Clinical Significance of Elevated Troponin I Level in Patients With Acute Gastrointestinal Bleeding Admitted to the Intensive Care Unit

CHEST Journal ◽  
2014 ◽  
Vol 146 (4) ◽  
pp. 222A
Author(s):  
Rahul Sinha ◽  
Udit Chaddha ◽  
Karim El Kersh ◽  
Matthew Rayner-Lawren Woodford ◽  
Juan Guardiola ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gastrointestinal Bleeding ◽  
Clinical Significance ◽  
Troponin I ◽  
Elevated Troponin ◽  
Acute Gastrointestinal Bleeding

scholarly journals Neural network predicts need for red blood cell transfusion for patients with acute gastrointestinal bleeding admitted to the intensive care unit

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dennis Shung ◽  
Jessie Huang ◽  
Egbert Castro ◽  
J. Kenneth Tay ◽  
Michael Simonov ◽  
...  
Keyword(s):  
Neural Network ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Gastrointestinal Bleeding ◽  
Blood Cells ◽  
External Validation ◽  
Red Blood Cell Transfusion ◽  
Internal Validation ◽  
Acute Gastrointestinal Bleeding ◽  
Risk Patients

AbstractAcute gastrointestinal bleeding is the most common gastrointestinal cause for hospitalization. For high-risk patients requiring intensive care unit stay, predicting transfusion needs during the first 24 h using dynamic risk assessment may improve resuscitation with red blood cell transfusion in admitted patients with severe acute gastrointestinal bleeding. A patient cohort admitted for acute gastrointestinal bleeding (N = 2,524) was identified from the Medical Information Mart for Intensive Care III (MIMIC-III) critical care database and separated into training (N = 2,032) and internal validation (N = 492) sets. The external validation patient cohort was identified from the eICU collaborative database of patients admitted for acute gastrointestinal bleeding presenting to large urban hospitals (N = 1,526). 62 demographic, clinical, and laboratory test features were consolidated into 4-h time intervals over the first 24 h from admission. The outcome measure was the transfusion of red blood cells during each 4-h time interval. A long short-term memory (LSTM) model, a type of Recurrent Neural Network, was compared to a regression-based models on time-updated data. The LSTM model performed better than discrete time regression-based models for both internal validation (AUROC 0.81 vs 0.75 vs 0.75; P < 0.001) and external validation (AUROC 0.65 vs 0.56 vs 0.56; P < 0.001). A LSTM model can be used to predict the need for transfusion of packed red blood cells over the first 24 h from admission to help personalize the care of high-risk patients with acute gastrointestinal bleeding.

scholarly journals Contamination of Propofol Infusions in the Intensive Care Unit: Incidence and Clinical Significance

1998 ◽  
Vol 26 (2) ◽  
pp. 162-164 ◽  
Author(s):  
S. A. R. Webb ◽  
B. Roberts ◽  
F. X. Breheny ◽  
C. L. Golledge ◽  
P. D. Cameron ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Nosocomial Infection ◽  
Wound Infection ◽  
Clinical Significance ◽  
Low Grade ◽  
Clinical Infection ◽  
Icu Patients

Epidemics of bacteraemia and wound infection have been associated with the infusion of bacterially contaminated propofol administered during anaesthesia. We conducted an observational study to determine the incidence and clinical significance of administration of potentially contaminated propofol to patients in an ICU setting. One hundred patients received a total of 302 infusions of propofol. Eighteen episodes of possible contamination of propofol syringes were identified, but in all cases contamination was by a low-grade virulence pathogen. There were no episodes of clinical infection or colonization which could be attributed to the administration of contaminated propofol. During the routine use of propofol to provide sedation in ICU patients the risk of nosocomial infection secondary to contamination of propofol is extremely low.

