Role of Ischemia Modified Albumin Serum Levels as an Oxidative Stress Marker in Children with Diabetic Ketoacidosis

2019 ◽  
Vol 22 (8) ◽  
pp. 577-581
Author(s):  
Mutlu U. Yazıcı ◽  
Ganime Ayar ◽  
Senay Savas-Erdeve ◽  
Ebru Azapağası ◽  
Salim Neşelioğlu ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Diabetic Ketoacidosis ◽  
Pediatric Patients ◽  
Serum Levels ◽  
Oxidative Stress Marker ◽  
Control Group ◽  
Study Group ◽  
Ischemia Modified Albumin

Aim and Objective: Ischemia modified albumin (IMA) is a biomarker that has been introduced recently for use in the evaluation of oxidative stress. The aim of this study was to measure the ischemia modified albumin serum levels in pediatric patients with diabetic ketoacidosis (DKA) during acidosis and after the patient recovered from acidosis and to compare these with the control group. Materials and Methods: Pediatric patients with Type I diabetes mellitus (T1DM) who were admitted to the pediatric intensive care unit with the diabetic ketoacidosis were assigned as the study group and healthy children who were admitted to the outpatient clinic and decided as healthy after clinic and laboratory evaluation were selected as the control group. IMA and adjusted IMA levels were evaluated in the blood samples from the control group and the study group when admitted first time to the intensive care unit during the acidosis period (DKA before treatment, DKA-BT), and after recovering from acidosis (DKA after treatment, DKA-AT). Results: A total of 24 pediatric patients with diabetic ketoacidosis and 30 healthy control children matching age and sex were included in the current study. The albumin levels in pediatric patients with T1DM during DKA-BT were higher than the albumin levels after acidosis (4.101±0.373, 3.854±0.369 g/dL, respectively) (p<0.05). However, there was no significant difference when these values were compared to the control group. Mean values of IMA and Adj-IMA were statistically higher in DKAAT compared to the control group (0.748±0.150 vs 0.591±0.099, p< 0.001; 0.708±0.125 vs 0.607±0.824, p< 0.001, respectively). IMA and adjusted IMA levels measured after recovered from acidosis were significantly higher compared to the level of IMA during DKA (0.748±0.150 vs 0.606±0.105 as absorbance unit, p<0.001; 0.708±0.125 vs 0.625±0.100, p<0.05, respectively). Conclusion: In children with T1DM, even though acidosis recovered following the treatment in diabetic ketoacidosis, which is an oxidative stress marker, the ischemia modified albumin levels and adjusted ischemia modified albumin levels were high.

Serum Thiol-Disulphide Levels in Epileptic Pediatric Patients

2019 ◽  
Vol 22 (1) ◽  
pp. 65-68
Author(s):  
Halit Halil ◽  
Nilden Tuygun ◽  
Erhan Aksoy ◽  
Ozcan Erel ◽  
Can Demir Karacan
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Status ◽  
Pediatric Patients ◽  
Serum Levels ◽  
The Body ◽  
Control Group ◽  
Study Group ◽  
Total Thiol ◽  
Stress Markers ◽  
Meaningful Relationship

Background: Epilepsy is a serious clinical condition characterized by recurrent seizures. Oxidative stress plays an important role in the etio-pathogenesis of epilepsy. Measurements of serum thiol and disulfide levels were used to evaluate the antioxidant status of the body. Objective: The aim of this study was to determine serum levels of thiol and disulfide in epileptic pediatric patients. Methods: Ninety patients, 54 epilepsy and 36 controls were included in the study. Serum levels of native thiol total thiol and disulfide were measured and disulfide/native, disulfide / total thiol and native thiol/ total thiol ratios were calculated. Hence, the ratios of disulfide/ native thiol, disulfide / total thiol and native thiol/ total thiol were calculated. Results: Serum levels of native thiol, total thiol and disulfide were significantly lower in the epilepsy group than the control group. The ratio of disulfide/native thiol and disulfide / total thiol were significantly higher in the study group than the control group. As well as, the native thiol / total thiol ratio was lower in the epilepsy group than the control group. Native thiol, total thiol and disulfide were significantly lower in the epilepsy group who were taking anti-epileptic drugs than those who were not taking anti-epileptic drugs. Conclusion: We demonstrated a meaningful relationship between oxidative stress markers and epilepsy in pediatric patients.

scholarly journals Effects of COVID-19 pandemic on breastfeeding rates in a neonatal intensive care unit

