Acute Endocrinology: From Cause to Consequence by Greet Van den Berghe MD, PhD (auth.)

By Greet Van den Berghe MD, PhD (auth.)

The integration of endocrinology in serious care drugs has resulted in new experimental and scientific facts at the complicated endocrine and metabolic derangements accompanying non-endocrine critical health problems. The becoming a member of of those disciplines has generated vital novel insights with major medical implications. Acute Endocrinology: From reason to outcome compiles those new findings into a tremendous and hugely appropriate new source. half one offers with the classical life-threatening health problems attributable to basic endocrine illnesses corresponding to thyrotoxicosis, hypothyroidism, acute adrenal hindrance, acute calcium issues, pheochromocytoma, serious hyper- and hypoglycemia. half appears at endocrinology from the ICU part, beginning with a basic evaluation of the dynamic neuroendocrine and metabolic tension responses within the of in depth care-dependent, non-endocrine severe disorder. Acute Endocrinology: From reason to final result presents a distinct and up to date evaluation of the becoming a member of of those disciplines and seeks to stimulate extra interdisciplinary examine during this vital and intriguing field.

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When hypothermia is suspected, low-reading rectal thermometers or rectal thermistor probes should be used (33). The clinical presentation in many patients may be sufficiently clear to make measurements of thyroid function tests necessary only for confirmation of the diagnosis. Given a reasonable index of suspicion, empiric thyroid hormone replacement should be immediately initiated while awaiting the results of these tests, including serum TSH and free thyroxine (free T4), which should only take several hours in most centers.

The initiation of mechanical ventilation via endotracheal tube or tracheostomy if needed should not be delayed in order to adequately treat or prevent hypoxia and hypercapnia. Intensive care protocol usually routinely measures arterial blood gas with changes in ventilatory settings, and extubation should not be attempted until the patient regains consciousness and is able to maintain the patency of their own airway and manage their respiratory secretions. Typically, mechanical ventilation will be required for 24– 48 hours, but may be longer in those patients whose hypoventilation and coma result from drug-induced respiratory depression.

Factors associated with mortality of myxedema coma: report of eight cases and literature survey. Thyroid 1999; 9(12): 1167–1174. 52. Rodriguez I, Fluiters E, Perez-Mendez LF, Luna R, Paramo C, Garcia-Mayor RV. Factors associated with mortality of patients with myxoedema coma: prospective study in 11 cases treated in a single institution. J Endocrinol 2004; 180(2): 347–350. 53. MacKerrow SD, Osborn LA, Levy H, et al. Myxedema-associated cardiogenic shock treated with intravenous triiodothyronine.

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