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https://www.readbyqxmd.com/read/29908046/sepsis-induced-acute-kidney-injury-a-disease-of-the-microcirculation
#1
Shuai Ma, Roger G Evans, Naoya Iguchi, Marianne Tare, Helena C Parkington, Rinaldo Bellomo, Clive N May, Yugeesh R Lankadeva
Acute kidney injury (AKI) is a common complication of sepsis and is significantly associated with mortality. Sepsis accounts for more than 50% of the cases of AKI, with a mortality rate of up to 40%. The pathogenesis of septic AKI is complex, but there is emerging evidence that, at least in the first 48 hours, the defects may be functional rather than structural in nature. For example, septic AKI is associated with an absence of histopathological changes, but with microvascular abnormalities and tubular stress...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29907211/comparison-of-dexmedetomidine-versus-propofol-on-hemodynamics-in-surgical-critically-ill-patients
#2
Ya-Fei Chang, Anne Chao, Po-Yuan Shih, Yen-Chun Hsu, Chen-Tse Lee, Yu-Wen Tien, Yu-Chang Yeh, Lee-Wei Chen
BACKGROUND: Sedation with dexmedetomidine and propofol may cause hypotension or bradycardia. This study aimed to compare the effects of dexmedetomidine and propofol on hemodynamics and clinical outcomes in surgical intensive care unit (ICU) patients after major abdominal surgery. MATERIALS AND METHODS: Enrolled patients were randomly allocated to the dexmedetomidine or propofol group. Cardiac index was measured using a continuous noninvasive cardiac output monitor on the basis of chest bioreactance...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907082/paravertebral-dexmedetomidine-as-an-adjuvant-to-ropivacaine-protects-against-independent-lung-injury-during-one-lung-ventilation-a-preliminary-randomized-clinical-trial
#3
Wei Zhang, Shanfeng Zhang, Bing Li, Mingyang Sun, Jiaqiang Zhang
BACKGROUND: To investigate the effect of paravertebral dexmedetomidine as an adjuvant to ropivacaine on independent lung injury during one-lung ventilation. METHODS: In total, 120 patients who underwent elective radical resection of pulmonary carcinoma were randomly assigned to one of six groups (n = 20): normal saline (C group), ropivacaine (R group), intravenous dexmedetomidine (Div group), 0.5 μg/kg paravertebral dexmedetomidine as an adjuvant to ropivacaine (RD0...
June 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29904429/effect-of-dexmedetomidine-midazolam-and-propofol-on-lipopolysaccharide-stimulated-dendritic-cells
#4
Feng Guo, Ying Ding, Xue Yu, Xiujun Cai
Dexmedetomidine, midazolam and propofol are common sedative drugs used in the intensive care unit. Lipopolysaccharides (LPS) are a potent inducer of human dendritic cells (DCs) maturation and survival, which induces cytokine production. The present study aimed to investigate the effect and mechanisms of sedative drugs on LPS-induced cytokine production in DCs. The mouse bone marrow-derived dendritic DC2.4 cell line was used in the present study. The Cell Counting Kit-8 assay was used to measure the viability of cells...
June 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29900768/hyperkalemia-in-two-jaguars-panthera-onca-anesthetized-with-dexmedetomidine-ketamine-and-isoflurane
#5
Marta Romano, Jordyn M Boesch, Santiago Peralta, Christine Parker, George Kollias
  Two jaguars were anesthetized with dexmedetomidine, ketamine, and isoflurane. Arterial blood samples analyzed shortly after darting revealed no abnormalities. Samples analyzed 2 and 1.5 hr after darting revealed moderate hyperkalemia in both animals (6.8 and 6.2 mEq/L, respectively). Shortly after hyperkalemia was recognized, one jaguar developed electrocardiographic abnormalities (sinoventricular rhythm and widened QRS complexes), and a few minutes later, suffered cardiopulmonary arrest. Resuscitation with chest compressions, intermittent positive-pressure ventilation, and epinephrine was successful, and autonomous breathing and circulation resumed within a few minutes...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29900763/hematology-and-serum-biochemistry-values-of-the-red-panda-subspecies-ailurus-fulgens-styani
#6
Caitlin Burrell, Li Luo, Marieke Kester Jones, Andrea Lee, Elizabeth Freeman, Copper Aitken-Palmer
  Health evaluations were conducted on individuals ( n = 62, age < 1 to 11 yr) from a captive red panda ( Ailurus fulgens styani) population at the Chengdu Research Base for Giant Panda Breeding in Sichuan Province, People's Republic of China. Individuals were anesthetized using combinations of ketamine, dexmedetomidine, diazepam, isoflurane, and tiletamine/zolazepam. Whereas physical exams revealed no abnormalities for 40% of red pandas, 24% had dental abnormalities and 18% had orthopedic abnormalities...
