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Adrenaline in shock

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https://www.readbyqxmd.com/read/28697004/experimental-models-of-endotheliopathy-impact-of-shock-severity
#1
Nikolaus Hofmann, Johannes Zipperle, Mohammad Jafarmadar, Mostafa Ashmwe, Claudia Keibl, Carina Penzenstadler, Martin Ponschab, Behnaz Jafarmadar, Heinz Redl, Soheyl Bahrami, Herbert Schöchl
BACKGROUND: Hemorrhagic shock (HS) followed by resuscitation is often associated with sympatho-adrenal activation (SAA) and endothelial damage (ED). OBJECTIVE: We aimed to a) evaluate the impact of HS alone on the magnitude of SAA and consecutive ED and b) characterize potential targets for a standardized and reproducible model of HS-induced endotheliopathy in rats. METHODS: Rats were subjected to either a volume controlled HS (40% of total blood volume: v-HS group) or to a lab guided HS (l-HS) targeting base deficit (BD) >5...
July 10, 2017: Shock
https://www.readbyqxmd.com/read/28656859/coping-with-the-stress-of-a-major-incident
#2
Mandy Day-Calder
When you are involved in any kind of traumatic event, at work or in your personal life, you may initially go into auto pilot and think of everyone else but yourself. However, once the shock and adrenaline wear off, you are likely to experience a wide range of thoughts and emotions.
June 28, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28540396/-anaphylactic-reactions-to-vaccines-chicken-egg-allergy-and-the-influenza-h1n1-vaccination
#3
L Klimek, S Wicht-Langhammer, L von Bernus, C Thorn, D Cazan, O Pfaar, K Hörmann
BACKGROUND: Allergic reactions to influenza vaccinations are a well-known phenomenon; however, only a few published statistics give information on the risks. Patients with a chicken egg allergy must be particularly carefully handled during an influenza epidemic where vaccines produced using embryonated chicken eggs are primarily employed. METHODS: A selective literature review and analysis of the problem of allergic reactions to vaccinations was performed. RESULTS: The two most common relative contraindications among patients to be vaccinated are the presence of an egg allergy and a previous anaphylactic reaction to vaccination...
May 24, 2017: HNO
https://www.readbyqxmd.com/read/28482886/adrenaline-overdose-in-pediatric-anaphylaxis-a-case-report
#4
Pui Yi Lily Liew, John Andrew Craven
BACKGROUND: Adrenaline is the standard treatment for anaphylaxis but appropriate administration remains challenging, and iatrogenic overdose is easily overlooked. Despite the established importance of pediatric blood pressure measurement, its use remains inconsistent in clinical practice. CASE PRESENTATION: We report a case of adrenaline overdose in a 9-year-old white boy with anaphylaxis, where signs of adrenaline overdose were indistinguishable from progressive shock until blood pressure measurement was taken...
May 8, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28416053/-treatment-of-anaphylactic-schock-in-pregnant-women
#5
Therese Simonsen Straarup, Ulla Bang
This is an update on the treatment of anaphylactic shock in pregnant women. Most guidelines recommend adrenaline as first-line treatment in all patients, but in pregnant patients some recommend ephedrine due to a potential risk of utero-placental hypoperfusion with adrenaline. However, ephedrine is a less potent vasopressor than adrenaline and does not possess the same anti-inflammatory or broncho-dilating effects. As immediate and correct treatment is essential for both the maternal and the fetal outcome, adrenaline should be first-line treatment also in pregnant women...
