Pub Date : 2020-07-01DOI: 10.1097/01.CCN.0000668556.08820.00
Fay Mitchell-Brown
www.nursingcriticalcare.com Hypertriglyceridemia (HTG) is a disorder where a patient’s serum triglyceride level is greater than 150 mg/dL (normal, less than 150 mg/dL).1 In the US, about 200,000 hospital admissions annually are due to acute pancreatitis, and this figure has been increasing.2 HTG is an important cause of acute pancreatitis and hypertriglyceridemia-induced pancreatitis (HTGP) occurs in 1% to 14% of patients diagnosed with acute pancreatitis.3,4 The risk of developing pancreatitis significantly increases when triglyceride levels are above 200 mg/dL.5 Both primary (genetic) and secondary disorders of lipoprotein metabolism are associated with HTGP. Primary disorders include type I dyslipidemia, also known as familial chylomicronemia. Secondary disorders include poorly controlled diabetes mellitus (types 1 and 2) and diabetic ketoacidosis.4 Pathophysiology Pancreatitis is an inflammation of the pancreas. In pancreatitis, intra-acinar activation of pancreatic enzymes (including trypsin, phospholipase A2, and elastase) can lead to autodigestion of the pancreas.6 These pancreatic enzymes damage tissue and activate the complement system and inflammatory cascade resulting in cytokine production, edema, inflammation, and sometimes necrosis. Injury occurs to the pancreatic cells with subsequent activation of the trypsinogen inside of the pancreas instead of in the duodenum; trypsinogen is then activated to trypsin by enterokinase. Normally, trypsin inhibitors in the pancreas inactivate the trypsin produced, but this fails to occur in an individual with pancreatitis, as digestive enzymes are secreted improperly leading to inflammation and autodigestion of the pancreas.6 Abstract: Hypertriglyceridemia-induced acute pancreatitis causes significant morbidity and mortality. It is important to promptly identify the underlying etiology and deliver the appropriate care to affected patients. Management includes supportive care and attempts to lower the serum triglyceride level. A case report of a patient treated successfully with an insulin infusion is presented.
{"title":"Hypertriglyceridemia-induced acute pancreatitis","authors":"Fay Mitchell-Brown","doi":"10.1097/01.CCN.0000668556.08820.00","DOIUrl":"https://doi.org/10.1097/01.CCN.0000668556.08820.00","url":null,"abstract":"www.nursingcriticalcare.com Hypertriglyceridemia (HTG) is a disorder where a patient’s serum triglyceride level is greater than 150 mg/dL (normal, less than 150 mg/dL).1 In the US, about 200,000 hospital admissions annually are due to acute pancreatitis, and this figure has been increasing.2 HTG is an important cause of acute pancreatitis and hypertriglyceridemia-induced pancreatitis (HTGP) occurs in 1% to 14% of patients diagnosed with acute pancreatitis.3,4 The risk of developing pancreatitis significantly increases when triglyceride levels are above 200 mg/dL.5 Both primary (genetic) and secondary disorders of lipoprotein metabolism are associated with HTGP. Primary disorders include type I dyslipidemia, also known as familial chylomicronemia. Secondary disorders include poorly controlled diabetes mellitus (types 1 and 2) and diabetic ketoacidosis.4 Pathophysiology Pancreatitis is an inflammation of the pancreas. In pancreatitis, intra-acinar activation of pancreatic enzymes (including trypsin, phospholipase A2, and elastase) can lead to autodigestion of the pancreas.6 These pancreatic enzymes damage tissue and activate the complement system and inflammatory cascade resulting in cytokine production, edema, inflammation, and sometimes necrosis. Injury occurs to the pancreatic cells with subsequent activation of the trypsinogen inside of the pancreas instead of in the duodenum; trypsinogen is then activated to trypsin by enterokinase. Normally, trypsin inhibitors in the pancreas inactivate the trypsin produced, but this fails to occur in an individual with pancreatitis, as digestive enzymes are secreted improperly leading to inflammation and autodigestion of the pancreas.6 Abstract: Hypertriglyceridemia-induced acute pancreatitis causes significant morbidity and mortality. It is important to promptly identify the underlying etiology and deliver the appropriate care to affected patients. Management includes supportive care and attempts to lower the serum triglyceride level. A case report of a patient treated successfully with an insulin infusion is presented.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000668556.08820.00","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42871473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/01.ccn.0000668580.03172.92
S. Kinthala, Burdett R. Porter, P. Saththasivam
