholesterol, HDL-cholesterol, LDL-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyl transferase (GGT), acid uric, bilirubin toàn phần, bilirubin trực tiếp trong mẫu máu toàn phần và huyết tương. Đối tượng và phương pháp: Gồm 162 mẫu máu toàn phần được chống đông bằng Li-heparin của 81 bệnh nhân (mỗi bệnh nhân lấy 2 ống mẫu) đến khám tại Khoa Khám bệnh - Bệnh viện Trung ương Quân đội 108 từ ngày 15/01/2021 đến ngày 15/02/2021. Với mỗi bệnh nhân: Ngay sau khi lấy máu, ống mẫu 1 được ly tâm, phân tích thường quy các chỉ số hóa sinh (phần còn lại sau phân tích gọi là mẫu 1), ống mẫu 2 được tách lấy huyết tương (mẫu 2). Sau đó, cả 2 mẫu được lưu trong tủ lạnh ở nhiệt độ 4oC. Sử dụng các mẫu này để phân tích các chỉ số hóa sinh tại các thời điểm 24, 48, và 72 giờ sau khi lấy máu. Kết quả: Nồng độ AST của các mẫu 1 được lưu trong 24, 48, 72 giờ cao hơn nồng độ AST phân tích thường quy (p<0,05). Nồng độ bilirubin toàn phần, bilirubin trực tiếp của mẫu 1 và mẫu 2 giảm dần theo thời gian lưu mẫu (p<0,05). Kết luận: Nồng độ các chỉ số AST, bilirubin toàn phần, bilirubin trực tiếp của các mẫu lưu (huyết tương và mẫu máu sau phân tích không loại bỏ các thành phần hữu hình) không ổn định theo thời gian bảo quản ở 4oC. Nồng độ các chỉ số urea, creatinine, triglycerid, cholesterol, HDL-cholesterol, LDL-cholesterol, ALT, GGT, acid uric (huyết tương và mẫu máu sau phân tích không loại bỏ các thành phần hữu hình) ổn định đến 72 giờ ở 4oC. Từ khóa: Hóa sinh, bảo quản bệnh phẩm, Bệnh viện Trung ương Quân đội 108.

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

scholarly journals Risk Factors Associated with Mechanical Ventilation in Critical Bronchiolitis

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1035
Author(s):  
Rachel K. Marlow ◽  
Sydney Brouillette ◽  
Vannessa Williams ◽  
Ariann Lenihan ◽  
Nichole Nemec ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Medical Center ◽  
Invasive Mechanical Ventilation ◽  
Severity Of Illness ◽  
Pediatric Intensive Care ◽  
Respiratory Support ◽  
Non Invasive ◽  
Lengths Of Stay

The American Academy of Pediatrics (AAP) recommends supportive care for the management of bronchiolitis. However, patients admitted to the intensive care unit with severe (critical) bronchiolitis define a unique group with varying needs for both non-invasive and invasive respiratory support. Currently, no guidance exists to help clinicians discern who will progress to invasive mechanical support. Here, we sought to identify key clinical features that distinguish pediatric patients with critical bronchiolitis requiring invasive mechanical ventilation from those that did not. We conducted a retrospective cohort study at a tertiary pediatric medical center. Children ≤2 years old admitted to the pediatric intensive care unit (PICU) from January 2015 to December 2019 with acute bronchiolitis were studied. Patients were divided into non-invasive respiratory support (NRS) and invasive mechanical ventilation (IMV) groups; the IMV group was further subdivided depending on timing of intubation relative to PICU admission. Of the 573 qualifying patients, 133 (23%) required invasive mechanical ventilation. Median age and weight were lower in the IMV group, while incidence of prematurity and pre-existing neurologic or genetic conditions were higher compared to the NRS group. Multi-microbial pneumonias were diagnosed more commonly in the IMV group, in turn associated with higher severity of illness scores, longer PICU lengths of stay, and more antibiotic usage. Within the IMV group, those intubated earlier had a shorter duration of mechanical ventilation and PICU length of stay, associated with lower pathogen load and, in turn, shorter antibiotic duration. Taken together, our data reveal that critically ill patients with bronchiolitis who require mechanical ventilation possess high risk features, including younger age, history of prematurity, neurologic or genetic co-morbidities, and a propensity for multi-microbial infections.