June 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29897736/dexmedetomidine-an-alpha-2a-adrenergic-receptor-agonist-mitigates-experimental-autoimmune-encephalomyelitis-by-desensitization-of-cxcr7-in-microglia
#7
Yi Huang, Shite Hu, Yongliang Li, Dan Xue, Xiuguo Wu
In the autoimmune disease multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), characterized by an ascending paralysis that is characterized by extensive infiltration of the central nervous system by inflammatory cells. Although several studies to some extent uncover the cellular mechanisms of microglia that govern EAE pathogenesis, the molecular mechanisms that orchestrate microglia movement remain unknown and potential novel therapeutic strategies are still required...
June 13, 2018: Biochemistry
https://www.readbyqxmd.com/read/29896269/beneficial-effects-of-dexmedetomidine-on-early-postoperative-cognitive-dysfunction-in-pediatric-patients-with-tonsillectomy
#8
Chuanlai Han, Rong Fu, Weifu Lei
According to clinical investigations, early postoperative cognitive dysfunction is the most common adverse event in pediatric patients after tonsillectomy. A previous study has indicated that dexmedetomidine (DEX) is an efficient drug for the treatment of postoperative cognitive dysfunction. However, the efficacy of DEX in alleviating early postoperative cognitive dysfunction in pediatric patients following tonsillectomy has remained elusive, which was therefore assessed in the present study. A total of 186 children presenting with cognitive dysfunction subsequent to tonsillectomy were recruited to analyze the efficacy of DEX...
July 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29891121/prognostic-factors-for-generalized-tetanus-in-adults-a-retrospective-study-in-a-chinese-hospital
#9
Chenliang Sun, Hongsheng Zhao, Yang Lu, Zhiwei Wang, Wanjiang Xue, Shu Lu, Haoliang Shen, Yiping Wang, Qingyun Peng, Lili Huang
BACKGROUND: We evaluated factors associated with mortality in patients with moderate/severe generalized tetanus. METHODS: This retrospective study included patients with moderate/severe generalized tetanus admitted to the Affiliated Hospital of Nantong University (China) between January 2005 and January 2017. Clinical data were extracted from medical records. Patients were divided into two groups based on outcome (survival or death). Factors associated with mortality were analyzed using univariate and multivariate logistic regression...
May 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29889105/dexmedetomidine-prevents-excessive-%C3%AE-aminobutyric-acid-type-a-receptor-function-after-anesthesia
#10
Dian-Shi Wang, Kirusanthy Kaneshwaran, Gang Lei, Fariya Mostafa, Junhui Wang, Irene Lecker, Sinziana Avramescu, Yu-Feng Xie, Nathan K Chan, Alejandro Fernandez-Escobar, Junsung Woo, Darren Chan, Amy J Ramsey, Jeremy M Sivak, C Justin Lee, Robert P Bonin, Beverley A Orser
BACKGROUND: Postoperative delirium is associated with poor long-term outcomes and increased mortality. General anesthetic drugs may contribute to delirium because they increase cell-surface expression and function of α5 subunit-containing γ-aminobutyric acid type A receptors, an effect that persists long after the drugs have been eliminated. Dexmedetomidine, an α2 adrenergic receptor agonist, prevents delirium in patients and reduces cognitive deficits in animals. Thus, it was postulated that dexmedetomidine prevents excessive function of α5 γ-aminobutyric acid type A receptors...
