9 research outputs found
Thyroid storm presenting as septic shock in the intensive care unit: A Case Series
No full textThyroid storm is a rare endocrine emergency that rarely presents with septic shock. It occurs in
thyrotoxic patients and is manifested by decompensation of multiple organs, triggered by severe
stress. The diagnosis and response to treatment is made by Burch-Wartofsky point scale or Japanese
thyroid association criteria due to lack of pathophysiology of thyroid storm. We reported series of
patients that presented with altered sensorium, cough, fever, palpitation, shortness of breath and
shock. Patient were treated initially for septic shock, later diagnosed as thyroid storm and was treated
with oral carbimazole, propanolol and digoxin. From this, we want to emphasize that thyroid storm
can have any presentation that should be kept in differential diagnosis of septic shock not responding
to usual treatment; early diagnosis and treatment with oral medication can decrease morbidity and
mortality in rural setting where intravenous form of antithyroid drug are not available for thyroid
storm
Human Albumin and N-Acetylcysteine for Treatment of Fat Embolism: A Case Report
No full textFat embolism is a life-threatening condition that mostly occurs after long bones and pelvis fractures and treatment is controversial with many available drugs. We hereby present a case of 53 years male who developed shortness of breath, tachycardia, fever, anemia, distended jugular vein, thrombocytopenia, hypoalbuminemia and was diagnosed to have fat embolism after fracture of femur, tibia, fibula and pubic rami following road traffic accident. Patient was treated with 20 percent human albumin, N-acetylcysteine, other supportive treatment and discharged after fourteen days. From this we want to emphasize role of human albumin and N-acetylcysteine in treatment of fat
Malposition of Central Venous Catheter Inserted under Ultrasound Guidance in Intensive Care Unit: A Case Series
No full textMalposition of central venous catheter tip inserted into the subclavian and internal jugular vein is a rare unavoidable complication that can be decreased if inserted under ultrasound guidance. We report case series of three patients, two of subclavian and another of internal jugular inserted central venous catheter, in which the catheter malpositioned into ipsilateral internal jugular and subclavian vein respectively but had no effect on patient management. From this, we want to emphasize that the effect of malposition of central venous catheter tip depends upon the indication for which central venous catheter was inserted; it can be detected bedside by ultrasound and flush test
Ulinastatin in the Management of Severe Acute Alcoholic Pancreatitis: A Case Series
No full textSevere acute alcoholic pancreatitis is a second common form of pancreatitis that requires intensive care unit care and has high morbidity and mortality due to lacking specific treatment. Management of alcoholic pancreatitis is generally non- specific and supportive. We hereby present a case-series of three patients that describes the successful treatment of severe acute alcoholic pancreatitis with ulinastatin and other supportive treatment. From this we want to emphasize that ulinastatin a protease inhibitor can be used in the treatment of alcoholic pancreatitis
1117: INFLUENCE OF ABG TO GUIDE EXTUBATION IN ICU PATIENTS AFTER SPONTANEOUS BREATHING TRIAL
No full textEosinophilic Cholecystitis presenting with Common Bile Duct Sludge and Cholangitis: A Case Report
No full textEosinophilic cholecystitis is a rare post-cholecystectomy inflammatory histopathological condition characterized by more than 90% eosinophilic infiltrate in the gallbladder. We present a case of 27-year female presented with abdominal pain, fever, jaundice, altered mental status, shock, leucocytosis, deranged liver function test, and peripheral blood eosinophilia. The patient underwent cholecystectomy and common bile duct exploration. She developed adult respiratory distress syndrome and hospital-acquired pneumonia. From this, we want to emphasize that eosinophilic cholecystitis and cholangiopathy should be a differential diagnosis in patients presenting with allergy, peripheral eosinophilia, obstructive jaundice that are planned to undergo cholecystectomy that will have early critical care intervention
