Acute and Critical Care

Original Article

Infection
The association between defecation frequency and mortality in critically ill patients with suspected sepsis in Israel: Michael Roimi, Anat Shrot, Roy Ilan, Avraham Tenenbaum, Danny Epstein, Yaron Bar-Lavie; Acute Crit Care. 2025;40(1):38-45. Published online February 18, 2025; DOI: https://doi.org/10.4266/acc.000696

564 View
79 Download

Abstract PDF: Background
The pivotal role of the gastrointestinal (GI) tract in sepsis is well recognized. This study aimed to evaluate the associations between defecation frequency as a basic assessment of GI function and the clinical outcomes of intensive care unit patients with suspected sepsis.
Methods
This retrospective, single-center study included patients suspected of having sepsis. The number of defecations and consecutive days without defecation during the 72 hours preceding the suspected infection were assessed. The primary outcome was 30-day all-cause mortality. Multivariate regression analysis adjusting for potential confounders was employed to establish the associations between GI function and clinical outcomes.
Results
The final analysis included 1,306 patients with a median age of 56.2 years (interquartile range [IQR], 39.6–69.1); 919 (70.4%) were male, and the median Acute Physiology and Chronic Health Evaluation II score was 22.0 (IQR, 17.0–27.0). The median Sequential Organ Failure Assessment score at the time of suspected infection was 5.0 (IQR, 3.0–7.0). Mortality rates were 20.3%, 28.0%, and 34.3% for patients with 0–2, 3–5, and >5 defecations, respectively (P<0.001). There was a strong correlation between the number of defecations and mortality (r=0.7, P=0.01). In multivariate analyses, each defecation was independently associated with increased mortality (adjusted odds ratio [aOR], 1.07; 95% CI, 1.01–1.12; P=0.01), while each consecutive day without a defecation was associated with reduced mortality (aOR, 0.83; 95% CI, 0.73–0.96; P=0.01).
Conclusions
A higher number of defecations in the 72 hours preceding suspected sepsis is associated with increased 30-day all-cause mortality, suggesting a potential association with GI tract dysfunction.

Case Reports

Infection
Primary Invasive Intestinal Aspergillosis in a Non-Severely Immunocompromised Patient: Eunmi Gil, Tae Sun Ha, Gee Young Suh, Chi Ryang Chung, Chi-Min Park; Korean J Crit Care Med. 2016;31(2):129-133. Published online May 31, 2016; DOI: https://doi.org/10.4266/kjccm.2016.31.2.129; Correction in: Acute Crit Care 2016;31(3):263

8,931 View
121 Download
1 Crossref

Invasive aspergillosis (IA) is most commonly seen in patients with risk factors, such as cytotoxic chemotherapy, prolonged neutropenia, corticosteroids, transplantation and acquired immune deficiency syndrome. IA commonly occurs in the respiratory tract. Extrapulmonary aspergillosis is usually a part of a disseminated infection, and primary invasive intestinal aspergillosis is very rare. Herein, we report a case of an immunocompetent 53-year-old male who suffered recurrent septic shock in the intensive care unit (ICU) and was finally diagnosed as invasive intestinal aspergillosis without dissemination. IA is rarely considered for patients who do not have an immune disorder. Thus, when such cases do occur, the diagnosis is delayed and the clinical outcome is often poor. However, there is a growing literature reporting IA cases in patients without an immune disorder, mostly among ICU patients. Primary intestinal aspergillosis should be considered for critically ill patients, especially with severe disrupted gastrointestinal mucosal barrier.

Citations

Citations to this article as recorded by

Aspergillus fumigatus cholangitis in a patient with cholangiocarcinoma: case report and review of the literature
Kathrin Rothe, Sebastian Rasch, Nina Wantia, Alexander Poszler, Joerg Ulrich, Christoph Schlag, Wolfgang Huber, Roland M. Schmid, Dirk H. Busch, Tobias Lahmer
Infection.2021; 49(1): 159. CrossRef

Infection
Disseminated Gastrointestinal Mucormycosis in Immunocompromised Disease: Tae Sun Ha, Chi-Min Park, Jeong Hoon Yang, Yang Hyun Cho, Chi Ryang Chung, Kyeongman Jeon, Gee Young Suh; Korean J Crit Care Med. 2015;30(4):323-328. Published online November 30, 2015; DOI: https://doi.org/10.4266/kjccm.2015.30.4.323

6,631 View
100 Download
3 Crossref

Abstract PDF

Mucormycosis is an uncommon opportunistic fungal infection mostly affecting immunocompromised patients and gastrointestinal mucormycosis is a rare and life-threatening. We describe a 31-year-old man with a history of idiopathic cyclic neutropenia who developed perforations of the stomach and intestine and intra-abdominal bleeding due to disseminated gastrointestinal mucormycosis after the initial operation.

