During intravenous treatment with terlipressin for recurrent gastrointestinal (GI) bleeding, a 50-year-old male with no history of heart disease developed a newly prolonged QT interval and torsade de pointes. Risk factors present for acquired long QT syndrome were mineral dysbalance and a history of alcohol abuse with hepatic impairment. The patient was brought back to a normal sinus rhythm after a single 300-J counter-shock. Terlipressin was discontinued, and the patient's QTc interval subsequently returned to baseline. During 6 weeks of monitoring, arrhythmia did not recur.
- MeSH
- dospělí MeSH
- elektrická defibrilace MeSH
- elektrokardiografie MeSH
- gastrointestinální krvácení diagnóza farmakoterapie MeSH
- hodnocení rizik MeSH
- intravenózní infuze MeSH
- lidé MeSH
- lypresin analogy a deriváty škodlivé účinky terapeutické užití MeSH
- následné studie MeSH
- stupeň závažnosti nemoci MeSH
- syndrom dlouhého QT diagnóza chemicky indukované terapie MeSH
- torsades de pointes diagnóza chemicky indukované terapie MeSH
- vazokonstriktory škodlivé účinky terapeutické užití MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND: Disseminated intravascular coagulation (DIC) is a syndrome characterized by over-activation of intravascular coagulation, accompanied by consumption of coagulation factors. It is a pathologic systemic inflammatory response accompanied by release of coagulatory substances into the circulation. AIM: The aim of this paper is to emphasize the importance of early the early diagnosis of DIC and to present a case report of a successful early diagnosis and treatment. METHOD: A case report giving a detailed account of clinical and laboratory presentation of a case of DIC in a patient with sepsis. Relevant laboratory results and other tests are presented, treatment is described in detail. CONCLUSIONS: DIC remains an important and potentially life-threatening complication of severe disease and states. Early diagnosis is vital for the success of treatment, and in severely ill patients, the possibility of DIC should always be kept in mind in order to detect early signs and initiate treatment as soon as possible.
- MeSH
- časná diagnóza MeSH
- diseminovaná intravaskulární koagulace diagnóza MeSH
- lidé MeSH
- vyšetření krevní srážlivosti MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The paper deals with pharmacotherapeutical approaches to decreasing hematocrit in order to improve macro and microcirculation in arteries of lower limbs of type 2 diabetes patients. The study included 37 patients with diabetic angiopathy, all of whom had inoperable changes to arteries. In order to decrease hematocrit and cause haemodilution, we used 10 % solution of hydroxyethyl starch. Indications for inclusion in the study were carried out in close cooperation with a vascular surgeon. We applied hydroxyethyl starch according to a predetermined scheme. Using normovolemic and hypervolemic haemodilution, we decreased hematocrit to 0.41-0.42. Patients underwent a treadmill examination at the beginning of the study and then repeatedly during the course of study, when we measured the claudication distance to quantify, the effects of decreased hematocrit. The results show that the effect is most pronounced after 6 weeks, when hematocrit fell from a baseline of 0.435 to 0.421 (p < 0.01) and claudication distance increased to 51% (also significant). On average the claudication distance rose from 55.7 m to 84.6 m (p < 0.01). In the following weeks (after the sixth week of the study), the studied parameters changed only insignificantly (p > 0.05).
- MeSH
- chůze MeSH
- deriváty hydroxyethylového škrobu aplikace a dávkování MeSH
- diabetické angiopatie krev komplikace terapie MeSH
- hematokrit MeSH
- hemodiluce MeSH
- intermitentní klaudikace patofyziologie terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhražky plazmy aplikace a dávkování MeSH
- tolerance zátěže MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- biologické markery MeSH
- cévní endotel patologie MeSH
- diabetické angiopatie diagnóza klasifikace MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
