Anaesthesia and intensive care
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Anaesth Intensive Care · Sep 2009
Case ReportsTakotsubo cardiomyopathy during emergence from general anaesthesia.
Takotsubo cardiomyopathy, or stress-induced cardiomyopathy, is a clinical syndrome mimicking acute myocardial infarction. We report a case of a 55-year-old man who developed Takotsubo cardiomyopathy during emergence from general anaesthesia for an elective procedure to remove a spinal cord stimulator The perioperative state is known to induce stress, but there are few cases describing the onset of Takotsubo syndrome during this period. The case presented demonstrates that Takotsubo cardiomyopathy may occur on emergence from anaesthesia and that the pattern of left ventricular dysfunction produced may not be typical.
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Anaesth Intensive Care · Sep 2009
Inflammation, vitamin deficiencies and organ failure in critically ill patients.
It is unknown whether biochemical vitamin deficiencies in critical illness are associated with severity of illness, organ dysfunction, inflammation or mortality. This nested cohort study recruited 98 patients admitted as emergencies to the intensive care unit, who had a stay of greater than 48 hours. Patient data were prospectively collected. ⋯ Vitamin A concentration was weakly associated with the C-reactive protein concentrations on days one and five (Spearman's r = -0.5 [P = 0.001], -0.4 [P = 0.03], respectively). Change in deficiency status of any of the vitamins over time in the first week of intensive care admission did not appear to influence mortality. We conclude that while weak correlations were identified between vitamins A and B12 and C-reactive protein and Sequential Organ Failure Assessment scores, the importance of these associations and their relationship to hospital mortality remain to be determined.