scholarly journals Thyroid status among critically ill patients admitted in the intensive care unit of the government tertiary care hospital in Mandya: a retrospective study

2020 ◽  
Vol 7 (3) ◽  
pp. 401
Author(s):  
Chethan Kumar K. L. ◽  
Shivakumar K. M.
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Thyroid Function ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Thyroid Status ◽  
Euthyroid Sick Syndrome ◽  
Low T3 ◽  
Low Levels

Background: The nonthyroidal illness syndrome, also known as the low T3 syndrome or euthyroid sick syndrome. Any acute severe illness can cause abnormalities of circulating Thyroid Stimulating Hormone (TSH) or Thyroid Hormone (TH) levels in the absence of underlying thyroid disease. The laboratory parameters of this syndrome include low serum levels of T3 and high levels of reverse T3, with normal or low levels of thyroxine (T4) and normal or low levels of TSH. This condition may affect 60-70% of critically ill patients. The severity of illness correlates well with the reduction in total serum T3 level. Objectives of the study was to assess the thyroid status of critically ill patients admitted in intensive care unit of a tertiary care hospital.Methods: This is a retrospective observational study done at Department of General Medicine, MIMS, Mandya among patients admitted with critical illness to ICU. 100 patients admitted with critical illness to ICU are included in this study. Thyroid function reports obtained from case sheets, data entered into MS Excel sheet and analysed.Results: Out of 100 patients studied 34 patients had sepsis, 26 patients had respiratory failure, 20 patients had Congestive cardiac failure, 12 patients had acute renal failure and 8 patients had Diabetic ketoacidosis. Among 100 patients 63% had abnormal thyroid function test, 56% had low T3, 12% had low T4, 2% had high T4 and 3% had low TSH.Conclusions: Thyroid function abnormality suggesting Non thyroid illness or euthyroid sick syndrome is common among critically ill patients.

scholarly journals Characteristics and Outcomes of Critically Ill Patients with Raised Cardiac Troponins Admitted in the Intensive Care Unit

2021 ◽  
Author(s):  
Sunil K. Nadar ◽  
Muhammad M. Shaikh ◽  
Muhammad A. Khatri ◽  
Wael A. Abdelmottaleb ◽  
Sheeraz Ahmed ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Myocardial Injury ◽  
Tertiary Care ◽  
Hospital Length Of Stay ◽  
Care Hospital ◽  
Coronary Syndrome

Objectives: Critically ill patients have been shown to have raised troponins.  The aim of our study was to assess the incidence of myocardial injury in the intensive care unit (ICU) a tertiary care hospital in Oman and assess their management and prognosis. Methods: This was a retrospective study involving adult patients admitted to the ICU of our institution between 1st January and 31st December 2019 who had a high sensitive cardiac troponin (Hs-CTn) assay performed. We excluded patients who were admitted with a primary diagnosis of myocardial infarction. Results: A total of 264 patients had a Hs-cTn measured during this period. Of these 128 patients (64.3+17.1 years; 58.5% male) had elevated levels giving an incidence of around 48.4%. Those with raised troponin were older and had more co-morbidities. These patients were also more critical with lower blood pressure, higher heart rates, hypotensive episodes. Of the 128 patients, 47 were treated as acute coronary syndrome and 32 underwent coronary angiography. Of these only 3 patients required stenting. Patients with raised troponin had a poor outcome with only 45 (35.1%) surviving to discharge as compared to 73.5% where troponin was normal. They had a shorter hospital length of stay as compared to those with normal troponin (16(8-25) vs 19(13-28) p=0.017). Conclusion: A high proportion of critically ill patients have evidence of myocardial injury without significant coronary artery disease. It is associated with poor prognosis. Further prospective studies are required to ascertain the best mode of treatment in these patients. Keywords: Troponin; Biomarkers; Intensive Care; Myocardial Infarction.

Study of incidence of acute renal failure and its associated factors and complications amongst patients admitted in intensive care unit of a tertiary care teaching hospital

2021 ◽  
Vol 11 (2) ◽  
pp. 108-111
Author(s):  
Rameshwar A Warkad ◽  
Keyword(s):  
Intensive Care Unit ◽  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Intensive Care ◽  
Critically Ill ◽  
Teaching Hospital ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Tertiary Care Teaching Hospital

Background: Impairment of renal function is a serious complication in critically ill patients. Mortality of acute renal failure remains high ranging from 35% to 86% despite haemodialysis therapy and substantial improvement of dialysis techniques. Therefore attention must be paid to the conditions favouring deterioration of renal function in order to prevent acute renal failure or to intervene in an early phase when less invasive therapies might be even more promising. Methods: This prospective study was conducted in a tertiary care teaching hospital in Mumbai from 1st January 2006 to 31st December 2006. All patients consecutively admitted in intensive care unit were studied. Results: Total number of patients admitted during the said period to the Intensive care Unit was 406, of which 50 had evidence of acute renal failure. The incidence of acute renal failure in the critically ill patients included in our study was 12.31%. There was a statistically significant difference in the incidence of fluid overload, oliguria and hyperkalemia between the pre-renal and renal failure groups. Conclusion: The incidence of acute renal failure in the critically ill patients was 12.31% and commonest predisposing factors associated with acute renal failure were acute insults like hypotension, sepsis and risk factors like age >50 years and pre-existing renal disease.

