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Study of primary and secondary hepatic dysfunction in critically ill children : A single center study / Haytham Ahmed Ghita ; Supervised Hanaa Mostafa Elkaraksy , Mona Elsaid Elraziky , Seham Awad Elsherbini

By: Contributor(s): Material type: TextTextLanguage: English Publication details: Cairo : Haytham Ahmed Ghita , 2017Description: 133 P. charts ; 25cmOther title:
  • دراسة القصور الكبدى الأولى و الثانوى لدى الأطفال فى حالة صحية حرجة : دراسة من مركز واحد [Added title page title]
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Dissertation note: Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics Summary: Background and objective: The liver is a key player in critical illness. Several studies on hepatic dysfunction in critically ill adult patients proved the significant impact of hepatic dysfunction on patients{u2019} morbidity and mortality. We conducted this study to address this problem in the pediatric population. We studied the frequency, risk factors and outcomes of hepatic dysfunction in critically ill children. Study design: This is a single center prospective analytical study Patients and methods: Patients were recruited from a 10-bed pediatric intensive care unit (PICU) at Cairo University Specialized Children Hospital. All patients admitted to this PICU in the period from April to December 2015 were included. Patients were followed up until they were discharged from or died in the PICU. Hepatic dysfunction was defined as any abnormality in liver function tests. Results: One hundred and fifty-one patients were included in this study. Ten patients (6.6%) were admitted with primary hepatic dysfunction. Patients with primary hepatic dysfunction were significantly associated with mortality (p< 0.001) but did not increase the length of stay (LOS) in PICU. Forty-three patients (28.5%) acquired secondary hepatic dysfunction during their PICU stay. Several risk factors were significantly associated with secondary hepatic dysfunction: malnutrition (p= 0.03), sepsis (p<0.001), cardiovascular events (p<0.001), hypoxia (p<0.001), use of inotropes (p<0.001) and mechanical ventilation (p=0.001), while surgery was not significantly associated with hepatic dysfunction. Independent risk factors of mortality in logistic regression analysis were cardiovascular events (p=0.009), mechanical ventilation (p=0.007) and multiple organ dysfunctions (p=0.37), while sepsis was significantly associated with prolonged LOS in PICU (p=0.005)
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Item type Current library Home library Call number Copy number Status Date due Barcode
Thesis Thesis قاعة الرسائل الجامعية - الدور الاول المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.28.Ph.D.2017.Ha.S (Browse shelf(Opens below)) Not for loan 01010110074775000
CD - Rom CD - Rom مخـــزن الرســائل الجـــامعية - البدروم المكتبة المركزبة الجديدة - جامعة القاهرة Cai01.11.28.Ph.D.2017.Ha.S (Browse shelf(Opens below)) 74775.CD Not for loan 01020110074775000

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background and objective: The liver is a key player in critical illness. Several studies on hepatic dysfunction in critically ill adult patients proved the significant impact of hepatic dysfunction on patients{u2019} morbidity and mortality. We conducted this study to address this problem in the pediatric population. We studied the frequency, risk factors and outcomes of hepatic dysfunction in critically ill children. Study design: This is a single center prospective analytical study Patients and methods: Patients were recruited from a 10-bed pediatric intensive care unit (PICU) at Cairo University Specialized Children Hospital. All patients admitted to this PICU in the period from April to December 2015 were included. Patients were followed up until they were discharged from or died in the PICU. Hepatic dysfunction was defined as any abnormality in liver function tests. Results: One hundred and fifty-one patients were included in this study. Ten patients (6.6%) were admitted with primary hepatic dysfunction. Patients with primary hepatic dysfunction were significantly associated with mortality (p< 0.001) but did not increase the length of stay (LOS) in PICU. Forty-three patients (28.5%) acquired secondary hepatic dysfunction during their PICU stay. Several risk factors were significantly associated with secondary hepatic dysfunction: malnutrition (p= 0.03), sepsis (p<0.001), cardiovascular events (p<0.001), hypoxia (p<0.001), use of inotropes (p<0.001) and mechanical ventilation (p=0.001), while surgery was not significantly associated with hepatic dysfunction. Independent risk factors of mortality in logistic regression analysis were cardiovascular events (p=0.009), mechanical ventilation (p=0.007) and multiple organ dysfunctions (p=0.37), while sepsis was significantly associated with prolonged LOS in PICU (p=0.005)

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