By Marc Leone, Claude Martin, Jean-Louis Vincent
This publication highlights the sensible features of unusual ailments and provides the main proper positive factors for the administration of extensive care devices. It doesn't objective to supply an exhaustive description of unusual illnesses, focusing in its place at the significant ailments that intensivists may well come upon of their medical practice.
After a quick advent at the epidemiology and pathophysiology of every illness, the authors emphasize the facets relating to prognosis and remedy, supplying concise and pragmatic assistance for citizens and intensivists who take care of sufferers with unusual diseases.
Although by means of definition unusual illnesses have a low incidence within the basic inhabitants, they could impact plenty of sufferers admitted to in depth care devices, as they could frequently be clinically determined at in depth care devices. certainly, frequently a hardship of the illness is what results in the patient’s being admitted to an extensive care unit.
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Additional info for Uncommon Diseases in the ICU
Contraction is transient and is followed by a relaxation phase due to the cytosolic calcium decrease brought on by three mechanisms: Sarcoplasmic reticulum calcium uptake by its Ca++-ATPase (SERCA), responsible for approximately 60 % of the calcium outflow (1) calcium outward movement through the cellular membrane Na/Ca++ exchanger (NCX). This is a ion cotransporter depending not on ATP but on transmembrane sodium and calcium gradients and membrane potential. Responsable for 30 % of calcium outflow, this cotransporter is electrogenic and plays its main role during the depolarization phase.
The maximal velocity of S (systolic) wave recorded by tissue Doppler at the lateral tricuspid annulus is correlated to RVEF. A S velocity value inferior to 11 cm/s correlates with altered RVEF whereas a value inferior to 9 cm/s is correlated with sever alteration of RV systolic function. The existence of pericardial effusion is associated with bad prognosis . Thoracic CT Scan Performing CT scan is of mandatory for the diagnosis of PAH, especially in order to exclude pulmonary, cardiac or thromboembolic cause of PH.
Accordingly, there is no interest to detect systematically this abnormality in a general population. On the other hand, it can be useful in patients presenting only partial diagnosis criteria or during familial surveys. These tests are performed only in rare specialized laboratories for research protocols. A test for SCN5A gene has a real diagnosis value only if positive. Other gene mutations are still actively researched, especially concerning the gene encoding the MOG1 protein. 26 Fig. 3 Indications of automatic defibrillator implantation according to ECG abnormalities (spontaneous and class I antiarrhythmic drugs-induced type 1 ECG) D.
Uncommon Diseases in the ICU by Marc Leone, Claude Martin, Jean-Louis Vincent