scholarly journals Analysis of enzyme activity and the level of malondialdehyde in the saliva of children with gingivitis

2009 ◽  
Vol 66 (11) ◽  
pp. 892-896
Author(s):  
Olivera Trickovic-Janjic ◽  
Tatjana Cvetkovic ◽  
Mirjana Apostolovic ◽  
Draginja Kojovic ◽  
Ljiljana Kostadinovic ◽  
...  
Keyword(s):  
Enzyme Activity ◽  
Lactate Dehydrogenase ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Study Groups ◽  
Functional Condition ◽  
Gamma Glutamyl Transferase ◽  
Gamma Glutamyl ◽  
Severe Inflammation ◽  
Glutamyl Transferase

Introduction/Aim. By analyzing activity of some of the enzymes normally present in the saliva and the level of malondialdehyde in gingivitis, it is possible to estimate the functional condition of parodontium, and the examined parameters can be considered as biochemical markers of its functional condition. The aim of this paper was to examine activity of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase, lactate dehydrogenase and the level of malondialdehyde in the saliva of children affected with gingivitis, as well as the values of the mentioned parameters in relation to the level of the inflammation of gingiva. Methods. The research included 120 children at the age of 12.2 with permanent dentition. L?e and Silness gingival index was used to estimate the condition of gingiva, based on which the children were classified into four groups: the children with healthy gingiva (the control groups), the children with mild, moderate and severe inflammation of gingiva (the study group). Enzymes of the saliva were determined by the use of original tests and measured by the autoanalyser (Bio Systems A25, Spain). A modified method with tiobarbituric acid was used to determine malondialdehyde in nonstimulated mixed saliva. Results. The results of the examined enzyme activity and the level of malondialdehyde in the saliva of the study groups showed statistically considerably higher values for the level of malondialdehyde (p < 0.001), for the activity of aspartate aminotransferase and gamma glutamyl transferase (p < 0.01), as well as for alanine aminotransferase (p < 0.05) in comparison with the control group, whereas the activity of lactate dehydrogenase did not show a statistically significant increase. In relation to the level of the inflammation of gingiva, the results of the examination of the enzyme activity in the study groups showed statistically significantly higher values in the group with severe inflammation in comparison with those with mild, as well as the moderate inflammatory, except for the gamma glutamyl transferase, and in the group with moderate inflammation compared to that with the mild one, except for alanine aminotransferase. The results of the examination of the level of malondialdehyde in the saliva of the study groups did not show a statistically significantly increase in relation to the level of the inflammation of gingiva. Conclusion. There is a higher level of alanine aminotransferase, aspartate aminotransferase, gamma glutamyl transferase and lactate dehydrogenase enzyme activity together with the higher level of malondialdehyde in the saliva of children with gingivitis in comparison with the activity of the same enzymes and the level of malondialdehyde in the saliva of children without gingivitis. The activity of the examined enzymes in the saliva of children with gingivitis increases in relation to the intensity of the pathological process, whereas the level of malondialdehyde shows no significant difference in relation to the level of the inflammation of gingiva.

scholarly journals Prediction of prolonged mechanical ventilation for intensive care unit patients: A cohort study

2013 ◽  
pp. 184-188 ◽  
Author(s):  
Alvaro Sanabria ◽  
Ximena Gomez ◽  
Valentin Vega ◽  
Luis Carlos Dominguez ◽  
Camilo Osorio
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Critically Ill ◽  
Medical Condition ◽  
Prolonged Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Adult Patients ◽  
Saps Ii Score

