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volume status critical care patients

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https://www.readbyqxmd.com/read/28940546/measuring-emergency-department-patient-population-acuity
#1
Maame Yaa A B Yiadom, Christopher W Baugh, Tyler W Barrett, Xulei Liu, Alan B Storrow, Timothy J Vogus, Vikram Tiwari, Corey M Slovis, Stephan Russ, Dandan Liu
BACKGROUND: Emergency department (ED) acuity is the general level of patient illness, urgency for clinical intervention, and intensity of resource use in an ED environment. The relative strength of commonly used measures of ED acuity is not well understood. METHODS: We performed a retrospective cross-sectional analysis of ED-level data to evaluate the relative strength of association between commonly used proxy measures with a full spectrum measure of ED acuity...
September 23, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28932401/practical-approach-to-detection-and-management-of-acute-kidney-injury-in-critically-ill-patient
#2
REVIEW
Vahid Mohsenin
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28866972/comparison-of-continous-wave-doppler-ultrasound-monitor-and-echocardiography-to-assess-cardiac-output-in-intensive-care-patients
#3
Ahmad Elgendy, Ian M Seppelt, Andrew S Lane
BACKGROUND: Continuous-wave Doppler (CWD) ultrasound through the left ventricular outflow tract is one modality used for non-invasive cardiac output measurement. The ultrasonic cardiac output monitor (USCOM) is a relatively new monitor which uses a small, transcutaneous ultrasound probe to measure cardiac output with CWD via the suprasternal window. It is faster and less complex to train new users than conventional echocardiography. In addition to stroke volume (SV), the USCOM can calculate stroke volume variation (SVV) and the Smith-Madigan inotropy index (SMII), which is an estimate of the pre-load independent contractility of the myocardium...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28828035/urine-flow-rate-monitoring-in-hypovolemic-multiple-trauma-patients
#4
Evgeni Brotfain, Yoram Klein, Ronen Toledano, Leonid Koyfman, Dmitry Frank, Micha Y Shamir, Moti Klein
BACKGROUND: The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill multiple trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive multiple trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. METHODS: The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28746899/hypertonic-saline-in-critical-illness-a-systematic-review
#5
REVIEW
Carmen Andrea Pfortmueller, Joerg C Schefold
INTRODUCTION: The optimal approach to fluid management in critically ill patients is highly debated. Fluid resuscitation using hypertonic saline was used in the past for more than thirty years, but has recently disappeared from clinical practice. Here we provide an overview on the currently available literature on effects of hypertonic saline infusion for fluid resuscitation in the critically ill. METHODS: Systematic analysis of reports of clinical trials comparing effects of hypertonic saline as resuscitation fluid to other available crystalloid solutions...
June 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28580340/a-system-for-continuous-estimating-and-monitoring-cardiac-output-via-arterial-waveform-analysis
#6
A Vakily, H Parsaei, M M Movahhedi, M A Sahmeddini
BACKGROUND: Cardiac output (CO) is the total volume of blood pumped by the heart per minute and is a function of heart rate and stroke volume. CO is one of the most important parameters for monitoring cardiac function, estimating global oxygen delivery and understanding the causes of high blood pressure. Hence, measuring CO has always been a matter of interest to researchers and clinicians. Several methods have been developed for this purpose, but a majority of them are either invasive, too expensive or need special expertise and experience...
June 2017: Journal of Biomedical Physics & Engineering
https://www.readbyqxmd.com/read/28567186/critical-evaluation-of-contemporary-management-in-a-new-pelvic-exenteration-unit-the-first-25-consecutive-cases
#7
Min Hoe Chew, Yu-Ting Yeh, Ee-Lin Toh, Stephen Aditya Sumarli, Ghee Kheng Chew, Lui Shiong Lee, Mann Hong Tan, Tiffany Priyanthi Hennedige, Shin Yi Ng, Say Kiat Lee, Tze Tec Chong, Hairil Rizal Abdullah, Terence Lin Hon Goh, Mohamed Zulfikar Rasheed, Kok Chai Tan, Choong Leong Tang
AIM: To critically appraise short-term outcomes in patients treated in a new Pelvic Exenteration (PE) Unit. METHODS: This retrospective observational study was conducted by analysing prospectively collected data for the first 25 patients (16 males, 9 females) who underwent PE for advanced pelvic tumours in our PE Unit between January 2012 and October 2016. Data evaluated included age, co-morbidities, American Society of Anesthesiologists (ASA) score, Eastern Cooperative Oncology Group (ECOG) status, preoperative adjuvant treatment, intra-operative blood loss, procedural duration, perioperative adverse event, lengths of intensive care unit (ICU) stay and hospital stay, and oncological outcome...
