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https://www.readbyqxmd.com/read/29344708/treatment-of-combined-traumatic-brain-injury-and-hemorrhagic-shock-with-fractionated-blood-products-versus-fresh-whole-blood-in-a-rat-model
#1
Akiva Leibowitz, Evgeni Brotfain, Leonid Koyfman, Moti Klein, Shmuel Hess, Alexander Zlotnik, Matthew Boyko
INTRODUCTION: Treatment of combined traumatic brain injury and hemorrhagic shock, poses a particular challenge due to the possible conflicting consequences. While restoring diminished volume is the treatment goal for hypovolemia, maintaining adequate cerebral perfusion pressure and avoidance of secondary damage remains a treatment goal for the injured brain. Various treatment modalities have been proposed, but the optimal resuscitation fluid and goals have not yet been clearly defined...
January 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29343170/accuracy-of-ultrasonographic-measurements-of-inferior-vena-cava-to-determine-fluid-responsiveness-a-systematic-review-and-meta-analysis
#2
Daniele Orso, Irene Paoli, Tommaso Piani, Francesco L Cilenti, Lorenzo Cristiani, Nicola Guglielmo
OBJECTIVE: Fluid responsiveness is the ability to increase the cardiac output in response to a fluid challenge. Only about 50% of patients receiving fluid resuscitation for acute circulatory failure increase their stroke volume, but the other 50% may worsen their outcome. Therefore, predicting fluid responsiveness is needed. In this purpose, in recent years, the assessment of the inferior vena cava (IVC) through ultrasound (US) has become very popular. The aim of our work was to systematically review all the previously published studies assessing the accuracy of the diameter of IVC or its respiratory variations measured through US in predicting fluid responsiveness...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29341045/approach-to-infants-born-through-meconium-stained-amniotic-fluid-evolution-based-on-evidence
#3
Munmun Rawat, Sushma Nangia, Praveen Chandrasekharan, Satyan Lakshminrusimha
Meconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator...
January 16, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29339230/balanced-crystalloids-vs-0-9-saline-for-adult-patients-undergoing-non-renal-surgery-a-meta-analysis
#4
REVIEW
Lili Huang, Xiaoshuang Zhou, Hai Yu
BACKGROUND: Fluid maintenance and resuscitation is an important strategy during major surgeries. There has been a debate on the choice of crystalloids over the past decades. 0.9% saline (normal saline) is more likely to cause hyperchloremic acidosis when compared to balanced crystalloids with low chloride content. Meta-analyses comparing these two kinds of crystalloids have been performed in renal transplantations. We aim to compare the safety of balanced crystalloids to normal saline among adult patients undergoing non-renal surgery...
January 12, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29338148/novel-applications-of-bedside-monitoring-to-plumb-patient-hemodynamic-state-and-response-to-therapy
#5
Fabio Guarracino, Pietro Bertini, Michael R Pinsky
Hemodynamic monitoring is essential during the treatment of the critically ill in order to address the hemodynamic alterations and assess the response to treatment. Traditionally classified causes of shock and underlying pathophysiological mechanisms are often neglected by resuscitative strategies included in the guidelines. Most of hemodynamic management focuses on the ability to early recognise patients susceptible to increase cardiac output (CO) and mean arterial pressure (MAP) after a defined fluid challenge by eliciting Starling's law of the heart, and less is known of the ones presenting in shock and not volume responsive...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29336676/vasopressors-in-sepsis
#6
Kristin P Colling, Kaysie L Banton, Greg J Beilman
BACKGROUND: Sepsis accounts for 10% of intensive care unit admissions and significant healthcare costs. Although the mortality rate from sepsis has been decreasing with better critical care, early identification of septic patients, and prompt interventions, the mortality rate remains 20%-30%. METHOD: Review of the English-language literature. RESULTS: Norepinephrine is the first-line vasopressor in shock and is associated with a lower mortality rate as well as fewer adverse effects...
