Abstract:
AIM:An increased thyroxine requirement has been described in hypothyroid patients who have chronic gastritis as well as in patients who are treated with drugs that modify the acidic environment of the stomach. Patients with acute critical illnesses are generally treated with calorically dense enteral solutions and antacids, both of which influence the gastric acidic environment. In this study, we evaluated levothyroxine (L-thyroxine) requirements in hypothyroid patients admitted to our ICU. METHODS:The medical records of nine patients with pre-existing hypothyroidism who did not have gastrointestinal diseases and who were admitted to our ICU between 2003 and 2008 were retrospectively reviewed. Serum TSH, FT4, and FT3 levels were measured at the time of admission and every four to eight days thereafter. After the second measurement of these parameters, patients' L-thyroxine doses were adjusted to maintain their TSH concentrations at baseline levels. RESULTS:At the time of ICU admission, the median [interquartile range] TSH, FT4, and FT3 values of the included patients were 1.52 [0.79-3.8] mU/L, 6.5 [4.9-9.3] pg/mL, and 1.0 [<1.0-1.25] pg/mL, respectively. After the first 4-8 days of their ICU stay, while their L-thyroxine doses were unchanged, the TSH levels of all included patients increased (5.69 [3.87-6.83] mU/L, P=0.012). Over the same period, their FT4 levels decreased significantly. To restore patients' TSH levels to those at the time of admission, the L-thyroxine dose was increased in 8/9 patients by an average of 54.4+/-31.6% (P=0.001). At the time of ICU discharge, patients' TSH and FT4 levels had returned to near their levels at the time of admission. All patients' serum FT3 levels remained low throughout the entire duration of their ICU stay. CONCLUSION:To maintain TSH levels in the normal range, it may be necessary to increase the L-thyroxine dose of critically ill patients with hypothyroidism. Our findings also suggest that during the first several days of a critical illness, the hypothalamic-pituitary-thyroid axis is not suppressed in hypothyroid patients.
journal_name
Minerva Anestesioljournal_title
Minerva anestesiologicaauthors
Imberti R,Ferrari M,Albertini R,Rizzo V,Tinelli C,Iotti GAsubject
Has Abstractpub_date
2010-07-01 00:00:00pages
500-3issue
7eissn
0375-9393issn
1827-1596pii
R02105776journal_volume
76pub_type
杂志文章abstract::Diabetes mellitus is a common endocrinopathy. Diabetic patients undergoing surgery have to be carefully evaluated in order to lower the risk of perioperative complications. The author reviews the possible pathological involvement of target organs, focusing on cardiovascular pathology, neuropathy, nephropathy, respirat...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2001-04-01 00:00:00
abstract::Traumatic brain injury (TBI) is a global public health epidemic. It represents the principal cause of death and disability in individuals aged under 35 in the USA. In the subacute phase, severe TBI patients who recover consciousness go through a state of agitation and delirium. However, there is only limited research ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.18.12294-2
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:Although blood gas analysis (BGA) is important for supplemental oxygen titration, it is invasive, intermittent, costly, and burdensome for staff. We assessed whether the Oxygen Reserve Index (ORi™), a novel pulse oximeter-based index that reflects the partial pressure of oxygen (PaO2), could determine the am...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.20.14895-8
更新日期:2020-12-15 00:00:00
abstract:BACKGROUND:Multiple organ dysfunction can occur in patients undergoing Veno-arterial Extra Corporal Membrane Oxygenation (VA-ECMO); however, liver function has not been well studied in this setting. METHODS:In a review of our institutional ECMO database (n=162), we collected aspartate (AST) and alanine (ALT) transamin...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:10.23736/S0375-9393.16.11442-7
更新日期:2017-03-01 00:00:00
abstract::Xenon is an interesting anesthetic as it appears to lack negative inotropicy and vasodilatation, giving great advantages to both patients with limited cardiovascular reserve or those who require hemodynamic stability. It has low toxicity and is not teratogenic. Xenon gives rapid induction and recovery, due to its low ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2004-05-01 00:00:00
abstract::The authors compared the efficacy of ketorolac trometamin (30 mg i.m. every 6 hours) and buprenorphine (0.3 mg i.m. every 12 hours) in the treatment of pain following cholecystectomy. Ketorolac was found to be equally efficacious in comparison to buprenorphine and caused fewer side effects. ...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-03-01 00:00:00
abstract:: ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:10.23736/S0375-9393.19.13597-3
更新日期:2019-02-01 00:00:00
abstract::Cardiac arrest carries a very poor prognosis. More than 70% of cardiac arrests are caused by acute myocardial infarction (AMI) or massive pulmonary embolism (PE). Thrombolysis during CPR has two major effects: first, it causally treats the condition that caused cardiac arrest and second, it has been shown to have bene...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:A new pulmonary artery catheter and monitor for continuous cardiac output measurement (CCO), based on thermodilution principle, has been recently developed. Aim of our study was to evaluate the new system by comparing data obtained with the CCO with the standard bolus thermodilution method (TD). METHODS:Nin...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1998-09-01 00:00:00
abstract::Pulmonary gas exchange is regularly impaired during general anaesthesia with mechanical ventilation. This results in decreased oxygenation of blood. Major causes are collapse of lung tissue (atelectasis) and airway closure. Collapsed lung tissue is present in 90% of all subjects, both during spontaneous breathing and ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:This study aimed to determine the accuracy of commonly used preoperative difficult airway indices as predictors of difficult mask ventilation (DMV) in obese patients (BMI >30 kg/m2). METHODS:In 309 consecutive obese patients undergoing general surgery, the modified Mallampati test, patient's Height/Thyromen...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-02-01 00:00:00
abstract::Cerebral edema complicates many neurosurgical conditions, such as head injuries, neoplasms and infections, and is the direct result of operative trauma. The recognition and the treatment of brain edema are of great practical importance, particularly in those conditions leading to brain herniations and/or intracranial ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:1992-04-01 00:00:00
abstract::Drugs used in anesthesia do not always produce the expected neurophysiological results. By studying those cases in which the reappearance of intraoperative awareness is most common, an attempt was made to estimate how many and which levels of cerebral function could be identified. Four levels were recognised: awarenes...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1990-05-01 00:00:00
abstract::The anaesthetic technique chosen for a laparohysterectomy in a woman affected by Apert's acrocephalosyndactilia is described. Difficulties in performing tracheal intubation were overcome by mean of loco-regional anesthesia (LRA). In order to minimize the anaesthetic risk, a standardised preoperative evaluation and ass...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract::Known for two centuries, positive pressure non invasive mechanical ventilation (VMNPP) has been widely applied in acute respiratory failure (IRA) only in the last ten years. The fact that VMNPP is able to improve gas exchange by avoiding endotracheal intubation and its complications is the most attractive aspect in bo...