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Asli Okbay Gunes ◽  
Emre Dincer ◽  
Nilgun Karadag ◽  
Sevilay Topcuoglu ◽  
Guner Karatekin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Breast Milk ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Control Group ◽  
Study Group ◽  
Intake Rate ◽  
Informed Consent Form ◽  
Group 2

Abstract Objectives To find out if the expressed breast milk delivery rate to neonatal intensive care unit (NICU) for babies who were hospitalized for any reason other than COVID-19, and exclusive breastfeeding (EB) rates between discharge date and 30th day of life of those babies were affected by COVID-19 pandemic. Methods Babies who were hospitalized before the date first coronavirus case was detected in our country were included as control group (CG). The study group was divided into two groups; study group 1 (SG1): the mothers whose babies were hospitalized in the period when mother were asked not to bring breast milk to NICU, study group 2 (SG2): the mothers whose babies were hospitalized after the date we started to use the informed consent form for feeding options. The breast milk delivery rates to NICU during hospitalization and EB rates between discharge and 30th day of life were compared between groups. Results Among 154 mother-baby dyads (CG, n=50; SG1, n=46; SG2, n=58), the percentage of breast milk delivery to NICU was 100%, 79% for CG, SG2, respectively (p<0.001). The EB rate between discharge and 30th day of life did not change between groups (CG:90%, SG1:89%, SG2:75.9; p=0.075). Conclusions If the mothers are informed about the importance of breast milk, the EB rates are not affected by the COVID-19 pandemic in short term, even if the mothers are obligatorily separated from their babies. The breast milk intake rate of the babies was lowest while our NICU protocol was uncertain, and after we prepared a protocol this rate increased.

Abstract TP329: Early Initiation of Oral Antihypertensives Reduces Intensive Care Unit Stay and Hospital Cost in Patients With Hypertensive Intracerebral Hemorrhage

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Zhu Zhu ◽  
Matthew Bower ◽  
Sara Stern-Nezer ◽  
Steven Atallah ◽  
Dana Stradling ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intracerebral Hemorrhage ◽  
Resource Utilization ◽  
Hospital Cost ◽  
Early Initiation ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
Hypertensive Intracerebral Hemorrhage

Background and Purpose: Intravenous nicardipine infusion is effective for intensive blood pressure (BP) control in patients with hypertensive intracerebral hemorrhage (ICH). However, its use requires close hemodynamic monitoring in the intensive care unit (ICU). Prompt transition from nicardipine infusion to oral antihypertensives may reduce ICU length of stay (LOS). This study aimed to examine the effect of early verse late initiation of oral antihypertensives on hospital resource utilization in patients with hypertensive ICH. Methods: This is a retrospective study of patients with hypertensive ICH and initial systolic BP ≥ 180 mmHg from January 1, 2013 to December 31, 2017. Only patients who received nicardipine infusion were included. Based on timing of receiving oral antihypertensives within or after 24 hours of emergency department arrival, patients were divided into study or control group, respectively. Baseline characteristics, duration of nicardipine infusion, ICU and hospital LOS, functional outcome at hospital discharge, and the cost were compared between the 2 groups using univariate and multivariate analysis to adjust for dependent variables. Results: A total of 166 patients (90 in study group, 76 in control group) were identified. There was no significant difference in demographic features, past medical history or initial SBP between the 2 groups. Patients in study group had lower initial NIHSS and ICH scores but higher GCS score than those in the control group. Using multivariant regression analysisto adjust for initial SBP, NIHSS, GCS and ICH scores, early initiation of oral antihypertensives was associated with significant shorter ICU LOS (median 2 vs 5, p =0.004), decreased duration of nicardipine infusion (55.5 ±60.1 vs 121.6 ±141.3, P =0.002), less pharmaceutical cost (median $14207 vs $ 29299, p =0.007) and total hospital cost (median $ 24564 vs $ 47366, p =0.007). After adjustment of confounders, there was also no significant difference in functional independence (mRS 0-2, 42.2% vs 17.1%, p =0.112) or mortality (6.7% vs 13.2%, p = 0.789) between the 2 groups. Conclusions: Early initiation of oral antihypertensive therapy is associated with reduced resource utilization and hospital cost in patients with hypertensive ICH.

scholarly journals Effect of Potassium Infusions on Serum Levels in Children during Treatment of Diabetic Ketoacidosis