April 10, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28385449/centhaquin-effects-in-a-swine-model-of-ventricular-fibrillation-centhaquin-and-cardiac-arrest
#6
Konstantina Papalexopoulou, Athanasios Chalkias, Paraskevi Pliatsika, Apostolos Papalois, Panagiotis Papapanagiotou, Georgios Papadopoulos, Eleni Arnaoutoglou, Anastasios Petrou, Anil Gulati, Theodoros Xanthos
BACKGROUND: Centhaquin citrate is a novel agent being developed for use in the treatment of haemorrhagic shock. The aim of our study was to assess whether the administration of centhaquin would improve initial resuscitation success, 24-hour survival, and neurologic outcome compared with adrenaline alone in a porcine model of ventricular fibrillation. METHODS: Ventricular fibrillation was induced in 20 healthy Landrace/Large White piglets. The animals were randomised to receive placebo plus adrenaline 0...
December 19, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28109996/survival-in-ventricular-fibrillation-with-emphasis-on-the-number-of-defibrillations-in-relation-to-other-factors-at-resuscitation
#7
Johan Holmén, Jacob Hollenberg, Andreas Claesson, Maria Jiménez Herrera, Youcef Azeli, Johan Herlitz, Christer Axelsson
INTRODUCTION: Mortality after out of hospital cardiac arrest (OHCA) is high and a shockable rhythm is a key predictor of survival. A concomitant need for repeated shocks appears to be associated with less favorable outcome. AIM: To, among patients found in ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT) describe: (a) factors associated with 30-day survival with emphasis on the number of defibrillatory shocks delivered; (b) the distribution of and the characteristics of patients in relation to the number of defibrillatory shocks that were delivered...
April 2017: Resuscitation
https://www.readbyqxmd.com/read/27836099/-management-of-cardiogenic-shock-results-from-a-survey-in-france-and-belgium
#8
S Champion, N Deye
PURPOSE: Physician survey on cardiogenic shock management; recommendations for the management of patients with cardiogenic shock are based mostly on experts' opinion. METHODS: Overall 1585 emails were sent to "senior" intensive care physicians from France and Belgium from September 2014 to march 2015. Response rate was 10% (157 respondents). Agreement was assessed based on RAND/UCLA methodology. RESULTS: Continuous monitoring of cardiac output, vascular filling, noninvasive ventilation were deemed appropriate...
November 8, 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27751290/aconite-poisoning-with-arrhythmia-and-shock
#9
Sandeep Tak, Manoj Lakhotia, Alok Gupta, Amit Sagar, Gopal Bohra, Rajesh Bajari
A 55-year-old male presented with history of nausea, vomiting, palpitation paresthesis and profuse sweating in emergency department 2h after ingestion of "Bachnaag" (Aconite) root. Examination revealed shock with irregular pulses. Initial ECG showed frequent multifocal ventricular ectopics (VE), which later turned to short runs of ventricular tachycardia (VT). Immediate gastric lavage was done and activated charcoal given. Patient was treated with fluid resuscitation without any improvement in blood pressure...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27516403/a-male-patient-with-syncope-anaphylaxis-and-st-elevation-hepatic-and-cardiac-echinococcosis-presenting-with-kounis-syndrome
#10
Antonio Mirijello, Gaetano Pepe, Patrizio Zampiello, Giovanni Marco Criconia, Angela Mendola, Antonio Manfrini
BACKGROUND: Approximately 1% of emergency department (ED) visits are due to anaphylaxis. Symptoms can include skin rash, facial and laryngeal edema, dyspnea, vomiting, hypotension, and shock. A transient loss of consciousness can also be a manifestation of anaphylaxis. A variety of electrocardiographic changes due to anaphylaxis have been described for Kounis syndrome, also known as allergic angina. CASE REPORT: Here we describe the case of a male patient presenting at an ED with syncope, anaphylactic shock, and ST-segment elevation on electrocardiogram (ECG)...
