Jaundice in critical illness: promoting factors of a concealed reality View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2006-02-01

AUTHORS

Nicola Brienza, Lidia Dalfino, Gilda Cinnella, Caterina Diele, Francesco Bruno, Tommaso Fiore

ABSTRACT

ObjectiveIn critical illness, liver dysfunction (LD) is associated with a poor outcome independently of other organ dysfunctions. Since strategies to support liver function are not available, a timely and accurate identification of factors promoting LD may lead to prevention or attenuation of its consequences. The aim of this study was to assess risk factors for LD in critically ill patients.DesignProspective, observational study.SettingA multidisciplinary intensive care unit (ICU) of a university hospital.PatientsAll patients consecutively admitted over a 6-month period.InterventionNone.Measurements and resultsLD was defined as serum bilirubin levels ≥ 2 mg/dl and lasting for at least 48 h. Out of 283 patients, 141 matched inclusion criteria. Forty-four patients (31.2%) showed LD (LD group), while 97 (68.8%) were included in control group (C group). A binomial analysis showed that LD occurrence was associated with moderate (odds ratio [OR] 3.11; p = 0.04) and severe shock (OR 3.46; p = 0.05), sepsis (OR 3.03; p = 0.04), PEEP ventilation (OR 4.25; p = 0.006), major surgery (OR 4.03; p = 0.03), and gram-negative infections (OR 3.94; p = 0.002). In stepwise multivariate analysis, the single independent predictive factors of LD resulted in severe shock (p = 0.002), sepsis (p = 0.03), PEEP ventilation (p = 0.04), and major surgery (p = 0.05).ConclusionsIn critically ill patients jaundice is common, and severe shock states, sepsis, mechanical ventilation with PEEP and major surgery are critical risk factors for its onset. Since there is no specific treatment, prompt resuscitation, treatment of sepsis and meticulous supportive care will likely reduce its incidence and severity. More... »

PAGES

267-274

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-005-0023-3

DOI

http://dx.doi.org/10.1007/s00134-005-0023-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1001164344

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/16450099


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