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العنوان
Serum sodium as a predictor to the outcome of critically ill cirrhotic patients /
المؤلف
Serageldin, Ahmed Mohamed Abdelmaguid.
هيئة الاعداد
باحث / Ahmed Mohamed Abdelmaguid Serageldin
مشرف / Sherif Wadie NaShed SergioS
مشرف / aShraf MahMoud hazeM MohaMed
مناقش / MarWa ahMed Khairy elbeialy
تاريخ النشر
2019.
عدد الصفحات
108 P. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
العناية المركزة والطب العناية المركزة
تاريخ الإجازة
1/1/2019
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم التخدير والرعاية المركزة
الفهرس
Only 14 pages are availabe for public view

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from 108

Abstract

End-stage liver disease is often complicated by hyponatremia. Cirrhotic patients with hyponatremia admitted to intensive care units (ICUs) have high mortality rates. This study analyzed the outcomes of critically ill cirrhotic patients and identified the prognostic value of serum sodium concentration . Many investigators have therefore used a variety of tools to predict the prognosis of patients with liver cirrhosis who admitted to ICU, and these tools included scoring systems (Child-Pugh, SOFA, MELD, APACHE II and APACHE III), hemodynamic variables and their response to therapy and other electrolyte disturbance.
In this study we evaluated the relationship between low serum sodium level (hyponatremia) in patient admitted to ICU and mortality and morbidity associated with them, also correlation between serum sodium and other prognostic factors such as lactate level was done.
The present Study was a prospective observational study that was conducted on 60 patients diagnosed with liver cirrhosis admitted in ICU of Theodor Bilharz Research Institute Hospital during the period September 2018 to February 2019.
The diagnosis of liver cirrhosis and patients selection was based on medical history, clinical examinations, biochemical tests and ultrasound abdomen.
patients were grouped on the bases of their Na level into 2 groups: Group1; NA level > 135 mEq/L and
group 2; Na level ≤ 135 mEq/L.
This current study showed that : Hyponatremia was associated with the etiology of liver cirrhosis mainly HCV and was strongly associated with the severity of liver cirrhosis mainly by Child-Pugh score.
In the present study diabetes was in (43.3%) and hypertension in (50%) of patients.
There was no significant association between hyponatremia and the patients Co morbid conditions.
Severity of hyponatremia was associated with high frequency of complications of liver cirrhosis.
In the present study ascites was seen in (91.6)% , GIT bleeding in (31.6%) , Hepatic encephalopathy in (60%),hepatorenal syndrome in (20%),spontaneous bacterial peritonitis(20%), jaundice (48.3%)and hepatocellular carcinoma in (28.3%) of patients .
There was a significant association between hyponatremia and hepatocellular carcinoma &jaundice.
There was no significant association between hyponatremia and ascites or GIT bleeding or Hepatic encephalopathy or spontaneous bacterial peritonitis.
In this study there was strong association between the hyponatremia and mortality.
The mortality was (66.7%) in the patients with hyponatremia .
There was strong correlation between the mortality and the serum lactate level in group 2
Finally this study suggest that finding of serum sodium concentration ≤135 mEq / L in cirrhotic patients on the first day of ICU admission should be considered an indicator poor prognosis.
So close follow up of serum sodium level in cirrhotic patients especially the critically ill patients admitted in ICU and early management of hyponatremic patients is highly recommended to improve the outcome of those patients.