Elevated Cardiac Troponin Levels in Critically Ill Patients: Prevalence, Incidence, and Outcomes

2006 ◽  
Vol 15 (3) ◽  
pp. 280-288 ◽  
Author(s):  
Wendy Lim ◽  
Deborah J. Cook ◽  
Lauren E. Griffith ◽  
Mark A. Crowther ◽  
P. J. Devereaux
Keyword(s):  
Myocardial Infarction ◽  
Intensive Care Unit ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Troponin Level ◽  
Elevated Troponin ◽  
Electrocardiographic Changes

• Background Levels of cardiac troponin, a sensitive and specific marker of myocardial injury, are often elevated in critically ill patients. • Objectives To document elevated levels of cardiac troponin I in patients in a medical-surgical intensive care unit and the relationship between elevated levels and electrocardiographic findings and mortality. • Methods A total of 198 patients expected to remain in the intensive care unit for at least 72 hours were classified as having myocardial infarction (cardiac troponin I level ≥1.2 μg/L and ischemic electrocardiographic changes), elevated troponin level only (≥1.2 μg/L and no ischemic electrocardiographic changes), or normal troponin levels. Events were classified as prevalent if they occurred within 48 hours after admission and as incident if they occurred 48 hours or later after admission. Factors associated with mortality were examined by using regression analysis. • Results A total of 171 patients had at least one troponin level measured in the first 48 hours. The prevalence of elevated troponin level was 42.1% (72 patients); 38 patients (22.2%) had myocardial infarction, and 34 (19.9%) had elevated troponin level only. After the first 48 hours, 136 patients had at least 1 troponin measurement. The incidence of elevated troponin level was 11.8% (16 patients); 7 patients (5.1%) met criteria for myocardial infarction, and 2 (1.5%) had elevated troponin level only. Elevated levels of troponin I at any time during admission were associated with mortality in the univariate but not the multivariate analysis. • Conclusions Elevated levels of cardiac troponin I in critically ill patients do not always indicate myocardial infarction or an adverse prognosis.

scholarly journals CLINICAL CHARACTERISTICS OF 28 PATIENTS WITH DIABETES AND COVID-19 IN WUHAN, CHINA

2020 ◽  
Vol 26 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Feng Wang ◽  
Yan Yang ◽  
Kun Dong ◽  
Yongli Yan ◽  
Shujun Zhang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Icu Patients ◽  
Patients With Diabetes

Objective: Previous studies on coronavirus disease 2019 (COVID-19) were based on information from the general population. We aimed to further clarify the clinical characteristics of diabetes with COVID-19. Methods: Twenty-eight patients with diabetes and COVID-19 were enrolled from January 29, 2020, to February 10, 2020, with a final follow-up on February 22, 2020. Epidemiologic, demographic, clinical, laboratory, treatment, and outcome data were analyzed. Results: The average age of the 28 patients was 68.6 ± 9.0 years. Most (75%) patients were male. Only 39.3% of the patients had a clear exposure of COVID-19. Fever (92.9%), dry cough (82.1%), and fatigue (64.3%) were the most common symptoms, followed by dyspnea (57.1%), anorexia (57.1%), diarrhea (42.9%), expectoration (25.0%), and nausea (21.4%). Fourteen patients were admitted to the intensive care unit (ICU). The hemoglobin A1c level was similar between ICU and non-ICU patients. ICU patients had a higher respiratory rate, higher levels of random blood glucose, aspartate transaminase, bilirubin, creatine, N-terminal prohormone of brain natriuretic peptide, troponin I, D-dimers, procalcitonin, C-reactive protein, ferritin, interleukin (IL)-2R, IL-6, and IL-8 than non-ICU patients. Eleven of 14 ICU patients received noninvasive ventilation and 7 patients received invasive mechanical ventilation. Twelve patients died in the ICU group and no patients died in the non-ICU group. Conclusion: ICU cases showed higher rates of organ failure and mortality than non-ICU cases. The poor outcomes of patients with diabetes and COVID-19 indicated that more supervision is required in these patients. Abbreviations: COVID-19 = coronavirus disease 2019; ICU = intensive care unit; MERS-CoV = middle East respiratory syndrome-related coronavirus; 2019- nCoV = 2019 novel coronavirus; NT-proBNP = N-terminal prohormone of brain natriuretic peptide; SARS-CoV = severe acute respiratory syndrome-related coronavirus

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