January 16, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29335914/accuracy-and-trending-of-non-invasive-hemoglobin-measurement-during-different-volume-and-perfusion-statuses
#7
Abdelmoneim Adel, Wael Awada, Bassant Abdelhamid, Heba Omar, Omnia Abd El Dayem, Ahmed Hasanin, Ashraf Rady
The evolution of non-invasive hemoglobin measuring technology would save time and improve transfusion practice. The validity of pulse co-oximetry hemoglobin (SpHb) measurement in the perioperative setting was previously evaluated; however, the accuracy of SpHb in different volume statuses as well as in different perfusion states was not well investigated. The aim of this work is to evaluate the accuracy and trending of SpHb in comparison to laboratory hemoglobin (Lab-Hb) during acute bleeding and after resuscitation...
January 15, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29335076/-value-of-arterial-blood-lactic-acid-in-the-evaluation-of-disease-severity-and-prognosis-in-neonatal-shock
#8
Wen-Hao Yuan, Ling-Kong Zeng, Bao-Huan Cai, Xiao-Yan Liu, Shi Wang, Ling-Xia Zhao, Yan-Ping Huang, Qiao-Ling Wang, Han-Chu Liu
OBJECTIVE: To evaluate the value of blood lactic acid (BLA) as a predictor for the severity and prognosis of neonatal shock. METHODS: A total of 326 neonates with shock were enrolled and divided into three groups based on the severity, namely mild group (n=147), moderate group (n=105), and severe group (n=74). BLA level was measured during and early after (about 6 hours later) fluid resuscitation, and lactate clearance rate (LCR) was calculated. The receiver operating characteristic (ROC) curve was applied to evaluate the predictive value of BLA in neonatal shock...
January 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29333494/ensuring-adequate-vascular-access-in-patients-with-major-trauma-a-quality-improvement-initiative
#9
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29332769/articles-that-may-change-your-practice-hypertonic-fluid-resuscitation-in-trauma
#10
REVIEW
Russell D MacDonald
No abstract text is available yet for this article.
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29329694/management-of-refractory-vasodilatory-shock
#11
REVIEW
Jacob C Jentzer, Saraschandra Vallabhajosyula, Ashish K Khanna, Lakhmir S Chawla, Laurence W Busse, Kianoush B Kashani
Refractory shock is a lethal manifestation of cardiovascular failure defined by an inadequate hemodynamic response to high doses of vasopressor medications. Approximately 7% of critically ill patients will develop refractory shock, with short-term mortality exceeding 50%. Refractory vasodilatory shock develops from uncontrolled vasodilation and vascular hyporesponsiveness to endogenous vasoconstrictors, causing failure of physiologic vasoregulatory mechanisms. Standard approaches to initial management of shock include fluid resuscitation and initiation of norepinephrine...
January 9, 2018: Chest
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#12
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29322942/purulent-pericarditis-an-unusual-complication-of-pneumococcal-pneumonia-a-case-report
#13
Ghizlane Zoulati, Ramatou Yèya Maïga, Rachid Kerzaz, Ghita Yahyaoui, Mustapha Harandou, Mustapha Mahmoud
Purulent pericarditis has become rare since the advent of antibiotics. Among the involved germs, S. pneumoniae remains the most implicated pathogen to evoke in principle, especially that prescription of systematic antibiotics for any febrile condition can considerably mask the clinical picture. A 36-year-old pregnant woman was visiting the emergency department for dyspnea and flu-like syndrom that had been going on for a week. The chest X-ray showed a white lung on the left and the transthoracic ultrasound revealed a pericardial effusion, resulting in pericardial drainage and pleural puncture that allows the evacuation of a purulent fluid...
January 11, 2018: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29321117/emergency-department-resuscitation-of-pediatric-trauma-patients-in-iraq-and-afghanistan
#14
Steven G Schauer, Guyon J Hill, Jason F Naylor, Michael D April, Matthew Borgman, Vikhyat S Bebarta
BACKGROUND: Military hospital healthcare providers treated children during the recent conflicts in Afghanistan and Iraq. Compared to adults, pediatric patients present unique challenges during trauma resuscitations and have notably been discussed in few research reports. We seek to describe ED interventions performed on pediatric trauma patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients in Iraq and Afghanistan from January 2007 to January 2016...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29319732/a-fatal-and-metabolic-experimental-hemorrhagic-shock-in-immature-swine
#15
Simone Alves Dos Santos Ferreira, Ana Cristina de Moraes, Renato Giuseppe Giovanni Terzi, Evandro Luis Assis Ferreira, William Adalberto Silva, Marcos Mello Moreira
PURPOSE: To use blood lactate (BL) as an end-point metabolic marker for the begin resuscitation of volume replacement in experimental hemorrhagic shock. METHODS: Group I (n=7) was not bled (Control). Animals in Group II (n=7) were bled to a MAP of 30mmHg in thirty minutes. Hemodynamic and metabolic data were recorded at Baseline, at 30, 60 and 120 minutes after Baseline. The animals were intubated in spontaneous breathing (FIO2=0.21) with halothane. RESULTS: Group I all survived...