Introduction: There are no established guidelines for selecting patients for early tracheostomy. The aim was to determine the factors that could predict the possibility of intubation longer than 7 days in critically ill adult patients. Methods: This is cohort study made at a general intensive care unit. Patients who required at least 48 hours of mechanical ventilation were included. Data on the clinical and physiologic features were collected for every intubated patient on the third day. Uni- and multivariate statistical analyses were conducted to determine the variables associated with extubation. Results: 163 (62%) were male, and the median age was 59±17 years. Almost one-third (36%) of patients required mechanical ventilation longer than 7 days. The variables strongly associated with prolonged mechanical ventilation were: age (HR 0.97 (95% CI 0.96-0.99); diagnosis of surgical emergency in a patient with a medical condition (HR 3.68 (95% CI 1.62-8.35), diagnosis of surgical condition-non emergency (HR 8.17 (95% CI 2.12-31.3); diagnosis of non-surgical-medical condition (HR 5.26 (95% CI 1.85-14.9); APACHE II (HR 0.91 (95% CI 0.85-0.97) and SAPS II score (HR 1.04 (95% CI 1.00-1.09) The area under ROC curve used for prediction was 0.52. 16% of patients were extubated after day 8 of intubation. Conclusions: It was not possible to predict early extubation in critically ill adult patients with invasive mechanical ventilation with common clinical scales used at the ICU. However, the probability of successfully weaning patients from mechanical ventilation without a tracheostomy is low after the eighth day of intubation.

scholarly journals Síndrome de Dificuldade Respiratória Aguda: Casuística de Dois Anos numa Unidade de Cuidados Intensivos

2014 ◽  
Vol 27 (2) ◽  
pp. 211 ◽  
Author(s):  
Lúcia Taborda ◽  
Filipa Barros ◽  
Vitor Fonseca ◽  
Manuel Irimia ◽  
Ramiro Carvalho ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Intensive Care ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Invasive Mechanical Ventilation ◽  
Interquartile Range ◽  
The Mean

<strong>Introduction:</strong> Acute Respiratory Distress Syndrome has a significant incidence and mortality at Intensive Care Units. Therefore, more studies are necessary in order to develop new effective therapeutic strategies. The authors have proposed themselves to characterize Acute Respiratory Distress Syndrome patients admitted to an Intensive Care Unit for 2 years.<br /><strong>Material and Methods:</strong> This was an observational retrospective study of the patients filling the Acute Respiratory Distress Syndrome criteria from the American-European Consensus Conference on ARDS, being excluded those non invasively ventilated. Demographic data, Acute Respiratory Distress Syndrome etiology, comorbidities, Gravity Indices, PaO2/FiO2, ventilator modalities and programmation, pulmonary compliance, days of invasive mechanical ventilation, corticosteroids use, rescue therapies, complications, days at<br />Intensive Care Unit and obits were searched for and were submitted to statistic description and analysis.<br /><strong>Results:</strong> A 40 patients sample was obtained, with a median age of 72.5 years (interquartile range = 22) and a female:male ratio of ≈1:1.86. Fifty five percent of the Acute Respiratory Distress Syndrome cases had pulmonary etiology. The mean minimal PaO2/FiO2 was 88mmHg (CI 95%: 78.5–97.6). The mean maximal applied PEEP was 12.4 cmH2O (Standard Deviation 4.12) and the mean maximal used tidal volume was 8.2 mL/ Kg ideal body weight (CI 95%: 7.7–8.6). The median invasive mechanical ventilation days was 10. Forty seven and one half percent of the patients had been administered corticosteroids and 52.5% had been submitted to recruitment maneuvers. The most frequent complication was Ventilator Associated Pneumonia (20%). The median Intensive Care Unit stay was 10.7 days (interquartile range 10.85). The fatality rate was 60%. The probability of the favorable outcome ‘non-death in Intensive Care Unit’ was 4.4x superior for patients who were administered corticosteroids and 11x superior for patients &lt; 65 years old.<br /><strong>Discussion and Conclusions:</strong> Acute Respiratory Distress Syndrome is associated with long hospitalization and significant mortality. New prospective studies will be necessary to endorse the potential benefit of steroid therapy and to identify the subgroups of patients that warrant its use.

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