ABSTRACT
Mauriac syndrome is a rare disorder that can present with the single feature of glycogenic hepatopathy in children and adults with poorly controlled diabetes mellitus. An often underrecognized finding of glycogenic hepatopathy is lactic acidosis and hyperlactatemia. Primary treatment of glycogenic hepatopathy is improved long-term blood glucose control. Resolution of symptoms and hepatomegaly will occur with improvement in hemoglobin A1C. We present here a case of a young adult female presenting to the intensive care unit with Mauriac syndrome. This case demonstrates exacerbation of lactic acidosis in a patient with glycogenic hepatopathy treated for diabetic ketoacidosis with high dose insulin and dextrose.
ABSTRACT
Heparin is commonly used in the intensive care unit for preventing and treating thromboembolic disease. One of its more significant complications is heparin-induced thrombocytopenia (HIT), an immune-mediated disorder which can provoke an extreme prothrombotic state. We describe an unusual presentation of HIT, where thrombocytopenia was absent.
Subject(s)
Anticoagulants/adverse effects , Heparin/adverse effects , Platelet Count , Thrombosis/chemically induced , Adult , Anticoagulants/administration & dosage , Anticoagulants/therapeutic use , Calcitonin/blood , Female , Follow-Up Studies , Heparin/administration & dosage , Heparin/therapeutic use , Hirudins , Humans , Intensive Care Units , Partial Thromboplastin Time , Protein Precursors/blood , Recombinant Proteins/therapeutic use , Stroke/diagnosis , Stroke/drug therapy , Thrombocytopenia/chemically induced , Thrombocytopenia/diagnosis , Thrombosis/blood , Thrombosis/diagnosis , Thrombosis/diagnostic imaging , Thrombosis/physiopathology , Time Factors , Tomography, X-Ray ComputedABSTRACT
PURPOSE OF REVIEW: An appreciation of a family's difficult experience in dealing with their critically ill loved ones has created the concept of 'family-centered care'. The purpose of this paper is to review the literature on the needs of the family during their intensive care unit experience. RECENT FINDINGS: Families consistently highlight three major issues that they deem could be improved from their perspective. Increased information about their loved ones, proximity to the patient and a more flexible visiting policy stand out as relevant issues to families. SUMMARY: Medical staff and administrators should recognize that families of critically ill patients have particular needs that help them cope with having their loved ones in an intensive care unit. Simple changes in philosophy and policy would greatly decrease the anxiety these families experience.
