scholarly journals RELATIONSHIP BETWEEN THYROID FUNCTION AND INTENSIVE CARE UNIT MORTALITY IN CRITICALLY ILL PATIENTS AT ZAGAZIG UNIVERSITY HOSPITAL

2015 ◽  
Vol 21 (2) ◽  
pp. 1-10
Author(s):  
Abd Elmonem Zaid ◽  
Mohamed Assy ◽  
Hatem Salem ◽  
Mohamed Saad ◽  
Mohamed Herzalla
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Thyroid Function ◽  
Critically Ill Patients ◽  
Intensive Care Unit Mortality ◽  
University Hospital

scholarly journals AChE-activity in critically ill patients with suspected septic encephalopathy: a prospective, single-centre study

2020 ◽  
Author(s):  
Benedikt Zujalovic ◽  
Benjamin Mayer ◽  
Sebastian Hafner ◽  
Florian Balling ◽  
Eberhard Barth
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Repeated Measures ◽  
Acetylcholinesterase Activity ◽  
University Hospital ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Baseline Values

Abstract Background In consequence of systemic inflammation, up to 70% of septic patients develop a diffuse brain dysfunction, accompanying with an increase in mortality, which is referred to as “septic associated encephalopathy”. Subsuming septic associated encephalopathy as a category of delirium, there is a common pathophysiology (neuro-inflammation and cholinergic transmitter imbalance). This can be approximated by measuring the acetylcholinesterase activity as a surrogate parameter of cholinergic activity. However, conflicting results for acetylcholinesterase activity exists, if single-point measurements have been done. Therefore, we wanted to test the hypothesis, whether longitudinal analysis of acetylcholinesterase activity in Intensive Care Unit patients displays septic associated encephalopathy/delirium in septic patients and reveals significant differences in comparison with non-septic, critically ill patients.Methods In this prospective, observational, single-center study, 175 patients, admitted to the surgical Intensive Care Unit of the University hospital Ulm, Germany, were included. Patients were divided into septic (n = 45) and non-septic (n = 130) patients and were screened for delirium/cognitive dysfunction. Subgroups for patients with delirium and altered acetylcholinesterase activity were built, dependent if an increase/decrease of the acetylcholinesterase activity was observed. Acetylcholinesterase activity was analysed over the course of time by using a linear regression model accounting for repeated measures. By using a time adjusted model, the effect of further possible predictors of acetylcholinesterase activity was analyzed. For nonparametric distributions, quantitative data were compared using Wilcoxon matched-pairs test. For the analysis of the independent samples, we used the Mann-Whitney test. Results There was a statistically significant, time-dependent change in acetylcholinesterase activity (decrease/increase) over a period of at least 5 days in septic patients which revealed septic associated encephalopathy/delirium in about 90%.Conclusion The longitudinal measurement of acetylcholinesterase activity over several consecutive days revealed a shift compared to baseline values exclusively in septic patients with septic associated encephalopathy/delirium. Acetylcholinesterase activity alteration compared to baseline values at the onset of sepsis may help to detect and differentiate septic associated encephalopathy from other delirium entities.Trial registration Retrospectively registered at German Clincial Trials Register, registration number DRKS 00020542, date of registration: January 27, 2020

KAMEDO Report No. 93 The Power Failure at Karolinska University Hospital, Huddinge, 07 April 2007

2009 ◽  
Vol 24 (5) ◽  
pp. 468-470 ◽  
Author(s):  
Lars-Göran Angantyr ◽  
Eskil Häggström ◽  
Per Kulling
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Great Risk ◽  
Critically Ill Patients ◽  
Lessons Learned ◽  
University Hospital ◽  
Power Failure ◽  
Future Events

AbstractA sudden and extensive power failure occurred at Karolinska University Hospital in Huddinge on Easter Saturday, 07 April 2007. The power failure lasted one hour and 22 minutes, but it took a longer time for activities to return to normal. It put many patients at great risk, particularly in the intensive care unit and other departments with critically ill patients. This report details the conditions and response at Karolinska University Hospital during the power failure and provides lessons learned for future events.

scholarly journals AChE-activity in critically ill patients with suspected septic encephalopathy: a prospective, single-centre study

2020 ◽  
Author(s):  
Benedikt Zujalovic ◽  
Benjamin Mayer ◽  
Sebastian Hafner ◽  
Florian Balling ◽  
Eberhard Barth
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Repeated Measures ◽  
Acetylcholinesterase Activity ◽  
Brain Dysfunction ◽  
University Hospital ◽  
Longitudinal Measurement ◽  
Baseline Values

