Ischemic Necrosis of the Tongue in Patients With Cardiogenic Shock
Identifieur interne : 002127 ( Pmc/Curation ); précédent : 002126; suivant : 002128Ischemic Necrosis of the Tongue in Patients With Cardiogenic Shock
Auteurs : Benjamin R. Roman ; Sara B. Immerman ; Luc G. T. MorrisSource :
- The Laryngoscope [ 0023-852X ] ; 2010.
Abstract
Ischemic necrosis of the tongue is a rare entity generally associated with vasculitis. Critically ill patients with shock might experience hypoperfusion of head and neck end organs including the tongue.
Retrospective analysis of hospital charts.
Case histories and photographs of five patients who developed ischemic tongue necrosis in the context of cardiogenic shock.
Five critically ill patients in our institution’s cardiothoracic intensive care unit developed ischemic necrosis of the tongue. All five patients experienced protracted courses of profound cardiogenic shock requiring high-dose vasopressor support and urgent cardiac surgery. Three patients required intraaortic balloon pumps. All patients had concomitant signs of poor end organ perfusion, including lower extremity ischemia and renal and hepatic failure. Ultimately, four of five patients died, with one patient surviving after sloughing of the entire oral tongue.
Ischemic necrosis of the oral tongue is an uncommon but perhaps under-reported manifestation of end organ hypoperfusion in shock, likely signifying poor prognosis.
Url:
DOI: 10.1002/lary.20974
PubMed: 20564667
PubMed Central: 3001120
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<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8607378</journal-id><journal-id journal-id-type="pubmed-jr-id">5476</journal-id><journal-id journal-id-type="nlm-ta">Laryngoscope</journal-id><journal-title>The Laryngoscope</journal-title><issn pub-type="ppub">0023-852X</issn><issn pub-type="epub">1531-4995</issn></journal-meta><article-meta><article-id pub-id-type="pmid">20564667</article-id><article-id pub-id-type="pmc">3001120</article-id><article-id pub-id-type="doi">10.1002/lary.20974</article-id><article-id pub-id-type="manuscript">NIHMS255345</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Ischemic Necrosis of the Tongue in Patients With Cardiogenic Shock</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Roman</surname><given-names>Benjamin R.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Immerman</surname><given-names>Sara B.</given-names></name><degrees>MD</degrees></contrib><contrib contrib-type="author"><name><surname>Morris</surname><given-names>Luc G. T.</given-names></name><degrees>MD</degrees></contrib><aff id="A1">Department of Otolaryngology, New York University Medical Center, New York, New York, U.S.A.</aff></contrib-group><author-notes><corresp id="cor1">Send correspondence to Luc G. T. Morris, Department of Otolaryngology, New York University Medical Center, 550 First Avenue NBV 5E5, New York, NY 10016. <email>morrisl@mskcc.org</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>7</day><month>12</month><year>2010</year></pub-date><pub-date pub-type="ppub"><month>7</month><year>2010</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>7</month><year>2011</year></pub-date><volume>120</volume><issue>7</issue><fpage>1345</fpage><lpage>1349</lpage><permissions><copyright-statement>© 2010 The American Laryngological, Rhinological and Otological Society, Inc.</copyright-statement><copyright-year>2010</copyright-year></permissions><abstract><sec id="S1"><title>Objectives/Hypothesis</title><p id="P1">Ischemic necrosis of the tongue is a rare entity generally associated with vasculitis. Critically ill patients with shock might experience hypoperfusion of head and neck end organs including the tongue.</p></sec><sec id="S2"><title>Study Design</title><p id="P2">Retrospective analysis of hospital charts.</p></sec><sec sec-type="methods" id="S3"><title>Methods</title><p id="P3">Case histories and photographs of five patients who developed ischemic tongue necrosis in the context of cardiogenic shock.</p></sec><sec id="S4"><title>Results</title><p id="P4">Five critically ill patients in our institution’s cardiothoracic intensive care unit developed ischemic necrosis of the tongue. All five patients experienced protracted courses of profound cardiogenic shock requiring high-dose vasopressor support and urgent cardiac surgery. Three patients required intraaortic balloon pumps. All patients had concomitant signs of poor end organ perfusion, including lower extremity ischemia and renal and hepatic failure. Ultimately, four of five patients died, with one patient surviving after sloughing of the entire oral tongue.</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">Ischemic necrosis of the oral tongue is an uncommon but perhaps under-reported manifestation of end organ hypoperfusion in shock, likely signifying poor prognosis.</p></sec></abstract><kwd-group><kwd>Tongue</kwd><kwd>necrosis</kwd><kwd>gangrene</kwd><kwd>ischemic</kwd><kwd>shock</kwd></kwd-group><contract-num rid="CA1">T32 CA009685-10
||CA</contract-num><contract-sponsor id="CA1">National Cancer Institute : NCI</contract-sponsor></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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