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Adrenaline in shock

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https://www.readbyqxmd.com/read/29123888/cardiac-arrest-caused-by-rapidly-increasing-ascites-in-a-patient-with-tafro-syndrome-a-case-report
#1
Masatoshi Okumura, Atsushi Ujiro, Yasunori Otsuka, Hiroshi Yamamoto, Sho Wada, Hirofumi Iwata, Toshiaki Kan, Seiji Miyauchi, Atsushi Hashimoto, Yuko Sato, Yoshihito Fujita, Yoshihiro Fujiwara, Hideki Shimaoka
Case: Thrombocytopenia, anasarca, fever, renal insufficiency, and organomegaly (TAFRO) syndrome is a newly defined systemic inflammatory disorder with gradual progression of symptoms. A 59-year-old man with fever and ascites of unknown cause developed sudden-onset shock and respiratory failure in the general ward. Cardiac arrest immediately followed. Although he was resuscitated, frequent administration of adrenaline was required to maintain his blood pressure. His circulation was most effectively stabilized by drainage of fluid from his distended abdomen...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123868/cardiocerebral-and-cardiopulmonary-resuscitation-2017-update
#2
REVIEW
Gordon A Ewy
Sudden cardiac arrest is a major public health problem in the industrialized nations of the world. Yet, in spite of recurrent updates of the guidelines for cardiopulmonary resuscitation and emergency cardiac care, many areas have suboptimal survival rates. Cardiocerebral resuscitation, a non-guidelines approach to therapy of primary cardiac arrest based on our animal research, was instituted in Tucson (AZ, USA) in 2002 and subsequently adopted in other areas of the USA. Survival rates of patients with primary cardiac arrest and a shockable rhythm significantly improved wherever it was adopted...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/28982383/unexpected-hypotension-in-catecholamine-reversal-a-case-report
#3
Yohei Okada, Wataru Ishi, Hiromichi Narumiya, Ryoji Liduka
BACKGROUND: Catecholamine agents are commonly used to support circulation; however, they may cause unexpected hypotension in a special situation. Here we describe the first unexpected case of hypotension in response to catecholamine agents. CASE PRESENTATION: A 29-year-old Japanese man with schizophrenia was transferred to our emergency department. He was in shock and in coma. After fluid resuscitation, we induced catecholamine agents; however, his blood pressure decreased to 59/40 mmHg in response to catecholamine infusion...
October 6, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28835457/neuroendocrine-modulation-of-il-27-in-macrophages
#4
Julian Roewe, Maximilian Higer, Dennis R Riehl, Adrian Gericke, Markus P Radsak, Markus Bosmann
Heterodimeric IL-27 (p28/EBV-induced gene 3) is an important member of the IL-6/IL-12 cytokine family. IL-27 is predominantly synthesized by mononuclear phagocytes and exerts immunoregulatory functional activities on lymphocytic and nonlymphocytic cells during infection, autoimmunity or neoplasms. There is a great body of evidence on the bidirectional interplay between the autonomic nervous system and immune responses during inflammatory disorders, but so far IL-27 has not been defined as a part of these multifaceted neuroendocrine networks...
October 1, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28819491/-psychiatric-and-psychological-evaluation-of-tako-tsubo-syndrome-about-a-case
#5
Ghizlane Slimani, Hicham Lakbiri, Fatima Zahra Sekkat
Stress cardiomyopathy or Tako Tsubo cardiomyopathy is a cardiac pathology evoking acute coronary syndrome characterized by electrocardiographic signs, cardiac enzyme elevation and no obstructive coronary lesions. It generally affects postmenopausal women and it usually occurs after periods of intense stress. Disease onset is widely variable, ranging from anginal pain (most common) to cardiogenic shock. Exact pathophysiological mechanism continues to be debated. Various hypotheses have been posited. Abrupt elevation of adrenaline levels appears to be the most credible...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28801782/common-pediatric-medical-emergencies-in-office-practice
#6
Bharat Mehra, Suresh Gupta
General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values...
August 12, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28758128/learning-and-treatment-of-anaphylaxis-by-laypeople-a-simulation-study-using-pupilar-technology
#7
Felipe Fernandez-Mendez, Nieves Maria Saez-Gallego, Roberto Barcala-Furelos, Cristian Abelairas-Gomez, Alexis Padron-Cabo, Alexandra Perez-Ferreiros, Carlos Garcia-Magan, Jose Moure-Gonzalez, Onofre Contreras-Jordan, Antonio Rodriguez-Nuñez
An anaphylactic shock is a time-critical emergency situation. The decision-making during emergencies is an important responsibility but difficult to study. Eye-tracking technology allows us to identify visual patterns involved in the decision-making. The aim of this pilot study was to evaluate two training models for the recognition and treatment of anaphylaxis by laypeople, based on expert assessment and eye-tracking technology. A cross-sectional quasi-experimental simulation study was made to evaluate the identification and treatment of anaphylaxis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28697004/experimental-models-of-endotheliopathy-impact-of-shock-severity
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
April 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27751290/aconite-poisoning-with-arrhythmia-and-shock
#16
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
#17
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
#18
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
#19
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
#20
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
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