with the disease. Many of these patients also require prolonged mechanical ventilation.1 A study by Gueret and colleagues in a medical ICU found a self-extubation rate of 1.3 per 100 days of mechanical ventilation.2 The presence of agitation is associated with increased risk of self-extubation.3 The need for reintubation is associated with a high rate of pulmonary complications, such as aspiration, ventilator-associated pneumonia, prolonged duration of mechanical ventilation, and increased hospital stay.4 Self-extubation by patients with COVID-19 poses a significant hazard to healthcare workers, because person-to-person spread of severe acute respira-
{"title":"Consider liberalizing restraint use in intubated patients with COVID-19","authors":"S. Kinthala, Burdett R. Porter, P. Saththasivam","doi":"10.1097/01.ccn.0000668580.03172.92","DOIUrl":"https://doi.org/10.1097/01.ccn.0000668580.03172.92","url":null,"abstract":"with the disease. Many of these patients also require prolonged mechanical ventilation.1 A study by Gueret and colleagues in a medical ICU found a self-extubation rate of 1.3 per 100 days of mechanical ventilation.2 The presence of agitation is associated with increased risk of self-extubation.3 The need for reintubation is associated with a high rate of pulmonary complications, such as aspiration, ventilator-associated pneumonia, prolonged duration of mechanical ventilation, and increased hospital stay.4 Self-extubation by patients with COVID-19 poses a significant hazard to healthcare workers, because person-to-person spread of severe acute respira-","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.ccn.0000668580.03172.92","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48054151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/01.CCN.0000668560.03626.5c
Carrie L. Griffiths, A. Patel, K. Hertel
{"title":"Common antidotes used in the ICU","authors":"Carrie L. Griffiths, A. Patel, K. Hertel","doi":"10.1097/01.CCN.0000668560.03626.5c","DOIUrl":"https://doi.org/10.1097/01.CCN.0000668560.03626.5c","url":null,"abstract":"","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000668560.03626.5c","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46666612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1097/01.ccn.0000660416.75245.f4
Melody K. Karycki
Transcatheter mitral valve repair (TMVR) is indicated in some patients with severe mitral regurgitation (MR). This procedure is an option for patients when surgical intervention is not considered appropriate. This article explores indications for TMVR and risks associated with the procedure. Diagnostic testing, post-procedural management, and critical care nursing considerations are also outlined.
{"title":"Transcatheter mitral valve repair","authors":"Melody K. Karycki","doi":"10.1097/01.ccn.0000660416.75245.f4","DOIUrl":"https://doi.org/10.1097/01.ccn.0000660416.75245.f4","url":null,"abstract":"Transcatheter mitral valve repair (TMVR) is indicated in some patients with severe mitral regurgitation (MR). This procedure is an option for patients when surgical intervention is not considered appropriate. This article explores indications for TMVR and risks associated with the procedure. Diagnostic testing, post-procedural management, and critical care nursing considerations are also outlined.","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45986859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.1097/01.ccn.0000654824.32618.d6
Fidelindo Lim, Leon L Chen, Alexander Salina
{"title":"CCRN® certification","authors":"Fidelindo Lim, Leon L Chen, Alexander Salina","doi":"10.1097/01.ccn.0000654824.32618.d6","DOIUrl":"https://doi.org/10.1097/01.ccn.0000654824.32618.d6","url":null,"abstract":"","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141208482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.1097/01.ccn.0000654824.32618.d6
Fidelindo Lim, Leon L Chen, Alexander Salina
{"title":"CCRN® certification","authors":"Fidelindo Lim, Leon L Chen, Alexander Salina","doi":"10.1097/01.ccn.0000654824.32618.d6","DOIUrl":"https://doi.org/10.1097/01.ccn.0000654824.32618.d6","url":null,"abstract":"","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":"43 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141206487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-05-01DOI: 10.1097/01.CCN.0000660380.54808.53
Grace L Earl
{"title":"A new look at managing hyperkalemia in high-risk patients","authors":"Grace L Earl","doi":"10.1097/01.CCN.0000660380.54808.53","DOIUrl":"https://doi.org/10.1097/01.CCN.0000660380.54808.53","url":null,"abstract":"","PeriodicalId":19344,"journal":{"name":"Nursing Critical Care","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.CCN.0000660380.54808.53","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41580176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：