重症监护病房格林-巴利综合征患者低镁血症的发生及影响

Akm Ferdous, Syed Tariq, M. Asaduzzaman, K. Satter, S. Akter, M. Salim, M. A. Rahman, Dmch Anesthesiologist, Senior Consultant
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引用次数: 0

摘要

背景:预测患者预后是重症监护病房患者护理的重要组成部分。这对集约主义者来说是至关重要的。因为它允许计划早期积极的治疗干预,最佳资源分配和适当的咨询家庭以及患者。因此,重症监护医师为上述目的开发了许多ICU患者的预后工具。两种广泛采用的预测死亡率的系统是急性生理评估慢性健康评估(APACHE2)和简化急性生理评分(SAP)。虽然有用,但这些工具很复杂,需要输入大量来自患者病史、体格检查和初始实验室数据的变量。多项研究表明,血清镁水平对危重病人的死亡率和发病率有重要影响。但目前尚无研究观察低镁对ICU GBS转归的影响。方法与材料:2014年1月至2015年12月在DMCH重症监护病房进行前瞻性观察研究。30例年龄大于18岁的疑似GBS患者被纳入ICU,需要重症监护至少2天。于患者入ICU当日取血测定血清总镁水平。最后将收集到的所有数据以标准统计方法制成表格,并使用SPSS version 17 for Windows进行分析。使用Chisquare检验将低镁血症和正常镁血症与结果联系起来。结果:患者总数30例。40%的患者患有低镁血症。40%的患者需要机械通气。低镁血症患者机械通气的平均时间(17.66±8.40)天高于正常镁血症患者(12.05±3.68)天。低镁组平均住院时间20.50(±9.48)天,正常镁组平均住院时间14.22(±3.33)天。33.33%患者低钠血症,58.33%患者低钾血症,50%患者低钙血症。50%的低镁血症患者有败血症。低镁血症患者的死亡率为80%,正常镁血症患者的死亡率为20%。结论:低镁血症在预测GBS的死亡率和发病率中起关键作用。因此,低镁血症可作为ICU患者GBS的预测工具。JBSA 2017;(1): 30。第21到26
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Occurrence and Effect of Hypomagnesemia in Patients Suffering from Guillain-Barre Syndrome in Intensive Care Unit
Background: Predicting patient outcome is an important component of patient care in the critical care units. It has a vital importance to the intensivists. Because it allows the planning of early aggressive therapeutic interventions, optimum resource allocation and appropriate counseling of the family as well as the patient. So the intensivists have developed a number of prognostication tools for the patient admitted to ICU for above purpose. The two widely adopted systems to predict mortality are the Acute Physiology Assessment Chronic Health Evaluation (APACHE2) & Simplified Acute Physiology Score(SAP).Though useful, these tools are complex & require input of a large number of variables derived from patients history, physical examination & initial laboratory data. In several studies, it has been shown that serum magnesium level has great effect on mortality & morbidity in critically ill patient. But there is no study to observe the effect of hypomagnesium on the outcome of GBS in ICU. Methods and materials: A prospective observational study in the intensive care unit of DMCH from January 2014 to December 2015. Thirty patients admitted to the ICU with suspected GBS requiring intensive care for more than at least 2 days with age more than 18 years were included. A blood sample was collected for estimation of serum total magnesium level on the day of admission to ICU. Finally all collected data were tabulated and analysed using standard statistical methods by SPSS version 17 for Windows. The Chisquare test was applied to correlate hypomagnesemia & normomagnesemia with the outcome. Result: Total numbers of patients were thirty. 40% of patient had been suffering from hypomagnesemia. 40% patient needed mechanical ventilation.The mean length of mechanical ventilation days were higher in hypomagnesemic patients than normomagnesemic with were 17.66±8.40 vs 12.05±3.68 days. The mean length of ICU stay were 20.50(±9.48) days in hypomagnesemia and 14.22(±3.33) days in normomagnesemics. 33.33% patient had hyponatremia,58.33% patient had hypokalemia,50% patient had hypocalcemia. 50% patients with hypomagnesemia had sepsis. :Mortality rate in hypomagnesemic patients were 80% that were 20% in normomagnesemia. Conclusion: Hypomagnesemia has played a pivotal role in prediction of mortality and morbidity in GBS. So hypomagnesemia can be used as a prediction tool for patient suffering from GBS in ICU. JBSA 2017; 30(1): 21-26
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