May 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28478875/assessment-of-volume-status-using-ultrasonography
#8
REVIEW
Brooke A Bailey, Sarah Davis, Briana Witherspoon
Ultrasonography is a first-line diagnostic tool when evaluating volume status in the critical care patient population. Ultrasonography leads to a prompt diagnosis and more appropriate management plan, while decreasing health care costs, time to diagnosis, hospital length of stay, time to definitive operation, and mortality. It is recommended that critical care providers treating critically ill patients be skilled and competent in critical care ultrasonography. As the critical care population and the shortage of critical care physicians increases, advanced practice providers are becoming more prevalent in critical care areas and should be competent in this skill as well...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28476093/association-of-condylar-bone-quality-with-tmj-osteoarthritis
#9
J Shi, S Lee, H C Pan, A Mohammad, A Lin, W Guo, E Chen, A Ahn, J Li, K Ting, J H Kwak
The etiology and treatment of temporomandibular joint (TMJ) osteoarthritis (TMJOA) remain complex and unclear. Based on clinical observations, we hypothesized that low condylar bone quality is significantly correlated with TMJOA and explored this association in a cross-sectional study with human patients. A total of 254 postmenopausal female participants were included in this study. Radiographic findings from cone beam computed tomography (CBCT) and clinical symptoms were used to classify each TMJ data sample as healthy control ( n = 124) or TMJOA ( n = 130)...
July 2017: Journal of Dental Research
https://www.readbyqxmd.com/read/28372500/clinical-significance-of-bioimpedance-spectroscopy-in-critically-ill-patients
#10
Shang-Feng Yang, Ching-Min Tseng, I-Fan Liu, Shin-Hung Tsai, Wein-Shung Kuo, Tien-Ping Tsao
BACKGROUND: Early fluid resuscitation is a key aspect in the successful management of critically ill patients, but the optimal goal for volume control after the acute stage of critical illness remains unclear. This study aimed to evaluate the prognostic value of bioimpedance spectrometry for fluid management in critically ill patients. METHODS: In this prospective observational study, patients who consented to participate were screened within the first 24 hours of admission to a medical intensive care unit (ICU) from February 4, 2015, to January 31, 2016...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28348943/correlation-of-ivc-diameter-and-collapsibility-index-with-central-venous-pressure-in-the-assessment-of-intravascular-volume-in-critically-ill-patients
#11
Abid Ilyas, Wasib Ishtiaq, Salman Assad, Haider Ghazanfar, Salman Mansoor, Muhammad Haris, Aayesha Qadeer, Aftab Akhtar
OBJECTIVE: The objective of our study is to assess the correlation between inferior vena cava (IVC) diameters, central venous pressure (CVP) and the IVC collapsibility index for estimating the volume status in critically ill patients. METHODS: This cross-sectional study used the convenient sampling of 100 adult medical intensive care unit (ICU) patients for a period of three months. Patients ≥ 18 years of age with an intrathoracic central venous catheter terminating in the distal superior vena cava connected to the transducer to produce a CVP waveform were included in the study...
February 12, 2017: Curēus
https://www.readbyqxmd.com/read/28299589/respiratory-variation-in-peak-aortic-velocity-accurately-predicts-fluid-responsiveness-in-children-undergoing-neurosurgery-under-general-anesthesia
#12
Kavita G Morparia, Srijaya K Reddy, Laura J Olivieri, Michael C Spaeder, Jennifer J Schuette
The determination of fluid responsiveness in the critically ill child is of vital importance, more so as fluid overload becomes increasingly associated with worse outcomes. Dynamic markers of volume responsiveness have shown some promise in the pediatric population, but more research is needed before they can be adopted for widespread use. Our aim was to investigate effectiveness of respiratory variation in peak aortic velocity and pulse pressure variation to predict fluid responsiveness, and determine their optimal cutoff values...
March 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28292533/assessment-of-hydration-status-using-bioelectrical-impedance-vector-analysis-in-critical-patients-with-acute-kidney-injury
#13
Ana Cláudia da Rosa Hise, Maria Cristina Gonzalez
BACKGROUND & AIMS: The state of hyperhydration in critically ill patients with acute kidney injury (AKI) is associated with increased mortality. Bioelectrical impedance vector analysis (BIVA) appears to be a viable method to access the fluid status of critical patients but has never been evaluated in critical patients with AKI. The objective of this study is to evaluate the hydration status measured using BIVA in critical patients under intensive care at the time of AKI diagnosis and to correlate this measurement with mortality...