2020 ◽  
Vol 09 (02) ◽  
pp. 113-118 ◽  
Author(s):  
Sangita Basnet ◽  
Rawan Musaitif ◽  
Aayush Khanal ◽  
Kimberly Powell ◽  
Giovanna Caprirolo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Diabetic Ketoacidosis ◽  
Treatment Period ◽  
Pediatric Intensive Care ◽  
Serum Levels ◽  
K Value ◽  
Data Points ◽  
Low K

AbstractA retrospective study was done to determine the effect of potassium (K+) infusions on serum levels in children admitted to the pediatric intensive care unit (PICU) with diabetic ketoacidosis (DKA). Eighty-two percent of 92 cases studied received 40 mEq/L K+ infusion over the treatment period of median 13.0 (interquartile range [IQR]: 7–18) hours. The median K+ value at the end of this period was 3.9 (IQR: 3.4–4.2) mEq/L. There were 31 data points of low K+ values (<3.5 mEq/L) and 4 high values (>5.5 mEq/L) during this treatment period. The K+ infusions of 40 mEq/L may be sufficient to normalize serum K+ when treating DKA.

scholarly journals Effects of Three Types of Massage on Serum Levels of Malondialdehyde, Superoxide Dismutase and Glutathione Peroxidase After One Session of Exhaustive Exercise in Female Futsal Players

2021 ◽  
Vol 10 (4) ◽  
pp. 328-339
Author(s):  
Bahare Heydari ◽  
◽  
Mohsen Ghofrani ◽  
Mohammad Ebrahim Bahram ◽  
◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Superoxide Dismutase ◽  
Glutathione Peroxidase ◽  
Recovery Period ◽  
Serum Levels ◽  
The Body ◽  
Exhaustive Exercise ◽  
Oxidative Stress Marker ◽  
Control Group ◽  
Significant Difference

Objective: The production of reactive oxygen species in exercise causes oxidative stress which disturbs the balance of oxidants and antioxidants, causing destructive effects on cells. The present study aims to investigate the effect of three types of massage (Swedish, Russian, Thai) on serum levels of Malondialdehyde (MDA), Glutathione Peroxidase (GPX) and Superoxide Dismutase (SOD) following one session of exhaustive exercise. Methods: This quasi-experimental study was conducted on 48 female futsal players aged 17-22 years in Zahedan, Iran who were selected using a purposive sampling method, and randomly divided into four groups of Swedish massage (Long strokes with pressing and tapping using hands), Russian massage (Medium to high pressure), Thai massage (Pressure to certain parts of the body) and Control. The exercise program was based on Bruce protocol. Serum levels of MDA, GPX and SOD were measured by before and immediately after exercise and after massage. Data analysis was performed using repeated measures ANOVA, considering a significance level of P≤0.05. Results: In all three types of massage, there was a significant decrease in serum level of MDA (0.22±0.08), and a significant increase in GPX (1.84±0.46) and SOD (10.02±2.86) levels after exhaustive (P=0.001). No significant difference was observed in the control group. Conclusion: It seems that Russian, Thai, and Swedish types of massage can affect the serum levels of the MDA (as an oxidative stress marker) and the antioxidant enzymes of GPX and SOD during the post-exercise recovery period.

The Effect of Noise in the Intensive Care Unit on the Oxidative Stress Response in Rats

2020 ◽  
Vol 22 (3) ◽  
pp. 397-402
Author(s):  
Nurcan Boyacioglu ◽  
Sultan Ozkan
Keyword(s):  
Oxidative Stress ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Noise Level ◽  
Noise Exposure ◽  
Laboratory Model ◽  
Control Group ◽  
Albino Rats ◽  
Recording Device ◽  
Experimental Stage

Objective: The objective of this study was to determine the effect of noise in the intensive care unit (ICU) on oxidative stress in a rat model. Method: This study had both a descriptive and a randomized controlled experimental stage. In the descriptive stage, to create a laboratory model of noise in the ICU, the noise level was measured for 24 hr on a randomly selected day in a surgical ICU, and voice recording was performed using a sound recording device. In the experimental stage, 30 male Wistar albino rats were randomly divided into 5 groups: a control group and groups exposed to the recording of the noise from the ICU for 24, 48, 72, and 168 hr. Results: The noise level in the ICU was higher than the levels recommended for hospitals. Plasma corticosterone levels of the rats in the group exposed to the ICU noise for 168 hr were significantly higher than those of the control group. Plasma total protein values were significantly reduced in the rats exposed to 48, 72, and 168 hr of ICU noise compared to those of the control group. Superoxide dismutase activity was significantly decreased and malondialdehyde levels significantly increased in serum, spleen, and brain tissues as the duration of noise exposure increased. Conclusion: Findings reveal that rats experienced increasing levels of stress and oxidative stress as time exposed to the ICU noise increased. These results suggest that interventions to reduce noise in the ICU may be warranted.

