妊娠期急性脂肪肝(acute fatty liver of pregnancy,AFLP)是一种少见的危及生命的急症,是妊娠所特有的,通常发生在妊娠晚期或产后早期。不论分娩年龄或严重程度如何,及时分娩对于遏制病情至关重要。现将本院收治的2例AFLP并发多器官功...妊娠期急性脂肪肝(acute fatty liver of pregnancy,AFLP)是一种少见的危及生命的急症,是妊娠所特有的,通常发生在妊娠晚期或产后早期。不论分娩年龄或严重程度如何,及时分娩对于遏制病情至关重要。现将本院收治的2例AFLP并发多器官功能衰竭综合征(multiple organ dysfunction syndrome,MODS)的病例报道如下,以期提高对AFLP的识别和管理。展开更多
Background: Multiple organ dysfunction syndrome(MODS) is the sequential failure of several organ systems after a trigger event, like cardiogenic shock or decompensated heart failure. Mortality is high, up to 70% . Aut...Background: Multiple organ dysfunction syndrome(MODS) is the sequential failure of several organ systems after a trigger event, like cardiogenic shock or decompensated heart failure. Mortality is high, up to 70% . Autonomic dysfunction(AD)may substantially contribute to the development of MODS. In cardiology, it has recently been shown that nonlinear parameters could predict mortality.Our study aimed at 1. characterising the complex characteristics of AD of critically ill MODS patients by the nonlinear parameters of autonomic information flow(AIF), 2. comparing AIF with autonomic function of healthy controls, and 3. characterising the accuracy of this parameter in predicting mortality in MODS. Methods: We enrolled 43 score-defined MODS patients who were consecutively admitted to a twelve-bed medical intensive care unit in a university centre into this prospective outcome study. Additionally, we assigned 50 healthy controls to the study. AIF was assessed as a complexity function of AD using 24-h ECG. Measures of AIF were introduced according to the standard HRV concept. The patients were followed up for 28-day mortality. Results: MODS causes a disorganisation of short term AIF in favour of an enhanced(rigid) long term AIF. Concerning prognosis increased short term AIF was associated with survival. Short term AIF discriminated between MODS survivors and nonsurvivors at the level of APACHE II score. Conclusions: This is the first study providing evidence that complex AD of MODS patients is specifically assessed by AIF time scales and that AIF has significant prognostic impact.展开更多
文摘妊娠期急性脂肪肝(acute fatty liver of pregnancy,AFLP)是一种少见的危及生命的急症,是妊娠所特有的,通常发生在妊娠晚期或产后早期。不论分娩年龄或严重程度如何,及时分娩对于遏制病情至关重要。现将本院收治的2例AFLP并发多器官功能衰竭综合征(multiple organ dysfunction syndrome,MODS)的病例报道如下,以期提高对AFLP的识别和管理。
文摘Background: Multiple organ dysfunction syndrome(MODS) is the sequential failure of several organ systems after a trigger event, like cardiogenic shock or decompensated heart failure. Mortality is high, up to 70% . Autonomic dysfunction(AD)may substantially contribute to the development of MODS. In cardiology, it has recently been shown that nonlinear parameters could predict mortality.Our study aimed at 1. characterising the complex characteristics of AD of critically ill MODS patients by the nonlinear parameters of autonomic information flow(AIF), 2. comparing AIF with autonomic function of healthy controls, and 3. characterising the accuracy of this parameter in predicting mortality in MODS. Methods: We enrolled 43 score-defined MODS patients who were consecutively admitted to a twelve-bed medical intensive care unit in a university centre into this prospective outcome study. Additionally, we assigned 50 healthy controls to the study. AIF was assessed as a complexity function of AD using 24-h ECG. Measures of AIF were introduced according to the standard HRV concept. The patients were followed up for 28-day mortality. Results: MODS causes a disorganisation of short term AIF in favour of an enhanced(rigid) long term AIF. Concerning prognosis increased short term AIF was associated with survival. Short term AIF discriminated between MODS survivors and nonsurvivors at the level of APACHE II score. Conclusions: This is the first study providing evidence that complex AD of MODS patients is specifically assessed by AIF time scales and that AIF has significant prognostic impact.
