• Title/Summary/Keyword: Critical illness

Search Result 127, Processing Time 0.026 seconds

A Case of Critical Illness Polyneuropathy and Myopathy (중환자 다발신경병증 및 근육병 1예)

  • Moon, So-Young;Lee, Sang-Soo;Lee, Sung-Hyun;Shin, Dong-Ick
    • Annals of Clinical Neurophysiology
    • /
    • v.9 no.1
    • /
    • pp.19-22
    • /
    • 2007
  • Critical illness polyneuropathy (CIP) and critical illness myopathy (CIM) occur commonly in the patients who have been on mechanical ventilation for more than 1 week. Even in some patients diagnosed with CIP, an underlying myopathy may be the primary cause of the muscle weakness. The cormorbid status of CIP and CIM is called as critical illness polyneuropathy and critical illness myopathy (CIPNM). We describe a 56-year-old man with acute quadriparesis and areflexia after systemic inflammatory response syndrome. The diagnosis of CIPNM is important to avoid unnecessary investigations and unreasonably pessimistic prognosis. Electrophysiologic studies are essential for the diagnosis and for planning further clinical management.

  • PDF

Critical Illness Myopathy (위험질병 근병증)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
    • /
    • v.4 no.2
    • /
    • pp.91-97
    • /
    • 2002
  • The field of critical care medicine has flourished, but an unfortunate result of improved patient survival in the intensive care unit is the occurrence of certain acquired neuromuscular disorders. During the last two decades, various neuromuscular disorders were recognized as common causes of weakness occurring in critically ill patients. The two most common disorders are an acute quadriplegic myopathy predominantly associated with the use of intravenous corticosteroids and neuromuscular junction blocking agents and severe systemic illness termed critical illness myopathy(CIM), and an axonal sensorimotor polyneuropathy termed critical illness polyneuropathy. I will review briefly about general components of the CIM.

  • PDF

Critical illness neuromyopathy

  • Park, Soo-Hyun;Jeong, Yoon-Jung;Kim, Nam-Hee
    • Annals of Clinical Neurophysiology
    • /
    • v.22 no.2
    • /
    • pp.61-66
    • /
    • 2020
  • Critical illness neuromyopathy (CINM) is a common but frequently underdiagnosed condition in critically ill patients that contributes to ventilator weaning failure and limb weakness in intensive care unit (ICU). CINM is subdivided into critical illness polyneuropathy and critical illness myopathy, and the occurrence of these conditions in the ICU is associated with multiple organ failure due to sepsis or certain medications. CINM survivors might have persistent functional disabilities and a poor quality of life. This situation demonstrates the need for efforts to minimize or prevent CINM in critically ill patients. This article provides a current overview of CINM and the associated clinical strategies.

Critical Illness Polyneuropathy (위험질병 다발신경병증)

  • Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
    • /
    • v.3 no.2
    • /
    • pp.115-121
    • /
    • 2001
  • The occurrence of muscle weakness in patients with sepsis or multiple organ failure managed in the intensive care unit has been recognized with increasing frequency in the last two decades. The difficulty in examining critically ill patients may explain why this complication has been only recently recognized. This weakness is due to an axonal polyneuropathy which is called critical illness polyneuropathy(CIP). It must be differentiated from myopathy or neuromuscular junction disturbance that can also occur in the intensive care setting. Neither the cause nor the exact mechanism of CIP has been elucidated. Electrophysiological studies demonstrated an acute axonal damage of the peripheral nerves. Before the recognition of CIP, these cases were usually misdiagnosed as Guillain-$Barr{\acute{e}}$ syndrome. Clinical recovery from the neuropathy is rapid and nearly complete in those patients who survive. Thus, neuropathy acquired during critical illness, although causing a delayed in weaning from ventilatory support and hospital discharge, does not worsen long-term prognosis.

