ANALYSIS THE PERCENTAGE, CLINICAL, SUB CLINICAL FEATURES OF ACUTE ADRENAL INSUFFICIENCY AND EVALUATION OF TREATMENT RESULTS IN PATIENTS WITH SEPTIC SHOCK AT KIEN GIANG PROVINE IN 2022-2023

Van Phuc Ha1, Nhu Nghia Nguyen1, Tan Dat Tran2,
1 Can Tho University of Medicine and Pharmacy
2 Kien Giang General Hospital

Main Article Content

Abstract

Background: The incidence of adrenal insufficiency in the reflex ratio is quite high, and it increases the poor outcome in patients. Most clinical and laboratory features of adrenal insufficiency lack specificity for the disease reflex. Serum cortisol levels are useful tools for detecting and reflecting the significance of this condition. Objectives: To determine the rate of acute adrenal insufficiency and describe the clinical and subclinical features of septic shock patients with acute adrenal insufficiency in Kien Giang province in 2022-2023. Materials and methods: A crosssectional descriptive study was conducted on 62 patients >16 years old with septic shock and acute adrenal insufficiency at Kien Giang General Hospital from October 2022 to August 2023.  Results: The NEWS score is significant in risk classification and predicting treatment outcome in patients with septic shock. 48% of patients with septic shock had acute adrenal insufficiency. Conclusion: Research results show that the rate of septic shock with acute renal failure in my study at Kien Giang  General Hospital was 48%. The NEWS scale is significant in predicting early events. 

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References

1. Iwashyna T.J., Cooke C.R., Wunsch H., Kahn J.M. (2012), Population burden of long-term survivorship after severe sepsis in older Americans, Journal of the American Geriatrics Society, 60(6), pp. 1070-1077, doi: 10.1111/j.1532-5415.2012.03989.x.
2. Maxime V., Lesur O., Annane D. (2009), Adrenal insufficiency in septic shock, Clinics in Chest Medicine, 30(1), pp. 17-27, doi: 10.1016/j.ccm.2008.10.003.
3. Ngô Văn Út (2015), Nghiên cứu đặc điểm lâm sàng, cận lâm sàng, biến chứng và kết quả điều trị bệnh nhiễm trùng huyết người lớn tại Bệnh viện Đa khoa Trung ương Cần Thơ năm 20142015, Luận văn Thạc sĩ Y học, trường Đại học Y Dược Cần Thơ, Cần Thơ.
4. Kiều Văn Khương (2019), Đánh giá vai trò thang điểm news trong dự báo biến cố lâm sàng sớm ở bệnh nhân sau khi chuyển khỏi khoa điều trị tích cực, tạp chí y học quân sự, số 3, Hà Nội.
5. Hà Ngọc Diễm, Nguyễn Như Nghĩa, Phạm Văn Lình (2019), Khảo sát tình hình tổn thương thận cấp ở bệnh nhân sốc nhiễm khuẩn tại bệnh viện đa khoa trung ương Cần Thơ năm 2017 - 2019, Tạp chí y dược học Cần Thơ, số 19/2019, Cần Thơ.
6. Costanzo L.S. (2017), Adrenal medulla and cortex, Physiology 6th Edition, pp. 427-440.
7. Piske C.T., Bloch K.C. (2018), “Sepsis & septic shock”, Pathophysiology of Disease: An Introduction to Clinical Medicine 8th Edition, pp. 82-84.
8. Nahid Hashemi-Madani, Marzieh Miri, Zahra Emami, Mitra Barati, and Fatemeh Golgiri (2021), Adrenal Insufficiency in Septic Patients Admitted to Intensive Care Unit: Prevalence and Associated Factors, Medical Journal of the Islamic Republic of Iran, doi: 10.47176/mjiri.35.154.
9. MJ Mpe, NC Muleba, EM Selepe & TG Mothabeng (2006) Adrenal insufficiency in critically ill septic patients at Dr George Mukhari Hospital, Southern African Journal of Anaesthesia and Analgesia, 12:4, 135-138, DOI: 10.1080/22201173.2006.10872454.
10. Sligl W.I., Milner D.A. Jr, Sundar S., et al (2009), Safety and efficacy of corticosteroids for the treatment of septic shock: a systematic review and meta-analysis, Clinical Infectious Diseases, 49(1), pp. 93-101, doi: 10.1086/599343.
11. Sprung C.L., Annane D., Keh D., et al; CORTICUS Study Group (2008), Hydrocortisone therapy for patients with septic shock, The New England Journal of Medicine, 358(2), pp. 111-124, doi:
10.1056/NEJMoa071366.
12. Tandan S.M., Guleria R., Gupta N. (2005), Low dose steroids and adrenocortical insufficiency in septic shock: a double-blind randomised controlled trial from India, American Journal of Respiratory and Critical Care Medicine, 2005, A24, doi: 10.1186/s13054-017-1659-4.