From: Ischemic necrosis of the tongue in surgical patients with septic shock: a case report
Patient 1 | Patient 2 | |
---|---|---|
Age (years) | 88 | 80 |
Gender | Male | Female |
Clinical presentation | Septic shock | Septic shock |
Intraoperative diagnosis | Ischemic necrosis of the colon | Ischemic necrosis of the ileum |
Operation | Total colectomy | Segmental resection of the ileum |
Possible cause of mesenteric ischemia | unknown | femoral herniation of ileum |
Length of vasopressor treatmenta (days) | 3 | until death |
Length of mechanical ventilationa (days) | 5 | until death |
Length of CRRTa (days) | until death | until death |
Maximum dose of norepinephrine (μg/kg/min) | 0.5 | 2 |
Maximum dose of epinephrine (μg/kg/min) | 0.05 | 0.5 |
Coagulation profileb | ||
Antithrombin III (%) | 28 | 13 |
Fibrinogen (mg/ml) | 201 | 97 |
FDP (μg/ml) | 8.6 | 18.7 |
SOFA score at ICU admissionb | 13 | 16 |
Respiratory (PaO2/FiO2) | 200 | 150 |
Coagulation (Platelet, × 103/μL) | 80 | 40 |
Liver (Total bilirubin, mg/dL) | 1.6 | 3.4 |
Dose of norepinephrine (μg/kg/min) | 0.5 | 1 |
Glasgow Coma Scale score | 13 | 13 |
Renal system (Creatinine, mg/dL) | 2.7 | 3.6 |
Blood culture testb | Candida species | none |
Time to enteral feeding | 5th POD | none |
Time to necrosis of the tongue | 7th POD | 8th POD |
Pressure on the tongue from endotracheal tube | none | suspicious |
Concomitant signs of other organ hypoperfusion | none | Lower limb |
Outcome | Died on the 12nd POD | Died on the 10th POD |