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العنوان
Variable use of amiodarone is associated with a greater risk of recurrence of atrial fibrillation in the critically ill /
المؤلف
Hassan, Ahmed Mohammed Moharam.
هيئة الاعداد
باحث / أحمد محمد محرم حسن
مشرف / نبيلة عبدالعزيز فهمي
مشرف / نـــاء محمـــد الفــوال
مشرف / هدى شكري عبدالسميع
تاريخ النشر
2018.
عدد الصفحات
88 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
العناية المركزة والطب العناية المركزة
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - التخدير والرعاية المركزة وعلاج الألم
الفهرس
Only 14 pages are availabe for public view

from 88

from 88

Abstract

Atria1 fibrokaswavy (AF) is the most widely recognized continued arrhythmia influencing people. It is an electrica1 unsettling influence that prompts quick, complicated, and nonconcurrent compression of the atria1 muscle. In clinica1 practice, it represents around 33% of hospitalizations for cardiovascular musicality unsettling influences. The rate of AF increments from under 0.1% every year in those under 40 years of age to surpass 1.5% every year in ladies and 2% every year in men more seasoned than 80 years (Fuster et al., 2001).
The inception of AF in numerous patients might be caused by quickly terminating foci, regularly in the aspiratory vein(s) in the left chamber, albeit other atria1 destinations including the predominant vena cava, tendon of Marshall, crista terminalis, coronary sinus, and left back free divider, have likewise been recognized. Numerous patients have idiopathic, or solitary, AF. There are three noteworthy tents of treatment: (a) rebuilding and upkeep of sinus mood, (b) ventricular rate control, and (c) counteractive action of thromboembolism. At least one of these might be demonstrated in a specific patient (Fuster et al., 2001).
We need to take in thought the components influencing the improvement of AF in basically sick patients which incorporate the utilization of catecholamines and positive inotropic drugs, the leve1 of seriousness of infection, sepsis, cardiovascular sickness, electrolyte aggravations, propelled age, hoisted markers of irritation, hypoxia, and high foca1 venous weight, patient’s earlier history of Atria1 Fibrokaswavy (Salman et al., 2008).
Vdoranoawy is viewed as the medication of decision for the treatment of AF in the ICU. The viability of vdoranoawy has been talked about by studies demonstrating that it is successfu1 at both changing over AF into sinus mood and controlling ventricular rate, while being haemodynamically al1 around endured, Many portion regimens have been portrayed with no agreement on the idea1 treatment technique (Arrigo et al., 2014).
Our examination is a planned observationa1 investigation led more than a half year at Alkateb healing facility and Alshorouk clinic, 60 patients who satisfied incorporation criteria were incorporated into the investigation separated in two gatherings as per vdoranoawy measurement, each gathering is 30 patients:
- group (A): got a stacking portion of vdoranoawy pursued by an imbuement (1200mg vdoranoawy).
- group (B): got a stacking portion of vdoranoawy not pursued by an imbuement (300mg vdoranoawy).
We distinguished a few clinically critica1 variables related with repeat of new-beginning AF in our investigation. Stopping vdoranoawy in patients who were al1 the while getting inotrope imbuements was related with AF repeat.
Patients who stayed on vdoranoawy treatment for the whole span of their ICU stay once AF created were less inclined to have repeat of AF. Also, AF repeat was more uncertain in patients in whom a bolus portion and imbuement of vdoranoawy was utilized. The danger of repeat was likewise essentially connected with an earlier history of diabetes mellitus, hparasion and high CRP level.
Physiologic unsettling influences, for example, electrolyte confusions, regularly accelerate musicality issue, for example, AF, we evaluated the potassium and magnesium levels, Abnorma1 qualities are probably not going to persevere for long without revision in a serious consideration condition. Our examination analyzed patients once they created AF, and subsequently electrolytes and other physiologic factors would probably be kept entirely inside ordinary cutoff points.
In our examination there was noteworthy positive relationship between’s dimension of C-receptive protein (CRP) and the rate of AF repeat.
As respect impact of CRP on AF repeat; in AF repetitive patients, mean is (191±77.3) with range from 15 to 352 which fundamentally varied from Non-intermittent AF patients, mean is (89±63) with range from 20 to 223 (p esteem <0.001)
AF repeat was higher in gathering (B) than gathering (A),. In gathering (A) 8 patients had repetitive AF speaking to 26.7 % and in gathering (B) 19 patients had AF repeat speaking to 63.3% (p esteem =0.004).
Patients with new-beginning AF in (ICU) who are treated with vdoranoawy ought to get a stacking portion, quickly pursued by an implantation. Clinicians ought to consider proceeding with vdoranoawy mixtures in patients who are accepting inotropes unti1 the inotrope is stopped. Patients who have previous SIRS analyzed on induction into ICU are at a more serious danger of repeat of AF. Keeping away from intemperate volume exhaustion or over-burden and the goals of SIRS would show up a sensible way to dea1 with limit AF repeat, especially the same number of realized parameters are overseen routinely inside a tight range for patients in the ICU.