October 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27442605/zero-order-metoprolol-pharmacokinetics-after-therapeutic-doses-severe-toxicity-and-cardiogenic-shock
#11
Geoffrey K Isbister, Karyn Ang, Kieron Gorman, Joyce Cooper, Ahmed Mostafa, Michael S Roberts
OBJECTIVE: Acute beta-blocker overdose can cause severe cardiac dysfunction. Chronic toxicity is rare but potentially severe. We report therapeutic dosing of metoprolol resulting in unusual pharmacokinetics and toxicity, given high-dose insulin therapy for treatment. CASE DETAILS: A 90-year-old female presented with hypotension, tachycardia and severe cardiac dysfunction after commencing a rapidly increasing metoprolol dose of 250 mg split daily. She was admitted to intensive care and given high-dose insulin therapy (10 U/kg/h), noradrenaline, adrenaline and dobutamine for severe cardiac dysfunction (cardiac index, 0...
November 2016: Clinical Toxicology
https://www.readbyqxmd.com/read/27374027/current-real-life-use-of-vasopressors-and-inotropes-in-cardiogenic-shock-adrenaline-use-is-associated-with-excess-organ-injury-and-mortality
#12
Tuukka Tarvasmäki, Johan Lassus, Marjut Varpula, Alessandro Sionis, Reijo Sund, Lars Køber, Jindrich Spinar, John Parissis, Marek Banaszewski, Jose Silva Cardoso, Valentina Carubelli, Salvatore Di Somma, Alexandre Mebazaa, Veli-Pekka Harjola
BACKGROUND: Vasopressors and inotropes remain a cornerstone in stabilization of the severely impaired hemodynamics and cardiac output in cardiogenic shock (CS). The aim of this study was to analyze current real-life use of these medications, and their impact on outcome and on changes in cardiac and renal biomarkers over time in CS. METHODS: The multinational CardShock study prospectively enrolled 219 patients with CS. The use of vasopressors and inotropes was analyzed in relation to the primary outcome, i...
July 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27362703/phenylephrine-decreases-vascular-tension-in-goat-arteries-in-specific-circumstances
#13
Renu R Raj, Sathya Subramani
Phenylephrine (PE) causes vasoconstriction through alpha adrenergic receptors. PE-induced vasodilatation has also been reported earlier in pre-constricted vessels. Here we demonstrate in spiral strips of goat arteries that addition of PE can decrease tone even from base-line levels (i.e. not pre-constricted) and show that this process requires nitric oxide (NO) and alpha adrenergic stimulation, but is cGMP-independent. Under control conditions, PE caused vasoconstriction, but under conditions where NO levels are higher, as with L-Arginine or sodium nitroprusside, PE decreased vessel tension...
2016: PloS One
https://www.readbyqxmd.com/read/27097513/-a-case-of-rocuronium-induced-anaphylaxis-in-which-surgery-was-subsequently-performed-under-general-anesthesia-without-neuromuscular-blocking-agents
#14
Tatsuo Horiuchi, Tomonori Takazawa, Shigeru Saito
We report here a case of rocuronium-induced anaphylactic shock in a 41-year-old woman. She was scheduled for partial hepatectomy due to liver metastasis of a pheochromocytoma. Anesthesia was induced with propofol, remifentanil, and rocuronium. Bag-mask ventilation was difficult, and her blood pressure fell to around 40 mmHg just after induction. Subsequently, her trachea was intubated and adrenaline was injected. However, due to the subsequent persistence of severe hypotension and hypoxia, cardiopulmonary resuscitation was necessary...
March 2016: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/26807260/adrenaline-aggravates-lung-injury-caused-by-liver-ischemia-reperfusion-and-high-tidal-volume-ventilation-in-rats
#15
Shuhei Ota, Takuya Yazawa, Kentaro Tojo, Yasuko Baba, Munehito Uchiyama, Takahisa Goto, Kiyoyasu Kurahashi
BACKGROUND: We often administer adrenaline to improve hypotension of patients undergoing systemic inflammation that is not treated with volume resuscitation. The effects of adrenaline on injured lungs during shock status have not been elucidated. We previously demonstrated that hepatic ischemia-reperfusion followed by high-tidal-volume ventilation-induced systemic inflammation, hypotension, and lung injury in rats. Using this animal model, we investigated the effects of adrenaline on lung injury and hemodynamics...