  • PDF

A LightGBM and XGBoost Learning Method for Postoperative Critical Illness Key Indicators Analysis

  • Lei Han;Yiziting Zhu;Yuwen Chen;Guoqiong Huang;Bin Yi
    • KSII Transactions on Internet and Information Systems (TIIS)
    • /
    • v.17 no.8
    • /
    • pp.2016-2029
    • /
    • 2023
  • Accurate prediction of critical illness is significant for ensuring the lives and health of patients. The selection of indicators affects the real-time capability and accuracy of the prediction for critical illness. However, the diversity and complexity of these indicators make it difficult to find potential connections between them and critical illnesses. For the first time, this study proposes an indicator analysis model to extract key indicators from the preoperative and intraoperative clinical indicators and laboratory results of critical illnesses. In this study, preoperative and intraoperative data of heart failure and respiratory failure are used to verify the model. The proposed model processes the datum and extracts key indicators through four parts. To test the effectiveness of the proposed model, the key indicators are used to predict the two critical illnesses. The classifiers used in the prediction are light gradient boosting machine (LightGBM) and eXtreme Gradient Boosting (XGBoost). The predictive performance using key indicators is better than that using all indicators. In the prediction of heart failure, LightGBM and XGBoost have sensitivities of 0.889 and 0.892, and specificities of 0.939 and 0.937, respectively. For respiratory failure, LightGBM and XGBoost have sensitivities of 0.709 and 0.689, and specificity of 0.936 and 0.940, respectively. The proposed model can effectively analyze the correlation between indicators and postoperative critical illness. The analytical results make it possible to find the key indicators for postoperative critical illnesses. This model is meaningful to assist doctors in extracting key indicators in time and improving the reliability and efficiency of prediction.

A Study on Changes of Serum $fT_3\;and\;rT_3$ Concentration in Nonthyroidal Critical Illness (비갑상선 중증 질환에서 혈청 $fT_3$$rT_3$의 변화에 관한 연구)

  • Lee, Jong-Wha;Kim, Ju-Ock;Yu, Cheol-Jae;Moon, Youn-Sung;Shin, Young-Tae;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
    • /
    • v.19 no.1
    • /
    • pp.103-111
    • /
    • 1985
  • Recently changes in thyroid physiology during acute and chronic medical illness were demonstrated. The serum $fT_3,\;rT_3,\;T_4,\;T_3,\;fT_4$, and TSH concentration were measured by radioimmunoassay method in 49 patients with critical illness and 10 normal subjects to assess the change of thyroid function in critical illness. The results were as follows; 1) The mean serum $fT_3$ concentration was $6.68{\pm}1.05pmol/ml$ in normal subjects while in patients with critical illness the serum $fT_3$ concentration was significantly lowered to $1.55{\pm}1.15pmol/ml$(p<0.001). 2) The mean serum $rT_3$ concentration was $0.22{\pm}0.44ng/ml$ in normal subjects and $0.42{\pm}0.37ng/ml$ in patient with critical illness. There was increment in critically ill patients as compared to normal subjects but no statistically significant difference(p>0.05). 3) The mean serum $T_3$ concentration was $1.24{\pm}0.25ng/ml$ in normal subjects and $0.56{\pm}0.56ng/ml$ in patients with criticial illness and there was significant difference in each other(p<0.005). 4) The mean serum $T_4,\;fT_4$, and TSH concentrations were $7.80{\pm}1.02{\mu}g/dl,\;1.26{\pm}0.39ng/dl,\;1.87{\pm}0.45{\mu}U/ml$ in normal subjects respectively and $6.02{\pm}3.06{\mu}g/dl,\;1.46{\pm}0.80ng/dl,\;1.74{\pm}0.79{\mu}U/ml$ in patients with critical illness and there was no significant difference between critically ill patients and normal subjects. 5) The ratio of mean serum concentration of $fT_3$ and $rT_3(fT_3/rT_3)$, $30.42{\pm}5.58$ in normal subjects was significantly higher(p<0.005) than the coresponding patients with critical illness. 6) The mean serum $fT_3$ concentration in expired cases(n=12) during admission was significant difference between expired and survived cases(p<0.005). The mean serum $rT_3$ centration was $0.67{\pm}0.58ng/ml$ in expired cases and $0.34{\pm}0.22ng/ml$ in survived cases with significant difference(p<0.005). Half of the cases who showed less than $3{\mu}g/dl$ of serum $T_4$ level were expired.

