جستجوی مقالات مرتبط با کلیدواژه « Anion Gap » در نشریات گروه « پزشکی »

Acute methyl alcohol toxicity can lead to severe ocular morbidity. In the present study, we aimed to observe the ocular outcomes in acute methyl alcohol poisoning and determine the biochemical predictors of the final visual outcome. This was a hospital- based descriptive study conducted on 19 consecutive patients of acute methanol poisoning presenting to the Ophthalmology department of a tertiary care multispecialty hospital in Eastern India. Thorough clinical history was obtained in each case.  A comprehensive ocular examination was done. Details of systemic treatment provided were obtained in all cases. Nineteen patients were included in the study. All patients were males. The average age of patients was 35.84 ± 9.25 years. All patients complained of bilateral blurring of vision. One patient had severe vision loss with visual acuity of hand movements in both eyes. . Colour vision was absent in 7 eyes (18.41%), and impaired in 5 eyes (13.15%). Disc edema was seen in 5 eyes (13.15%). High anion gap metabolic acidosis was seen in 13 (78.9%) cases. Serum bicarbonate level was < 22 mmol L-1 in 13 (68.42%) patients. Eleven (57.89%) patients underwent hemodialysis. The presence of metabolic acidosis, high anion gap, and high base deficit were associated with poor visual acuity and defective color vision both at the initial presentation and final follow-up. Metabolic acidosis, high anion gap, and base deficit at the time of presentation are associated with defective color vision, abnormal pupillary reaction, and poor vision both during initial and final visits. Prompt management of these metabolic abnormalities can decrease ocular morbidity and improve the final visual outcomes.

Background:

 Hypernatremia commonly occurs in ICUs, mostly developing soon after admission. It has been associated with prolonged ICU stay and has a mortality rate of 40–60%. The aim of our study is to estimate the values of serum anion gap (AG), corrected anion gap (CAG), and hypernatremia for an early prediction of mortality in pediatric intensive care units (PICUs).

 Materials and Methods: 

This retrospective comparative study used data collected from the records of children admitted to the PICU at Minia University Hospital between June, 2017 and June, 2019.

Results:

 Patients were from 1 month to 18 years old. ROC curve analysis for the prediction of mortality showed the cutoff point of Na >154 (64.04% sensitivity and 79.75% specificity) and of cAG > 42.1 (57.37% sensitivity and 70.25% specificity).

 Conclusion:

Ventilation, respiratory failure, severe and moderate GCS, PH, CO2, anion gap, high cAG, hypernatremia, K, CL, CRP, PLT, and creatinine were significant predictors of mortality among children admitted to the PICU.