journal_title:Minerva anestesiologica
pub_type: 历史文章,杂志文章,评审
doi:
更新日期:2000-10-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,多中心研究
doi:
更新日期:1992-12-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract:METHODS:Published studies, including abstracts, has been reviewed and summarized. RESULTS:Studies in sheep have demonstrated no significant differences in pharmacokinetic and placental transfer of levobuvacaine when compared with bupivacaine. Clinical studies on cesarean section confirmed similar performance between t...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:Devices that limit microaspiration through the cuffs of endotracheal tubes could help prevent ventilator-associated pneumonia (VAP). The amount of tracheal microaspirations could be a relevant study endpoint. The aim of our study was to assess whether amylase measured in tracheal secretions constituted a rel...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2013-09-01 00:00:00
abstract::This report describes a computer based program of patient clinical data collection: the ARCHIDIA system. The project relies on descriptive analysis of clinical events according to well defined methodological criteria. This allows the formulation of a concise diagnosis which is, at the same time, exhaustive of all esse...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1994-05-01 00:00:00
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journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Early prediction of neurological outcome for patients resuscitated from cardiac arrest (CA) is a challenging task. Therapeutic hypothermia (TH) has been shown to improve neurological outcome after CA. Two recent studies indicated that somatosensory evoked potentials (SEP) recorded during TH retains high pred...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2013-04-01 00:00:00
abstract::Mechanical ventilation (MV) with positive pressure insufflations of gas into the lung may be required to ensure sufficient oxygenation of blood and elimination of carbon dioxide in acute respiratory failure. Interfacing spontaneous breathing and mechanical ventilation has been used to improve gas exchange and may offe...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-04-01 00:00:00
abstract::The utility of laparoscopic cholecystectomy in reducing postoperative pain and patient's hospital discharge is already known. Nevertheless peritoneal gas insufflation required by surgical procedure can modify respiratory homeostasis during general anesthesia. The aim of this study was to evaluate the effect of laparos...
journal_title:Minerva anestesiologica
pub_type: 临床试验,杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::Systemic air embolisms are a rare but often a fatal complication of endoscopic retrograde cholangiopancreatography (ERCP). Only few cases have been reported in scientific studies. This paper concerns a case of a systemic air embolism that occurred during endoscopic sphincterotomy for gallstone removal in a 79-year-old...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
abstract::Cervical vertebral dislocations and fractures require the complete immobility of the neck until an intervention of stabilization of the spinal cord, by surgery or external means, is performed. Endotracheal intubation, which might represent a harmful operation, can become difficult when the stabilization of the spinal ...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract::Spinal and peridural anaesthesia has several advantages over general anaesthesia due to their low influence to endocrine and metabolic activity and their capacity to reduce postoperative surgical complications, intraoperative bleeding and deep venous thromboembolism incidence. Nevertheless, these anaesthesiologic tech...
journal_title:Minerva anestesiologica
pub_type: 杂志文章,评审
doi:
更新日期:2003-10-01 00:00:00
abstract::This report takes into consideration the complications due to "body packers" cocaine absorption. In particular we report a clinical case in which severe dysrhythmias occurred. We think an early insertion of a pacemaker able to rid ectopic focus by overdriving is essential by comparison with an effective anti-dysrhythm...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:The novel influenza A (H1N1) pandemic was associated with an epidemic of critical illness. METHODS:We describe the clinical profiles of critically ill patients with severe complications due to microbiologically confirmed pandemic influenza A (H1N1) infection admitted to a medical ICU in Monza, Italy, over a...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Gastric residual volume in ventilated critically ill may complicate gut function. Over the years studies suggested to tolerate progressively higher residuals. The relationship between such volumes and the development of ventilator-associated pneumonia (VAP) is still under debate. No reports deal with the rel...
journal_title:Minerva anestesiologica
pub_type: 杂志文章
doi:
更新日期:2014-04-01 00:00:00