Medizinische Universität Graz - Research portal
Selected Publication:
Rauch, I.
Acute Intoxications in Intensive Care Medicine:
A Retrospective Data Analysis of an Internal Medicine Intensive Care Unit
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2021. pp. 60
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- Authors Med Uni Graz:
- Advisor:
- Hackl Gerald
- Reisinger Alexander Christian
- Altmetrics:
- Abstract:
- Background: Intoxications following the ingestion, inhalation or intravenous application of substances can require treatment in an intensive care unit (ICU). Due to reduced states of consciousness or impaired organ function, invasive therapeutical measures such as intubation, mechanical ventilation, monitoring and toxin elimination may be necessary. Objective: The aim of this diploma thesis is to categorize the intoxications that required a stay at the medical intensive care unit at the University Hospital Graz and to analyze the distribution of necessary therapeutical measures. Material and Methods: In this retrospective data analysis, ICU patients (n=227) from January 2013 until December 2018 were included. The patient files and electronic medical documentation were utilized to collect the data. Patients were separated into nine groups according to the causational substance (0= unknown, 1= ethanol, 2= analgesics, 3= antidepressants, antiepileptics and antipsychotics, 4= street drugs including opiates, cocaine and amphetamines, 5= sedatives, 6= carbon monoxide, arsenic and cyanide, 7= other not categorized substances and 8= combined drug intoxications of two or more substance groups). These intoxications were analyzed according to the distribution of sex, age, reason for intoxication, toxin elimination, antidotes administered, intubation, as well as length of the ICU stay and ICU mortality. Results: Combined drug intoxications are the most common intoxication group requiring intensive care treatment. In females, this was followed by the group of antidepressants, antiepileptics and antipsychotics (17.5%), and the group “other” (9.7%). Analgesics, sedatives and ethanol were almost equally common making up 5-8%. In males, following the combined drug intoxications, the most common singular substance intoxication were street drugs, resulting in 15.3% of patients, followed by ethanol (12.1%), and the group of antidepressants, antiepileptics and antipsychotics (9.7%). Approximately half of all intoxications were intended suicide. Furthermore, in regards to treament of toxicological intensive care patients, one quarter of patients received activated charcoal as a method of primary detoxification and 6.6% of patients required secondary detoxification methods. In addition, females received primary detoxification methods significantly more often than males (p=0.008). ICU mortality regarding intoxication patients was low at 4%. Conclusion: In this retrospective data analysis, the distribution of the most common intoxications leading to a stay at the medical intensive care unit and the necessary therapeutical steps, as well as ICU mortality were determined and compared to international data.