February 21, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28291456/anesthesia-and-postoperative-respiratory-compromise-following-major-lower-extremity-surgery-implications-for-combat-casualties
#14
Samuel M Galvagno, Jordan Brayanov, George Williams, Edward E George
Care of military casualties requires not only assessment of patient, injury, and setting, but also the consequences of care decisions on other organ systems. In contemporary conflicts, pelviperineal and lower extremity trauma are common injuries, yet the optimal perioperative anesthetic and analgesic care remains unclear. Residual anesthesia and opioids can cause respiratory depression, specifically postoperative respiratory depression and opioid-induced respiratory depression. This observational study quantified and compared the incidences of respiratory depression following general anesthesia (GA) and spinal anesthesia (SA) for lower extremity surgery...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28259855/restrictive-versus-liberal-fluid-therapy-in-major-abdominal-surgery-relief-rationale-and-design-for-a-multicentre-randomised-trial
#15
Paul Myles, Rinaldo Bellomo, Tomas Corcoran, Andrew Forbes, Sophie Wallace, Philip Peyton, Chris Christophi, David Story, Kate Leslie, Jonathan Serpell, Shay McGuinness, Rachel Parke
INTRODUCTION: The optimal intravenous fluid regimen for patients undergoing major abdominal surgery is unclear. However, results from many small studies suggest a restrictive regimen may lead to better outcomes. A large, definitive clinical trial evaluating perioperative fluid replacement in major abdominal surgery, therefore, is required. METHODS/ANALYSIS: We designed a pragmatic, multicentre, randomised, controlled trial (the RELIEF trial). A total of 3000 patients were enrolled in this study and randomly allocated to a restrictive or liberal fluid regimen in a 1:1 ratio, stratified by centre and planned critical care admission...
March 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28249879/quality-of-care-at-hospitals-identified-as-outliers-in-publicly-reported-mortality-statistics-for-percutaneous-coronary-intervention
#16
Stephen W Waldo, James M McCabe, Kevin F Kennedy, Corwin M Zigler, Duane S Pinto, Robert W Yeh
BACKGROUND: Public reporting of percutaneous coronary intervention (PCI) outcomes may create disincentives for physicians to provide care for critically ill patients, particularly at institutions with worse clinical outcomes. We thus sought to evaluate the procedural management and in-hospital outcomes of patients treated for acute myocardial infarction before and after a hospital had been publicly identified as a negative outlier. METHODS: Using state reports, we identified hospitals that were recognized as negative PCI outliers in 2 states (Massachusetts and New York) from 2002 to 2012...
May 16, 2017: Circulation
https://www.readbyqxmd.com/read/28140382/the-need-to-consider-longer-term-outcomes-of-care-racial-ethnic-disparities-among-adult-and-older-adult-emergency-general-surgery-patients-at-30-90-and-180-days
#17
Cheryl K Zogg, Olubode A Olufajo, Wei Jiang, Anna Bystricky, John W Scott, Shahid Shafi, Joaquim M Havens, Ali Salim, Andrew J Schoenfeld, Adil H Haider
OBJECTIVES: Following calls from the National Institutes of Health and American College of Surgeons for "urgently needed" research, the objectives of the present study were to (1) ascertain whether differences in 30/90/180-day mortality, major morbidity, and unplanned readmissions exist among adult (18-64 yr) and older adult (≥65 yr) emergency general surgery (EGS) patients; (2) vary by diagnostic category; and (3) are explained by variations in insurance, income, teaching status, hospital EGS volume, and a hospital's proportion of minority patients...
July 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28018763/predicting-central-venous-pressure-by-measuring-femoral-venous-diameter-using-ultrasonography
#18
Akram Malik, Aftab Akhtar, Shoab Saadat, Salman Mansoor
OBJECTIVES: The objective of this exploratory study was to find out the correlation of femoral vein diameter (FVD) to central venous pressure (CVP) measurements and to derive a prediction equation to help ascertain the fluid volume status in a critical patient. PATIENTS AND METHODS: This was a single-centered prospective cohort study designed and conducted by the critical care department of Shifa International hospital in Islamabad, Pakistan. Patients were enrolled from the medical and surgical intensive care units...
November 23, 2016: Curēus
https://www.readbyqxmd.com/read/27968814/practical-assessment-of-volume-status-in-daily-practice
#19
REVIEW
Paula Johnson
Fluid therapy is considered the cornerstone of treatment for patients suffering from various medical ailments particularly in emergency and critical care situations where hypovolemia commonly occurs. The ability to accurately assess a patient's volume status is critical to the decision making process when synthesizing and implementing a fluid therapy plan. Both extremes, over supplementation or not supplementing enough fluid can be detrimental to the patient. Precisely assessing a patient's blood volume without access to advanced often complicated equipment and monitoring devices is challenging...
September 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/27843206/role-of-systemic-chemotherapy-in-metastatic-hormone-sensitive-prostate-cancer
#20
REVIEW
Niraj Shenoy, Manish Kohli
INTRODUCTION: Patients with metastatic hormone sensitive prostate cancer (mHSPC) have traditionally been treated with androgen deprivation therapy (ADT). Recently, there has been a demonstration of a survival benefit with the addition of docetaxel to ADT from three large randomized controlled trials. This review summarizes these trials, draws comparisons between the trials, and attempts to provide critical evidence-based recommendation on the role of docetaxel in mHSPC. METHODS: Of the two published (GETUG-AFU, Chemo-Hormonal therapy vs...
October 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
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