June 8, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29888025/lc-ms-ms-method-for-simultaneous-quantification-of-dexmedetomidine-dezocine-and-midazolam-in-rat-plasma-and-its-application-to-their-pharmacokinetic-study
#11
Wenjuan Cui, Qin Liu, Shan Xiong, Lujun Qiao
A simple, sensitive, and accurate LC-MS/MS method was established and validated for the simultaneous quantification of dexmedetomidine, dezocine, and midazolam in rat plasma. Chromatographic separation was achieved on a C18 column (50 mm × 2.1 mm, 3  µ m) using a mobile phase composed of water (containing 0.1% formic acid) and acetonitrile. The lower limits of quantification were 0.1, 0.1, and 0.2 ng/mL for dexmedetomidine, dezocine, and midazolam in rat plasma, respectively. The analytes were determined with selected reaction monitoring under positive ionization mode...
2018: Journal of Analytical Methods in Chemistry
https://www.readbyqxmd.com/read/29887292/dexmedetomidine-in-difficult-airway-management-with-a-fibre-optic-bronchoscope-in-the-awake-patient-with-klippel-feil-syndrome
#12
S Pacreu, S Martínez, E Vilà, L Moltó, J Fernández-Candil
Klippel-Feil Syndrome is a disease characterised by congenital fusion of cervical vertebra, which leads to cervical limitation and instability. In these cases, the best option is the orotracheal intubation with the fibre-optic bronchoscope with the patient awake. The advantage is that cervical movements that could lead to neurological damage are minimised. In these patients, adequate sedation, together with instillation of local anaesthetic in the pharynx and hypopharynx, is the key to reducing patient discomfort and achieving successful orotracheal intubation...
June 7, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29885938/-does-dexmedetomidine-prevent-colistin-nephrotoxicity
#13
Gamze Talih, Aliye Esmaoğlu, Adnan Bayram, Cevat Yazici, Kemal Deniz, Tutkun Talih
BACKGROUND: In this study, we aimed to investigate the effect of dexmedetomidine on colistin nephrotoxicity in rats. METHODS: Thirty-two Wistar albino rats were allocated into four groups. Intraperitoneal (ip) saline at 1mL.kg-1 was administered to the control group and 10mg.kg-1 ip colistin was given to the colistin group. In the DEX10 group 10mcg.kg-1 dexmedetomidine ip was given 20min before the injection of 10mg.kg-1 ip colistin. In the DEX20 group ip 20mcg...
June 6, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29883964/effect-of-dexmedetomidine-on-intraocular-pressure-in-patients-undergoing-robot-assisted-laparoscopic-radical-prostatectomy-under-total-intravenous-anesthesia-a-randomized-double-blinded-placebo-controlled-clinical-trial
#14
Sakiko Kitamura, Kenichi Takechi, Tasuku Nishihara, Amane Konishi, Yasushi Takasaki, Toshihiro Yorozuya
STUDY OBJECTIVE: To study the effects of intraoperative dexmedetomidine on the intraocular pressure (IOP) in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALRP) under propofol-remifentanil anesthesia. DESIGN: Double-blind, randomized controlled trial. SETTING: Operating room. PATIENTS: Forty consenting male patients aged ≥20 to <80 years with American Society of Anesthesiologists physical status classes I and II...
June 5, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29882346/efficacy-of-prophylactic-dexmedetomidine-in-preventing-postoperative-junctional-ectopic-tachycardia-in-pediatric-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#15
REVIEW
Laxmi V Ghimire, Fu-Sheng Chou
BACKGROUND: Junctional ectopic tachycardia is a serious tachyarrhythmic complication following pediatric cardiac surgery. It is difficult to manage and is associated with significant morbidity and mortality. Conventional nonpharmacological and pharmacological measures have shown limited effects. Dexmedetomidine is an α2 agonist which has recently been shown in multiple studies to be effective. AIMS: The aim of this systematic review with meta-analysis was to evaluate the efficacy of prophylactic dexmedetomidine administration in the prevention of junctional ectopic tachycardia in pediatric patients following cardiac surgeries...
