scholarly journals Improved Outcome of Severe Acute Pancreatitis in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Polychronis Pavlidis ◽  
Siobhan Crichton ◽  
Joanna Lemmich Smith ◽  
David Morrison ◽  
Simon Atkinson ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Pancreatitis ◽  
Intensive Care ◽  
Severe Acute Pancreatitis ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Severity Index ◽  
Apache Ii Score ◽  
Tertiary Care Centre

Background. Severe acute pancreatitis (SAP) is associated with serious morbidity and mortality. Our objective was to describe the case mix, management, and outcome of patients with SAP receiving modern critical care in the Intensive Care Unit (ICU).Methods. Retrospective analysis of patients with SAP admitted to the ICU in a single tertiary care centre in the UK between January 2005 and December 2010.Results. Fifty SAP patients were admitted to ICU (62% male, mean age 51.7 (SD 14.8)). The most common aetiologies were alcohol (40%) and gallstones (30%). On admission to ICU, the median Acute Physiology and Chronic Health Evaluation (APACHE) II score was 17, the pancreatitis outcome prediction score was 8, and the median Computed Tomography Severity Index (CTSI) was 4. Forty patients (80%) tolerated enteral nutrition, and 46% received antibiotics for non-SAP reasons. Acute kidney injury was significantly more common among hospital nonsurvivors compared to survivors (100% versus 42%, ). ICU mortality and hospital mortality were 16% and 20%, respectively, and median lengths of stay in ICU and hospital were 13.5 and 30 days, respectively. Among hospital survivors, 27.5% developed diabetes mellitus and 5% needed long-term renal replacement therapy.Conclusions. The outcome of patients with SAP in ICU was better than previously reported but associated with a resource demanding hospital stay and long-term morbidity.

scholarly journals Clinical Profile of Acute Kidney Injury in Intensive care unit: a prospective observational study from a rural tertiary care centre in North India

2020 ◽  
Vol 19 (4) ◽  
pp. 685-691
Author(s):  
Shashwat Jindal ◽  
Sandeep Joshi ◽  
Ruby Sharma ◽  
Chander Mohan Adya ◽  
Nitin Gupta
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Kidney Injury ◽  
North India ◽  
Care Centre ◽  
Tertiary Care Centre

Introduction: Acute Kidney Injury is characterized by an acute and potentially reversible deterioration of renal function, which results in failure of the kidney to excrete nitrogenous waste products and to maintain fluid and electrolyte balance. There is marked variation in epidemiological data of Acute Kidney Injury depending upon the definitions used, population being studied and the clinical settings. Aims and Objectives: This study was designed to determine the clinical profile of adult patients with Acute Kidney Injury (AKI) admitted in the medical ICU at a rural tertiary care centre in North India. Materials and Methods: This prospective observational study was conducted on 70 patients of Acute Kidney Injury admitted in the Medical Intensive Care Unit in Department of Medicine at M. M. Institute of Medical Sciences and Research, Mullana, Ambala. AKI was diagnosed and staged for severity according to the KDIGO criteria. Results and Observations: Amongst the 70 cases of AKI, 32 cases (45.7%) were females while 38 cases (54.3%) were males. The mean age at presentation was 55.22 ± 14.91 years. Sepsis was found to be the major cause of AKI. Out of 70 patients in our study, 45 (64.2%) cases were attributed to sepsis. Mortality rate seen in this study was 40% (n=28). Conclusion: Acute Kidney Injury is a common clinical problem encountered in critically ill patients, especially in the medical ICU. Early detection and adequate management is important to reduce AKI related as well as all- cause mortality in critically ill patients. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.685-691

Clinical Profile and Outcomes in Patients with Acute Pancreatitis attending a Teaching Hospital at Gandaki Province, Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Subash Bhattarai ◽  
Merina Gyawali
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Age Groups ◽  
Data Entry ◽  
Kidney Injury ◽  
Severity Index ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Systemic Complications ◽  
Keywords Alcohol

Background: Acute pancreatitis (AP) is inflammatory process of pancreas presenting with acute abdominal pain.The majority of patients have mild disease. Some patients develop local and systemic complications with increased morbidity and mortality. This study was undertaken to describe the clinical profile and outcomes in patients with acute pancreatitis.   Methods:  A cross-sectional hospital based study comprising of 62 consecutive patients with acute pancreatitis were enrolled between Jan 2019 to August 2020. Clinical profile at admission, complications and clinical outcomes including mortality were studied. Patients were classified into mild, moderately severe and severe acute pancreatitis based on revised Atlanta classification and modified CT severity index.  Data entry was done in Statistical Packages for the Social Sciences version 20. Results: The mean age of study subjects was 44±10.87 years with 43 (56%) males and 19 (44%) females (M:F=2.1:1). The commonest etiology of pancreatitis was alcohol (53.2%) followed by biliary pancreatitis (37.1%)  The most common presentation was abdominal pain (100%). The most common complication was pancreatic necrosis (21%) followed by acute kidney injury (19.4%) and pleural effusion (17.3%). Majority( 72.6%) was mild and 17.7% had severe acute pancreatitis. Mortality was seen in 6.5% patients. Mortality was observed in patients with persistent complications, organ failure, low serum calcium and high modified CT severity index.   Conclusions: Alcohol and gallstones were the two main etiologies of acute pancreatitis and were common in males, and in middle age groups. Majority presented with mild severity. Mortality was observed in some patients with severe acute pancreatitis.   Keywords: alcohol; biliary; CT severity index; mortality; outcome; pancreatitis          

Haemorrhage in severe acute pancreatitis: Management and outcome at a tertiary care centre

Pancreatology ◽  
2014 ◽  
Vol 14 (2) ◽  
pp. S5
Author(s):  
P. Patnaik ◽  
V. Arun Kumar ◽  
R. Dhingra ◽  
Sujoy Pal ◽  
N.R. Dash ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre

scholarly journals Outcomes of Chronic Hemodialysis Patients in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-7
Author(s):  
Melanie Chan ◽  
Marlies Ostermann
Keyword(s):  
Intensive Care Unit ◽  
Renal Function ◽  
Intensive Care ◽  
Kidney Injury ◽  
Chronic Hemodialysis ◽  
Current Evidence ◽  
Icu Outcome ◽  
Stage Renal Disease ◽  
End Stage

Patients with end-stage renal disease (ESRD) experience higher rates of hospitalisation, cardiovascular events, and all-cause mortality and are more likely to require admission to the intensive care unit (ICU) than patients with normal renal function. Sepsis and cardiovascular diseases are the most common reasons for ICU admission. ICU mortality rates in patients requiring chronic hemodialysis are significantly higher than for patients without ESRD; however, dialysis patients have a better ICU outcome than those with acute kidney injury (AKI) requiring renal replacement therapy suggesting that factors other than loss of renal function contribute to their prognosis. Current evidence suggests, the longer-term outcomes after discharge from ICU may be favourable and that long-term dependence on dialysis should not prejudice against prompt referral or admission to ICU.

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