scholarly journals Usefulness of oxidative stress marker evaluation at admission to the intensive care unit in patients with COVID-19

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110277
Author(s):  
Hayrettin Daskaya ◽  
Sinan Yilmaz ◽  
Harun Uysal ◽  
Muhittin Calim ◽  
Bilge Sümbül ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Severity ◽  
Oxidative Stress Marker ◽  
Icu Admission ◽  
Stress Marker ◽  
Icu Discharge ◽  
Discharge Status ◽  
Marker Status

Objective Two critical processes in the coronavirus disease 2019 (COVID-19) pandemic involve assessing patients’ intensive care needs and predicting disease progression during patients’ intensive care unit (ICU) stay. We aimed to evaluate oxidative stress marker status at ICU admission and ICU discharge status in patients with COVID-19. Methods We included patients in a tertiary referral center ICU during June–December 2020. Scores of Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), and clinical severity, radiologic scores, and healthy discharge status were noted. We collected peripheral blood samples at ICU admission to evaluate total antioxidants, total oxidants, catalase, and myeloperoxidase levels. Results Thirty-one (24 male, 7 female) patients were included. At ICU admission, patients’ mean APACHE II score at ICU admission was 17.61 ± 8.9; the mean SOFA score was 6.29 ± 3.16. There was no significant relationship between clinical severity and oxidative stress (OS) markers nor between radiological imaging and COVID-19 data classification and OS levels. Differences in OS levels between patients with healthy and exitus discharge status were not significant. Conclusions We found no significant relationship between oxidative stress marker status in patients with COVID-19 at ICU admission and patients’ ICU discharge status.

scholarly journals A new look at the correction of COVID-19-mediated pulmonary gas exchange disorders

2021 ◽  
Vol 102 (3) ◽  
pp. 362-372
Author(s):  
I S Simutis ◽  
G A Boyarinov ◽  
M Yu Yuriev ◽  
D S Petrovsky ◽  
A I Kovalenko ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gas Exchange ◽  
Sodium Succinate ◽  
Intensive Therapy ◽  
Infusion Therapy ◽  
Control Group ◽  
Electrolyte Balance ◽  
Study Group ◽  
Coronavirus Infection

Aim. To assess the effect of meglumine sodium succinate on the effectiveness of basic therapy in correcting gas exchange abnormalities in patients with severe COVID-19 infection complicated by bilateral community-acquired pneumonia. Methods. The analysis of the effectiveness of therapy of 12 patients with a diagnosis of New coronavirus infection COVID-19 (confirmed), severe form U07.1. Complication: bilateral multifocal pneumonia was carried out. The patients were divided into two groups: 7 received, as part of standard therapy, a solution of meglumine sodium succinate in a daily dose of 5 ml/kg during stay in the intensive care unit; 5 patients received a similar volume of Ringer's solution and formed the control group. In the arterial and venous blood of all patients, the indicators of acid-base state and water-electrolyte balance, glycemia and lactatemia were measured at several stages: (1) at admission to the intensive care unit, (2) 24 hours after the start of intensive therapy, (3) after 812 hours, (4) after 24 hours. On the 28th day of observation, mortality, the duration of treatment in the intensive care unit and the incidence of thrombotic complications in the groups were assessed. The Friedman nonparametric hypothesis test was used to assess intragroup dynamics, and the nonparametric Mannhitney U test for intergroup comparisons. Results. In the group of patients who received meglumine sodium succinate, there was a significant decrease in the incidence of thromboembolic events during 28 days of treatment: myocardial ischemia event rate ratio from 0.89 [95% confidence interval (CI) 0.191.16] in the control group to 0.55 (95% CI 0.060.81) in the study group at p=0.043; pulmonary embolism event from 0.50 (95% CI 01.0) in the control group to 0.28 (95% CI 01.0) in the study group at p=0.041. There was also a decrease in the duration of intensive care unit length of stay to 6.11.1 days in the study group versus 8.91.3 days in the control group. Conclusion. Compared with standard infusion therapy, the use of meglumine sodium succinate leads to a faster normalization of ventilation-perfusion ratios in patients with severe coronavirus infection.