  • PDF

A Literature Study on the Association with Critical State of Sasang Constitutional Symptoms and Cancer Related Symptoms (사상인 체질병증 험위증(險危證) 중 악성 종양으로 유발될 수 있는 증(證)에 대한 고찰)

  • Lee, Soo-Min;Park, So-Ra;Lee, Soo-Kyung
    • Journal of Sasang Constitutional Medicine
    • /
    • v.27 no.3
    • /
    • pp.307-317
    • /
    • 2015
  • Objectives The purpose of study was to identify cancer related symptoms of Sasang Constitution based on the classic of Sasang Constitutional Medicine (SCM). Methods The bibliographical study was performed with "Dongyisoosebowon-Shinchukbon(東醫壽世保元 辛丑本)", Dongyisoosebowon-Sasangchobongwon(東醫壽世保元 四象草本券), "Cancer", and several review articles. The perspective on severe illness in SCM was investigated. And 'the critical state' of constitutional symptoms based on "Dongyisoosebowon" was identified as cancer related symptoms. Results and Conclusions The perspective on severe illness of SCM was focused on the human being itself, compared with symptom based traditional Chinese medicine. The preservation of requisite energy (保命之主) was a vital factor of longevity to maintain healthy status and the classification of severity of disease. And critical state was an important indicator to control severe illness. Regarding cancer related symptoms in SCM, Janggwol(臟厥), Eumsung-gyeokyang(陰盛隔陽證), Janggyeol(藏結證) of Soeumin symptoms, Hwangdal(黃疸), Haso(下消), Eumheo-oyel(陰虛午熱證), Gochang, Tohyul(吐血) of Soyangin's symptoms, Joyeol(燥熱證), Bokchang-bujong(腹脹浮腫) of Taeeumin's symptoms, and Eolgyek of Taeyangin's symptoms could be shown the association with cancer. According to the prognosis on disease severity, regimens of daily life, behavior modifications as well as medications were also emphasized with great importance to control severe illness in SCM. These holistic approach for controlling severe illness in SCM could lead to the improvement of treatment outcome.

The Discourse associated with mental illness on TV documentaries : The Completion of Distinction (TV 다큐멘터리가 생성한 정신장애 담론 : 구별짓기의 완성)

  • Chang, Hae Kyung;Woo, Ah Young
    • Korean Journal of Social Welfare Studies
    • /
    • v.42 no.1
    • /
    • pp.179-217
    • /
    • 2011
  • This paper discusses the type of discourse associated with mental illness and individuals with mental illness in the context of TV documentary. Discourse is an linguistic product which prescribes and interprets the reality and reconstructs the reality systematically. Therefore, TV documentary contents illuminate the dominant discourse associate with mental illness through the diverse types of representation. We picked four TV documentaries from each public channels and analyzed these documentaries using Fairclough's Critical Discourse Analysis. Faircough suggests the analysis frame consisting of three level. The analysis reveals that TV documentaries produce the discourse "the Completion of Distinction" associated with mental illness and individuals with mental illness. TV documentaries suggest the reason why we distinct them from us in textual level. In discourse practice level, they suggest the method and the principal agent of distinction. For social practice, TV documentaries reinforce the dual attitude of viewer. Alternative discourse associated with mental illness and individuals with mental illness will be constructed when individuals with mental illness recovers the status of principal agents and produces strong voices about themselves.

Post-intensive Care Syndrome and Quality of Life in Survivors of Critical Illness (중환자실 퇴원환자의 집중치료 후 증후군과 삶의 질)

  • Kim, Soo Gyeong;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
    • /
    • v.9 no.1
    • /
    • pp.1-14
    • /
    • 2016
  • Purpose: To investigate the post-intensive care syndrome (PICS) and to analyze the factors affecting the quality of life (QoL) of survivors of critical illness. Methods: Subjects were 114 outpatients who had been discharged from intensive care units of a university hospital in B city, Korea. From July 30 through September 30, 2015, PICS was assessed using the Korean Montreal Cognitive Assessment, Hospital Anxiety-Depression Scale, Korean Instrumental/Activities of Daily Living (K-I/ADL) index, and handwriting transformation, while physical and mental health-related QoL was measured using the SF-12. Results: Of the subjects, 39.5% were screened for mild cognitive disorder and 23.7% experienced handwriting transformation after discharge. Multiple regression analysis revealed that restraint application, current job, time of ${\geq}36$ months after discharge, depression, anxiety, and handwriting transformation accounted for 40.9% of the physical health-related QoL, and depression, anxiety and experience of delirium accounted for 62.4% of the mental health-related QoL. Conclusions: It is necessary to make efforts to reduce restraint application in intensive care units and prevent the occurrence of delirium, with the objective of reducing PICS and improving the QoL of critical illness survivors.

  • PDF