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العنوان
Role of Troponin-T at Admission and Serial
Troponin-T Testing in Predicting Outcomes in
Severe Sepsis and Septic Shock /
المؤلف
Younis,Akram Ibrahim.
هيئة الاعداد
باحث / Akram Ibrahim Younis
مشرف / Azza Mohamed Shafeek Abdel Mageed
مشرف / Walid Hamed Nofal
مشرف / Eman Abu bakr El Seddik Ahmed
تاريخ النشر
2019
عدد الصفحات
128p.:
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
العناية المركزة والطب العناية المركزة
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - الرعاية المركزة العامة
الفهرس
Only 14 pages are availabe for public view

from 128

from 128

Abstract

Background: Serum troponin concentrations have been associated with
increased mortality in almost every clinical setting they have been
examined, including sepsis. Sepsis is the physiological response to severe
infection. It is defined as the presence (probable or documented) of
infection together with systemic features of inflammation. Severe sepsis is
sepsis-induced tissue hypoperfusion or organ dysfunction, and septic shock
refers to sepsis-induced hypotension, persisting despite adequate fluid
resuscitation, which may be defined as infusion of 30 ml/kg of crystalloids.
Elevated troponin levels are observed in 43% across all intensive care
patient groups. The estimated prevalence of positive troponin in the context
of sepsis is 61%. The mechanism of myocyte insult in severe sepsis and
septic shock, in the absence of thrombotic acute coronary syndrome,
leading to elevated serum troponin, is not yet fully understood. Myocardial
depressive factors (inflammatory mediators, endotoxins), microvascular
dysfunction and increased myocardial cell membrane permeability in
conjunction with myocardial oxygen demand– supply mismatch, are
potential explanations for sepsis induced troponin elevation. In this setting,
troponin elevation occurs in the absence of myocytenecrosis and this
hypothesis is supported by clinical observations that myocardial depression
in the context of sepsis is a reversible process in most surviving patients.
The aim of this study is to evaluate the prognostic value of troponin T level
at admission and serial troponin T testing in patients with severe sepsis and
septic shock. This work was carried on 70 patients with severe sepsis and
septic shock from those attending the intensive care units in Ain shams
university hospitals in the time period between February 2018 and July
2018. These patients were subdivided into 2 groups each consisted of 35
patients, the first group with elevated troponin T at admission and the other
group with negative troponin T at admission.
Keywords: Role; Troponin-T; Admission; Serial Troponin-T; Testing;
Predicting Outcome; Severe Sepsis; Septic Shock