Benefits of early enteral nutrition with glutamine and probiotics in brain injury patients

2004 ◽  
Vol 106 (3) ◽  
pp. 287-292 ◽  
Author(s):  
IRA S. FALCÃO DE ARRUDA ◽  
JOSÉ E. DE AGUILAR-NASCIMENTO
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Brain Injury ◽  
Infection Rate ◽  
Control Group ◽  
Early Enteral Nutrition ◽  
Study Group ◽  
Diet Control ◽  
Enteral Formula

Brain injury patients have higher energy and protein expenditures and are prone to infections. The aim of the present study was to evaluate the results of early enteral feeding with glutamine and probiotics in brain injury patients. Twenty-three brain injury patients (Glasgow score between 5–12 and therapeutic intervention scoring system>20) were studied. Three patients were excluded to leave 20 remaining patients. Patients were randomized to receive either an early enteral diet (control group, n=10) or the same formula with glutamine and probiotics added (study group, n=10) for a minimum of 5 days (range, 5–14 days). The diets were isocaloric and isonitrogenous [35 kcal·kg-1·day-1 (where 1 kcal≈4.184 kJ) and 1.5 g of protein·kg-1·day-1]. Main outcome measures were the incidence of infection, the length of stay in the intensive care unit and the number of days requiring mechanical ventilation. The two groups were homogeneous in gender, age, nutritional status and severity of trauma. There was no mortality during the study period. The infection rate was higher in controls (100%) when compared with the study group (50%; P=0.03) and the median (range) number of infections per patient was significantly greater (P<0.01) in the control group [3 (1–5)] compared with the study group [1 (0–3)]. Both the critical care unit stay [22 (7–57) compared with 10 (5–20) days; P<0.01; median (range)] and days of mechanical ventilation [14 (3–53) compared with 7 (1–15) days; P=0.04; median (range)] were higher in the patients in the control group than in the study group. We conclude that the enteral formula containing glutamine and probiotics decreased the infection rate and shortened the stay in the intensive care unit of brain injury patients.

scholarly journals Effect of cough assist device on blood gasses and period of mechanical ventilator for pneumonic children with general hypotonia

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Raheel Sanad ◽  
Shimaa Mohamed Refaat ◽  
Faten Hassan Abdelazeim ◽  
Bassant Meligy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Physical Therapy ◽  
Post Treatment ◽  
Control Group ◽  
Study Group ◽  
Mechanical Ventilator ◽  
Assist Device ◽  
Therapy Program ◽  
Physical Therapy Program

Abstract Background Cough assist devices play an important role with patients in the intensive care unit (ICU), particularly those with neuromuscular diseases which had abnormal muscle tone. It was previously thought to be the main technique for improving cough efficacy, which aids in weaning from mechanical ventilation and improves patient outcomes. So, we selected randomly the odd numbers from Abo El-Reesh hospital records, and 30 children of both sexes with pneumonia were selected, aged from 6 months to 3 years, who were selected from intensive care unit: fifteen children were the control group, who received the selected physical therapy program (postural drainage, percussion and resist diaphragm), and another fifteen children were the study group, who received previous physical therapy program, which was selected, and cough assist device. Results This study revealed the effect of cough assist device on blood gasses and the period of mechanical ventilator on children with pneumonia and general hypotonia. There was a significant decrease in pH, PaCO2, and HCO3 post treatment compared with that pretreatment in the study and control groups (p < 0.05). The percentage of decrease in pH, PaCO2, and HCO3 in study group A were 0.4, 38.26, and 30.28% respectively while that in the control group were 0.4, 32.56, and 25.48% for pH, PaCO2, and HCO3 respectively. There was a significant increase in PaO2 post treatment compared with that pretreatment in the study and control groups (p < 0.001). The percentage of increase in PaO2 in the study group was 32.13% and that in control group was 30.09%. There was no significant difference in pH, PaCO2, and HCO3 between both groups pre-treatment (p ˃ 0.05). Also, there was no significant difference between groups post treatment (p ˃ 0.05). The median (IQR) period of mechanical ventilation in the study group was 5 (7, 4) days while that in control group was 8 (18, 5) days. There was a significant decrease in period of mechanical ventilator of the study group compared with that of control group (p = 0.03). Conclusion The cough assist device and physical therapy program were selected for children in the intensive care unit which have the same effect on arterial blood gasses as they optimize pH, PO2, PCO2, and HCO3, but the cough assist device helps in accelerating weaning of mechanical ventilator so as decrease the period of mechanical ventilator.

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