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Intensive Care Medicine

Published in:

01-02-2006 | Original

Jaundice in critical illness: promoting factors of a concealed reality

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

Published in: Intensive Care Medicine | Issue 2/2006

Abstract

Objective

In 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.

Design

Prospective, observational study.

Setting

A multidisciplinary intensive care unit (ICU) of a university hospital.

Patients

All patients consecutively admitted over a 6-month period.

Intervention

None.

Measurements and results

LD 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).

Conclusions

In 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.

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Title: Jaundice in critical illness: promoting factors of a concealed reality
Authors: Nicola Brienza
Lidia Dalfino
Gilda Cinnella
Caterina Diele
Francesco Bruno
Tommaso Fiore
Publication date: 01-02-2006
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 2/2006
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-005-0023-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Jaundice in critical illness: promoting factors of a concealed reality

Abstract

Objective

Design

Setting

Patients

Intervention

Measurements and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Intervention

Measurements and results

Conclusions

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