Abstract BackgroundIn consequence of systemic inflammation, up to 70% of septic patients develop a diffuse brain dysfunction, accompanying with an increase in mortality, which is referred to as “septic associated encephalopathy”. Subsuming septic associated encephalopathy as a category of delirium, there is a common pathophysiology (neuroinflammation and cholinergic transmitter imbalance). This can be approximated by measuring the acetylcholinesterase activity as a surrogate parameter of cholinergic activity. However, conflicting results for acetylcholinesterase activity exists, if singlepoint measurements have been done. Therefore, we wanted to test the hypothesis, whether longitudinal analysis of acetylcholinesterase activity in Intensive Care Unit patients displays septic associated encephalopathy/delirium in septic patients and reveals significant differences in comparison with non-septic, critically ill patients. MethodsIn this prospective, observational, single-center study, 175 patients, admitted to the operative Intensive Care Unit of the University hospital Ulm, Germany, were included. Patients were divided into septic (n = 45) and non-septic (n = 130) patients and were screened for delirium/cognitive dysfunction. Subgroups for patients with delirium and altered acetylcholinesterase activity were built, dependent if an increase/decrease of the acetylcholinesterase activity was observed. Acetylcholinesterase activity was analysed over the course of time by using a linear regression model accounting for repeated measures. By using a time adjusted model, the effect of further possible predictors of acetylcholinesterase activity was analyzed. For nonparametric distributions, quantitative data were compared using Wilcoxon matched-pairs test. For the analysis of the independent samples, we used the Mann-Whitney test. ResultsThere was a statistically significant, time-dependent change in acetylcholinesterase activity (decrease/increase) over a period of at least 5 days in septic patients which revealed septic associated encephalopathy/delirium in about 90%. ConclusionThe longitudinal measurement of acetylcholinesterase activity over several consecutive days revealed a shift compared to baseline values exclusively in septic patients with septic associated encephalopathy/delirium. Acetylcholinesterase activity alteration compared to baseline values at the onset of sepsis may help to detect and differentiate septic associated encephalopathy from other delirium entities. Trial registrationRetrospectively registered at German Clincial Trials Register, registration number DRKS 00020542, date of registration: January 27, 2020

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 Impact of fluid balance on intensive care unit mortality in critically ill patients with cardiovascular disorders. Authors' reply

2020 ◽  
Vol 78 (2) ◽  
pp. 175-176
Author(s):  
Ewa Trejnowska ◽  
Szymon Skoczyński ◽  
Paul Armatowicz ◽  
Małgorzata Knapik ◽  
Paulina Kurdyś ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Intensive Care Unit Mortality ◽  
Cardiovascular Disorders

scholarly journals Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

2021 ◽  
Vol 18 (21) ◽  
pp. 11178
Author(s):  
Lucyna Płaszewska-Żywko ◽  
Aurelia Sega ◽  
Agnieszka Bukowa ◽  
Katarzyna Wojnar-Gruszka ◽  
Marcelina Podstawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
University Hospital ◽  
Study Group ◽  
Eye Care ◽  
Severe Condition ◽  
Care Protocol

In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients’ severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care. The study was conducted in the ICU of a university hospital. Methods for estimating and analyzing medical records were used. The patient’s evaluation sheet covering 12 categories of risk factors for eye complications was worked out. The study group included 76 patients (34 patients with injuries and 42 without injuries). The Shapiro–Wilk test, the Spearman’s rank correlation test, the Mann–Whitney U test and the Friedman’s ANOVA test were used. The level of significance was set at α = 0.05. The most important risk factors for eye complications in the study group were: lagophthalmos (p < 0.001), sedation (p < 0.01), use of some cardiological drugs and antibiotics (p < 0.01), mechanical ventilation (p < 0.05), use of an open suctioning system (p < 0.01), presence of injuries (p < 0.01) including craniofacial trauma (p < 0.001), high level of care intensity (p < 0.01), failure to follow eye care protocol (p < 0.001), length of hospitalization at the ICU (p < 0.001), and the frequency of ophthalmological consultations (p < 0.001). There was no correlation between the incidence of these complications and the age and gender of the patients. The exposure of critically ill patients to eye complications was high. It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk factors.

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