a patient of ours died tonight.
they think it may have something to do with elevated troponin, that was evident in lab draws. it was very high.
i think it has something to do with overstimulation of the vagus complex or tenth cranial nerve. heres my rationalization which is probably way off. the lady's gastrointestinal functioning had been significantly reduced secondary to starvation due to catatonia. peg tube had been implanted on thursday, tube feedings lead to impaction which was digitally removed this am. bradycardia and hypotension which can be caused by stimulation and the lack of parasympathetic recovery. also their must have been a decrease insulin prodution, evident by high blood glucose. but this could be a result of iv d5 1/2 that she was receiving at least until this past friday. i don't think she was getting this today, but i could be wrong. what do you think?
they think it may have something to do with elevated troponin, that was evident in lab draws. it was very high.
i think it has something to do with overstimulation of the vagus complex or tenth cranial nerve. heres my rationalization which is probably way off. the lady's gastrointestinal functioning had been significantly reduced secondary to starvation due to catatonia. peg tube had been implanted on thursday, tube feedings lead to impaction which was digitally removed this am. bradycardia and hypotension which can be caused by stimulation and the lack of parasympathetic recovery. also their must have been a decrease insulin prodution, evident by high blood glucose. but this could be a result of iv d5 1/2 that she was receiving at least until this past friday. i don't think she was getting this today, but i could be wrong. what do you think?
the elevated troponin level indicates cardiac muscle damage, i.e. MI
in psych, typically cpk-mb is a more familiar assay, i.e. NMS