scholarly journals Knowledge, Attitude, and Practices towards Physical Assessment of Critically Ill Patients among Nurses Working in Intensive Care Unit: A Cross-Sectional Study in Lahore, Pakistan

2021 ◽  
Vol 3 (1) ◽  
pp. 44-61
Author(s):  
Muhammad Saghir ◽  
Muhammad Hussain ◽  
Kousar Perveen ◽  
Muhammad Afzal ◽  
Maliha Shoukat Shoukat
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Pearson Correlation ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Physical Assessment

Purpose: The purpose of the study to examine nurses' knowledge, attitudes, and practices towards physical assessment of critically ill patients in Tertiary Care Hospital, Lahore Pakistan. Methodology: The cross-sectional study was performed. A well-designed questionnaire was used to observe responses. Statistical Package for the Social Sciences (SPSS) version 25 was used to analyze the data. For the analysis, descriptive statistics of demographic data were used, meaning standard deviation and frequency. The Pearson correlation test was used to measure the correlation between knowledge, attitude, and practice towards physical assessment of critically ill patients. The study results display in tables and charts. Pearson correlation at p <0.05 consider as significant. Findings: The study was carried out to assess the knowledge, attitude, and practice among intensive care unit nurses towards physical assessment of critically sick patients in Tertiary Care Hospital Lahore, Pakistan. In this study, around 57.2% of nurses had good knowledge, 59.4% positive attitude, and 68.1% good practice towards critical ill patient’s physical assessment Unique contribution to theory, practice and policy: This study provide the opportunity to the nurses better to enhance their level of knowledge and skill of practice on physical assessment. Nurses, who had better knowledge and skill, should also teach their respective colleagues. Keywords: Knowledge, Attitude, Practice, Intensive Care Unit, Nurses, Physical Assessment.

The Association of Age With Short-Term and Long-Term Mortality in Adults Admitted to the Intensive Care Unit

2016 ◽  
Vol 32 (9) ◽  
pp. 554-558 ◽  
Author(s):  
Raghu R. Seethala ◽  
Kevin Blackney ◽  
Peter Hou ◽  
Haytham M. A. Kaafarani ◽  
Daniel Dante Yeh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tertiary Care ◽  
Age Groups ◽  
The Elderly ◽  
Short Term ◽  
Long Term Mortality

Background: Based on the current literature, it is unclear whether advanced age itself leads to higher mortality in critically ill patients or whether it is due to the greater number of comorbidities in the elderly patients. We hypothesized that increasing age would increase the odds of short-term and long-term mortality after adjusting for baseline comorbidities in intensive care unit (ICU) patients. Methods: We performed a retrospective cohort study of 57 160 adults admitted to any ICU over 5 years at 2 academic tertiary care centers. Patients were divided into age-groups, 18 to 39, 40 to 59, 60 to 79, and ≥80. The primary outcomes were 30-day and 365-day mortality. Results were analyzed with multivariate logistic regression adjusting for demographics and the Elixhauser-van Walraven Comorbidity Index. Results: The adjusted 30-day mortality odds ratios (ORs) were 1.39 (95% confidence interval [CI]: 1.21-1.60), 2.00 (95% CI: 1.75-2.28), and 3.33 (95% CI: 2.90-3.82) for age-groups 40 to 59, 60 to 79, and ≥80, respectively, using the age-group 18 to 39 as the reference. The adjusted 365-day mortality ORs were 1.46 (95% CI: 1.32-1.61), 2.10 (95% CI: 1.91-2.31), and 2.96 (95% CI: 2.67-3.27). Conclusion: In critically ill patients, increasing age is associated with higher odds of short-term and long-term death after correcting for existing comorbidities.

scholarly journals The Type II Iodothyronine Deiodinase Is Up-Regulated in Skeletal Muscle during Prolonged Critical Illness

2007 ◽  
Vol 92 (8) ◽  
pp. 3330-3333 ◽  
Author(s):  
Liese Mebis ◽  
Lies Langouche ◽  
Theo J. Visser ◽  
Greet Van den Berghe
Keyword(s):  
Skeletal Muscle ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Surgical Intensive Care Unit ◽  
Type Ii ◽  
Low T3 Syndrome ◽  
Low T3

Abstract Context: Critical illness is associated with the low T3 syndrome. It remains unclear whether altered type II deiodinase activity (D2) in skeletal muscle contributes to this syndrome. Objective: Our objective was to study D2 expression and activity in skeletal muscle of acute and prolonged critically ill patients. Design and Setting: We conducted a clinical observational study in acute and prolonged critical illness with comparison with healthy controls at a university hospital surgical intensive care unit. Patients: Subjects included 63 prolonged critically ill patients who died in the intensive care unit, 21 acutely ill patients, and 38 controls matched for age, gender, and body mass index. Results: Elevated expression of the D2 gene and D2 activity in skeletal muscle of prolonged, but not acute, critically ill patients were observed in the face of low circulating thyroid hormone levels. Conclusions: Reduced D2 activity does not appear to play a role in the pathogenesis of the low T3 syndrome of critical illness.

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