December 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29319648/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-hemorrhage-control-in-trauma-patients-an-evidence-based-review
#16
Molly Sambor
Traditionally, resuscitative efforts for uncontrolled noncompressible torso hemorrhage are achieved by cross-clamping the proximal aorta via thoracotomy to deliver temporary hemodynamic stability during injury repair. A less commonly used method of promoting early resuscitation and hemorrhagic control in trauma patients is resuscitative endovascular balloon occlusion of the aorta (REBOA). The focus of this literature review is to examine the effectiveness of REBOA in the management of noncompressible pelvic hemorrhage when compared with traditional methods of hemorrhage control in trauma patients...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29319257/bottle-gourd-lagenaria-siceraria-juice-poisoning
#17
Pravin M Rathi, Pinakin S Patel
We present the case of a young woman who presented to us with multiple episodes of vomiting, followed by hematemesis and abdominal pain after consuming bottle gourd juice. The patient was resuscitated and stabilized with fluids, proton pump inhibitors and antiemetics and discharged in stable condition. As a member of the Cucurbitaceae family, bottle gourd contains toxic tetracyclic triterpenoid compounds called cucurbitacins which are responsible for the bitter taste and toxicity. There is no known antidote for this toxicity, and clinicians treat such patients symptomatically only...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29315469/changes-in-colloid-solution-sales-in-nordic-countries
#18
U E Kongsgaard, A Holtan, A Perner
BACKGROUND: Administration of resuscitation fluid is a common intervention in the treatment of critically ill patients, but the right choice of fluid is still a matter of debate. Changes in medical practice are based on new evidence and guidelines as well as traditions and personal preferences. Official warnings against the use of hydroxyl-ethyl-starch (HES) solutions have been issued. Nordic guidelines have issued several strong recommendations favouring crystalloids over colloids in all patient groups...
January 7, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29306258/the-reno-protective-effects-of-atorvastatin-in-crush-syndrome-and-rhabdomyolysis-is-there-a-dilemma
#19
Demet Acar, Mustafa Gülpembe, Can Gökay Yıldız, Emine Nur Özdamar, Kerem Açıkgöz, Ahmet Çağlar, Başar Cander
Background/aim: We aim to determine the effects of low-dose atorvastatin treatment together with crush fluid resuscitation on renal functions and muscle enzyme levels in a rat model of crush syndrome. Materials and methods: The study involved female Wistar Albino rats weighing 250-300 g that were housed with free access to food and water. The crush model was obtained by compression. Rats were randomly divided into four groups: control (C) group, atorvastatin + crush fluid (ACF) group, crush fluid (CF) group, and hypertonic saline (%3) + mannitol + sodium bicarbonate (SM) group...
December 19, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29304490/inflammatory-lung-edema-correlates-with-echocardiographic-estimation-of-capillary-wedge-pressure-in-newly-diagnosed-septic-patients
#20
Thiago M Santos, Daniel Franci, Carolina M Gontijo-Coutinho, Tatiana Mirabetti Ozahata, Tiago de Araújo Guerra Grangeia, José R Matos-Souza, Marco A Carvalho-Filho
PURPOSE: Lung ultrasound is an accurate and accessible tool to quantify lung edema. Furthermore, left ventricle filling pressures (LVFP) can be assessed with transthoracic echocardiography (TTE) by the E/e' ratio (E/e'). The present study aimed to assess the correlation between E/e' and lung edema quantified by a simplified lung ultrasound score (LUS) in newly admitted septic patients. MATERIALS AND METHODS: In this prospective observational cohort, septic adult patients admitted at the emergency department of a tertiary hospital were included...
December 5, 2017: Journal of Critical Care
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