Citations

Citations to this article as recorded by

Gastric Mucormycosis: A Systematic Review with Metadata
Ayman M. Mustafa, Yousif M. Mahmood, Ali H. Hasan, Hoshmand R. Asaad, Dana T. Gharib, Karokh F. Hama Hussein, Karzan M. Hasan, Deari A. Ismaeil, Dilan S. Hiwa, Rawa M. Ali, Khanda A. Anwar, Diyar A. Omar, Mohammed Q. Mustafa
Barw Medical Journal.2024;[Epub] CrossRef
A Fatal Case of Disseminated Intestinal Mucormycosis in a Patient with Vibrio Sepsis
Seungwoo Chung, Hyun-Jung Sung, Jong Won Chang, Ile Hur, Ho Cheol Kim
Journal of Acute Care Surgery.2021; 11(3): 133. CrossRef
Gastric Mucormycosis Followed by Traumatic Cardiac Rupture in an Immunocompetent Patient
Sang Won Lee, Hyun Seok Lee
The Korean Journal of Gastroenterology.2016; 68(2): 99. CrossRef

Gastroenterology
Successful Bridging Hemostasis Using a Sengstaken-Blakemore Tube in Massive Rectal Variceal Bleeding: Kyung Su Kim, Gil Joon Suh, Woon Yong Kwon; Korean J Crit Care Med. 2014;29(3):237-240. Published online August 31, 2014; DOI: https://doi.org/10.4266/kjccm.2014.29.3.237

8,734 View
110 Download
2 Crossref

Abstract PDF

Life-threatening rectal variceal bleeding is a rare complication of liver cirrhosis. Various therapeutic interventions including endoscopic variceal ligation and percutaneous transvenous obliteration have been proposed to control significant rectal variceal bleeding. However, these definite hemostasis modalities are not readily available and require an experienced endoscopist or interventional radiologist. Therefore, bridging therapy to control active bleeding is necessary especially in patients with massive bleeding. We report a case of massive rectal variceal bleeding in which a Sengstaken-Blakemore tube was effective at stopping the bleeding until percutaneous transvenous obliteration could be performed.

Citations

Citations to this article as recorded by

Use of TC-325 Hemostatic Powder as a Rescue Monotherapy for Management of Rectal Variceal Bleed
Amel Tabet Aoul, Vamsee Mupparuju, Jonathan Cirillo, Sreekanth Chandrupatla, Jeffrey Jordan, Maria Castano, Olugbenga Oyesanmi
ACG Case Reports Journal.2024; 11(6): e01391. CrossRef
Anorectal emergencies: WSES-AAST guidelines
Antonio Tarasconi, Gennaro Perrone, Justin Davies, Raul Coimbra, Ernest Moore, Francesco Azzaroli, Hariscine Abongwa, Belinda De Simone, Gaetano Gallo, Giorgio Rossi, Fikri Abu-Zidan, Vanni Agnoletti, Gianluigi de’Angelis, Nicola de’Angelis, Luca Ansaloni
World Journal of Emergency Surgery.2021;[Epub] CrossRef

Oropharyneal Bezoar in a Patient with Amyotrophic Lateral Sclerosis under Mechanical Ventilation: A case report: Cheung Soo Shin, Jin Mo Ahn, Gab Soo Kim, Song Mi Lee; Korean J Crit Care Med. 1998;13(1):97-100.

1,694 View
12 Download

Abstract PDF: Bezoars are not uncommonly found during upper gastrointestinal investigations (UGI), are known to be associated with conditions causing stasis changes in gastrointestinal tract. We described here a curious presentation of an oropharyngea bezoar associated with medication and tube feeding. Only few cases of regurgated esophageal bezoar have been reported. A 54 years old man with amyotropic lateral sclerosis required ventilatory support. Nasogastric tube was placed, enteral feeding with special liquid diet (Geenvia TF) was begun. In addition, almagate was given via the feeding tube. Tracheotomy was done for long term mechanical ventilation support. On the 10th day of ICU stay, he complained of foreign body sensation in oral cavity. We could find a white brown colored 15cm solid mass in deep oropharynx. Some factors including sucralfate and the peripheral neuropathy have been suspected to be ascribed forming the esophageal bezoar. Gastrointestinal motility was decrease in patients with peripheral neuropathy. In this case, aluminum hydroxides, one of the aluminium substance like sucralfate, was given to the patient with the peripheral neuropathy. From this experience, we became to know that it is necessary to use the aluminium compound anti-ulcer drug with caution in the patients with the gastrointestinal depression.

First
Prev
Page of 1
Next
Last

Search