June 7, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29882298/low-dose-dexmedetomidine-as-an-adjuvant-to-propofol-infusion-for-children-in-mri-a-double-cohort-study
#16
Makoto Nagoshi, Swayta Reddy, Marisa Bell, Allan Cresencia, Rebecca Margolis, Randall Wetzel, Patrick Ross
INTRODUCTION: Propofol is an effective sedative for magnetic resonance imaging. Nevertheless, it may cause hemodynamic and respiratory complications in a dose dependent fashion. We investigated the role of low-dose dexmedetomidine (0.5 μg/kg) as an adjuvant to propofol sedation for children undergoing magnetic resonance imaging. We hypothesized that dexmedetomidine would decrease the propofol dose required, airway complications, and hemodynamic instability. METHODS: We performed a retrospective chart review of patients' age of 1 month to 20 years...
June 7, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29875020/comparative-addition-of-dexmedetomidine-and-fentanyl-to-intrathecal-bupivacaine-in-orthopedic-procedure-in-lower-limbs
#17
Poupak Rahimzadeh, Seyed Hamid Reza Faiz, Farnad Imani, Pooya Derakhshan, Saeed Amniati
BACKGROUND: Spinal block is a common procedure for lower limbs surgery. Fentanyl, a synthetic opioid and dexmedetomidine, a selective α2 agonist have been used as adjuvants in spinal anesthesia to prolong intraoperative and postoperative analgesia. The aim of current study is to compare the efficacy of dexmedetomidine and fentanyl added to intrathecal bupivacaine in orthopedic procedures in lower limbs. METHODS: In this randomized clinical trial, 90 patients undergoing elective lower limb surgeries were randomly allocated to three groups...
June 6, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29872336/dexmedetomidine-attenuates-persistent-postsurgical-pain-by-upregulating-k-cl-cotransporter-2-in-the-spinal-dorsal-horn-in-rats
#18
Shuhong Dai, Yu Qi, Jie Fu, Na Li, Xu Zhang, Juan Zhang, Wei Zhang, Haijun Xu, Hai Zhou, Zhengliang Ma
Background: Dexmedetomidine (DEX) could have an analgesic effect on pain transmission through the modulation of brain-derived neurotrophic factor (BDNF). In addition, KCC2-induced shift in neuronal Cl- homeostasis is crucial for postsynaptic inhibition mediated by GABAA receptors. Accumulating evidence shows that nerve injury, peripheral inflammation and stress activate the spinal BDNF/TrkB signal, which results in the downregulation of KCC2 transport and expression, eventually leads to GAGAergic disinhibition and hyperalgesia...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29870425/ect-a-new-look-at-an-old-friend
#19
Pavan Kumar Kadiyala, Lakshmi Deepthi Kadiyala
PURPOSE OF REVIEW: Electroconvulsive therapy (ECT) as a treatment option in psychiatry is advancing day by day. This review discusses new advancements in ECT with regards to anesthetic variables, stimulus, and response variables along with their impact on clinical outcomes. RECENT FINDINGS: Anesthetic variables influence clinical efficacy and patient tolerance of ECT. Although etomidate or a ketamine-propofol combination may be the first choice for many clinicians, the search for ideal induction agent continues...
June 4, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29866205/effects-of-dexmedetomidine-on-delirium-duration-of-non-intubated-icu-patients-4d-trial-study-protocol-for-a-randomized-trial
#20
Clémence Louis, Thomas Godet, Gérald Chanques, Nathalie Bourguignon, Dominique Morand, Bruno Pereira, Jean-Michel Constantin
BACKGROUND: Delirium during intensive care unit (ICU) stay is frequent and associated with significant morbidity, mortality and healthcare-related costs. International guidelines suggest its prevention. However, curative treatment remains unclearly established. Despite contradictory and ambiguous academic literature, international guidelines suggest the use of second-generation (atypical) antipsychotics over haloperidol. However, haloperidol remains the most widely used neuroleptic worldwide as a first-line treatment of agitation and/or delirium...
June 4, 2018: Trials
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