Therapy with L-thyroxine and Omnadren after Cardiac Surgery. A Case Report

Background: Cardiopulmonary bypass in cardiac surgery produces systemic inflammatory response and catabolic state. Severe stress frequently causes abnormalities in thyroid hormones in the absence of primary thyroid disease, defined as sick euthyroid syndrome (SES). Materials and methods: Supplementation therapy with thyroid and anabolic hormones in combination with an adequate nutritional support has been used to improve outcome in critically ill patient after cardiac surgery. Results: Administration of thyroid and anabolic hormones significantly improved patient’s condition. Conclusions: Supplementation therapy with thyroid and anabolic hormones in combination with an adequate nutritional support could be used to improve hemodynamics, achieve transition to anabolic metabolism and enhance recovery, which could eventually help for a reduction in post-operative morbidity and mortality.

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Nutrition in open abdomen

10.33699/pis.2021.100.2.83-87 ◽

2021 ◽

Vol 100 (2) ◽

Keyword(s):

Septic Shock ◽

Case Report ◽

Nutritional Support ◽

Open Abdomen ◽

Comprehensive Approach ◽

Severe Stress ◽

Nutritional Care ◽

Threatening Condition ◽

Life Threatening ◽

Intestinal Fistulas

Open abdomen is known as a serious consequence of various intra-abdominal pathologies. Initially, patients often have a life-threatening condition, sepsis or septic shock. Severe stress related malnutrition, mineral and fluid imbalance develop as metabolic consequences. Intestinal fistulas also occur as a frequent complication in patients with open abdomen. In such patients, a comprehensive approach is needed, including rehabilitation, nutritional support using optimal formulas, and local care for the open abdomen. Our case report presents a patient with open abdomen and enterocutaneous fistulation. A complex nutritional approach in the course of the disease is described and its importance is discussed. Finally, a summary of nutritional care for open abdomen patients is provided based on current recommendations.

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Case report of Erdheim-Chester disease in a female cardiac surgery patient

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0030-1269044 ◽

2011 ◽

Vol 59 (S 01) ◽

Author(s):

HR Mahoozi ◽

A Zittermann ◽

K Hakim-Meibodi ◽

J Gummert ◽

N Mirow

Keyword(s):

Cardiac Surgery ◽

Case Report ◽

Cardiac Surgery Patient ◽

Erdheim Chester Disease ◽

Surgery Patient ◽

Erdheim Chester ◽

Chester Disease

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Assessment of factors affecting short-term pulmonary functions following cardiac surgery: A prospective observational study

Asian Cardiovascular and Thoracic Annals ◽

10.1177/02184923211010079 ◽

2021 ◽

pp. 021849232110100

Author(s):

Neetika Katiyar ◽

Sandeep Negi ◽

Sunder Lal Negi ◽

Goverdhan Dutt Puri ◽

Shyam Kumar Singh Thingnam

Keyword(s):

Cardiac Surgery ◽

Pulmonary Function ◽

Forced Vital Capacity ◽

Vital Capacity ◽

Forced Expiratory Volume ◽

Pulmonary Complications ◽

Operative Morbidity ◽

Factors Affecting ◽

Factors Influencing ◽

Significant Impairment

Background Pulmonary complications after cardiac surgery are very common and lead to an increased incidence of post-operative morbidity and mortality. Several factors, either modifiable or non-modifiable, may contribute to the associated unfavorable consequences related to pulmonary function. This study was aimed to investigate the degree of alteration and factors influencing pulmonary function (forced expiratory volume in one second (FEV1) and forced vital capacity), on third, fifth, and seventh post-operative days following cardiac surgery. Methods This study was executed in 71 patients who underwent on-pump cardiac surgery. Pulmonary function was assessed before surgery and on the third, fifth, and seventh post-operative days. Data including surgical details, information about risk factors, and assessment of pulmonary function were obtained. Results The FEV1 and forced vital capacity were significantly impaired on post-operative days 3, 5, and 7 compared to pre-operative values. The reduction in FEV1 was 41%, 29%, and 16% and in forced vital capacity was 42%, 29%, and 19% consecutively on post-operative days 3, 5, and 7. Multivariate analysis was done to detect the factors influencing post-operative FEV1 and forced vital capacity. Discussion This study observed a significant impairment in FEV1 and forced vital capacity, which did not completely recover by the seventh post-operative day. Different factors affecting post-operative FEV1 and forced vital capacity were pre-operative FEV1, age ≥60, less body surface area, lower pre-operative chest expansion at the axillary level, and having more duration of cardiopulmonary bypass during surgery. Presence of these factors enhances the chance of developing post-operative pulmonary complications.

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Pneumocystis and SARS-CoV-2 Co-Infection: A Case Report and Review of an Emerging Diagnostic Dilemma

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa633 ◽

2020 ◽

Author(s):

Carlos Rubiano ◽

Kathleen Tompkins ◽

Subhashini A Sellers ◽

Brian Bramson ◽

Joseph Eron ◽

...

Keyword(s):

Case Report ◽

Critically Ill ◽

Therapeutic Strategies ◽

Pneumocystis Jirovecii ◽

Critically Ill Patient ◽

Pneumocystis Jirovecii Pneumonia ◽

Diagnostic Dilemma

Abstract We present a case of a critically ill patient with COVID-19 found to have AIDS and Pneumocystis jirovecii pneumonia (PCP). COVID-19 and PCP co-occurrence is increasingly reported and may complicate diagnostic and therapeutic strategies. Patients with severe COVID-19 should be screened for underlying immunocompromise and coinfections should be considered.

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Nonepileptic Myoclonus in COVID-19: Case Report

The Neurohospitalist ◽

10.1177/19418744211004315 ◽

2021 ◽

pp. 194187442110043

Author(s):

Henly Hewan ◽

Annie Yang ◽

Aparna Vaddiparti ◽

Benison Keung

Keyword(s):

Case Report ◽

Critically Ill ◽

Recovery Phase ◽

Critically Ill Patient ◽

High Dose ◽

The Novel ◽

Neurological Manifestations ◽

Immune Mediated ◽

Novel Coronavirus ◽

Post Infectious

In late 2019, the novel coronavirus, SARS-CoV-2, and the disease it causes, COVID-19, was identified. Since then many different neurological manifestations of COVID-19 have been well reported. Movement abnormalities have been rarely described. We report here a critically ill patient with COVID-19 who developed generalized myoclonus during the recovery phase of the infection. Myoclonus was associated with cyclical fevers and decreased alertness. Movements were refractory to conventional anti-epileptic therapies. There was concern that myoclonus could be part of a post-infectious immune-mediated syndrome. The patient improved fully with a 4-day course of high-dose steroids. Our experience highlights a rare, generalized myoclonus syndrome associated with COVID-19 that may be immune-mediated and is responsive to treatment.

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