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/26717337/hypertensive-emergency-due-to-pheochromocytoma-crisis-complicated-with-refractory-hemodynamic-collapse
#16
Mert İlker Hayıroğlu, Özlem Yıldırımtürk, Mehmet Bozbay, Mehmet Eren, Seçkin Pehlivanoğlu
Hypertensive emergency usually appears in older patients with previous recurrent episodes, and is among the most frequent admissions to emergency departments. A 29-year-old woman was referred to our clinic with the diagnosis of hypertensive emergency. The patient complained of severe headache, dyspnea, palpitation, diaphoresis, and confusion due to hypertensive encephalopathy. Her blood pressure was 250/150 mmHg on admission. At the referral hospital, the patient had undergone cranial CT because of her confused state and this excluded acute cerebral hemorrhage...
December 2015: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/26696217/intra-aortic-balloon-pump-iabp-rescue-therapy-for-refractory-cardiogenic-shock-due-to-scorpion-sting-envenomation
#17
Shilpa Reynal D'sa, John Victor Peter, Binila Chacko, Kishore Pichamuthu, Sowmya Sathyendra
BACKGROUND: Cardiomyopathy, cardiogenic shock or acute pulmonary oedema are well recognised complications of scorpion sting envenomation occurring in about 1-3% of patients. Current treatment recommendations include afterload reduction using prazosin and improving cardiac contractility with inotropes like dobutamine. We report the use of intra-aortic balloon pump (IABP) as rescue therapy in a patient with refractory cardiogenic shock due to Mesobuthus tamulus (Indian red scorpion) envenomation...
2016: Clinical Toxicology
https://www.readbyqxmd.com/read/26689353/cardiorespiratory-arrest-in-children-out-of-hospital
#18
Kristina Krmpotic, Hilary Writer
INTRODUCTION: Cardiorespiratory arrest outside hospital occurs in approximately 1/10,000 children per year in resource-rich countries, with two-thirds of arrests occurring in children under 18 months of age. Approximately 45% of cases have undetermined causes, including sudden infant death syndrome. Of the rest, 20% are caused by trauma, 10% by chronic disease, and 6% by pneumonia. METHODS AND OUTCOMES: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of treatments for non-submersion out-of-hospital cardiorespiratory arrest in children? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview)...
2015: Clinical Evidence
https://www.readbyqxmd.com/read/26644776/bullous-dermatitis-and-skin-necrosis-developing-after-adrenalin-extravasation
#19
Alper Ozcan, Emre Baratalı, Ozge Meral, Ayşe Betul Ergul, Hümeyra Aslaner, Ramazan Coskun, Yasemin Altuner Torun
Extravasation of vasopressors can have serious complications varying from simple local reactions to skin necrosis and compartment syndrome. Here, we presented bullous dermatitis and skin necrosis which developed due to extravasation of adrenalin infusion in a Hodgkin lymphoma patient with septic shock who was admitted due febrile neutropenia.
October 2015: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/26623433/cardiotoxic-and-arrhythmogenic-effects-of-hemiscorpius-lepturus-scorpion-venom-in-rats
#20
Khalil Pourkhalili, Euikyung Kim, Navid Reza Mashayekhy, Mostafa Kamyab, Seyed Mehdi Hoseiny, Reihane Evazy, Abbas Zare Mirakabadi, Ramin Seyedian
BACKGROUND: Envenomation by Hemiscorpius lepturus is not painful and the clinical manifestations include bloody urine due to hemoglobinuria or hematuria, dermonecrotic reactions, cardiac arrhythmia and in minority of cases acute renal failure which may lead to death following disseminated intravascular coagulation in infants. Cardiac effects of envenomation by H. lepturus venom including inotropic, chronotropic and arrhythmogenic properties are not studied as now in rat hearts with Langendorff apparatus...
December 2015: Journal of Arthropod-borne Diseases
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