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fluid management in icu patients

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https://www.readbyqxmd.com/read/29657606/early-biliary-drainage-is-associated-with-favourable-outcomes-in-critically-ill-patients-with-acute-cholangitis
#1
Mohammed Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen Al-Qadi
Introduction: Acute cholangitis (AC) is a clinical condition that requires prompt medical management with IV fluids, antibiotics, and biliary drainage (BD). The optimal timing for BD remains unclear. Aim: To investigate the effect of biliary drainage timing on clinical outcomes in AC. Material and methods: We conducted a retrospective study of patients with AC admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database...
2018: Przegla̜d Gastroenterologiczny
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#2
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29650049/variation-in-general-supportive-and-preventive-intensive-care-management-of-traumatic-brain-injury-a-survey-in-66-neurotrauma-centers-participating-in-the-collaborative-european-neurotrauma-effectiveness-research-in-traumatic-brain-injury-center-tbi-study
#3
Jilske A Huijben, Victor Volovici, Maryse C Cnossen, Iain K Haitsma, Nino Stocchetti, Andrew I R Maas, David K Menon, Ari Ercole, Giuseppe Citerio, David Nelson, Suzanne Polinder, Ewout W Steyerberg, Hester F Lingsma, Mathieu van der Jagt
BACKGROUND: General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. METHODS: We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study...
April 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29648477/acute-intensive-care-unit-management-of-mustard-gas-victims-the-turkish-experience
#4
Ertugrul Kilic, Mesut Ortatatli, Sermet Sezigen, Rusen Koray Eyison, Levent Kenar
Sulfur mustard (SM) is an highly toxic and vesicant chemical weapon that was used in various military conflicts several times in the history. The severity of ocular, dermal, and pulmonary symptoms that may appear following a characteristic asymptomatic period are depending on the SM concentration and exposure duration. The aim of this study is to present the clinical features and share the intensive care unit (ICU) experiences for the medical management of mustard gas victims. Thirteen Free Syrian Army soldiers near Al-Bab region of North Syria were reportedly exposed to oily blackish smoke with garlic smell due to the explosion of a trapped bomb without causing any blast or thermal effect on 26th November 2016...
April 12, 2018: Cutaneous and Ocular Toxicology
https://www.readbyqxmd.com/read/29628184/the-two-bag-method-for-treatment-of-diabetic-ketoacidosis-in-adults
#5
Nathan L Haas, Roma Y Gianchandani, Kyle J Gunnerson, Benjamin S Bassin, Arun Ganti, Christopher Hapner, Caryn Boyd, James A Cranford, Sage P Whitmore
BACKGROUND: The "two-bag method" of management of diabetic ketoacidosis (DKA) allows for titration of dextrose delivery by adjusting the infusions of two i.v. fluid bags of varying dextrose concentrations while keeping fluid, electrolyte, and insulin infusion rates constant. OBJECTIVE: We aimed to evaluate the feasibility and potential benefits of this strategy in adult emergency department (ED) patients with DKA. METHODS: This is a before-and-after comparison of a protocol using the two-bag method operationalized in our adult ED in 2015...
April 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29627131/treatment-of-toxic-epidermal-necrolysis-by-a-multidisciplinary-team-a-review-of-literature-and-treatment-results
#6
Anthony Papp, Sheena Sikora, Morgan Evans, Diana Song, Mark Kirchhof, Monica Miliszewski, Jan Dutz
BACKGROUND: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are mucocutaneous hypersensitivity reactions, usually to drugs or their metabolites. TEN is the most severe involving greater than 30% of the total body surface area (TBSA). Management of these patients usually benefits from a large multidisciplinary team for both wound and medical management. Treatment of these patients varies between centers and physicians and there is lack of a standardized treatment protocol in the medical literature...
April 4, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29617940/intraosseous-versus-intravenous-access-in-pediatric-septic-shock-patients-admitted-to-alexandria-university-pediatric-intensive-care-unit
#7
Ahmed A El-Nawawy, Omneya M Omar, Mona Khalil
The cornerstone of emergency management of sepsis is early, goal-directed therapy. The purpose of this study was to evaluate the effect of intraosseous (IO) vs. intravenous (IV) access for resuscitation of patients with septic shock admitted to pediatric intensive care unit. This prospective interventional randomized clinical trial study was conducted on 60 patients with septic shock who need rapid administration of fluids and drugs; 30 cases were randomly chosen for IO vascular access, while the other 30 were selected for IV access...
April 1, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29614588/-the-effect-of-continuous-veno-venous-hemofiltration-on-neutrophil-gelatinase-associated-lipocalin-plasma-levels-in-critically-ill-patients-with-acute-kidney-injury
#8
H Wang, N Cui, Y K Zhou, W Cheng, L Li, Y Long, D W Liu
Objective: To evaluate the effect of continuous veno venous hemofiltration (CVVH) on neutrophil gelatinase associated lipocalin (NGAL) in critically ill patients with acute kidney injury (AKI). Methods: Critically ill patients with AKI who needed CVVH and admitted to Department of Critical Care Medicine of Peking Union Medical College Hospital were enrolled prospectively from January 2015 to June 2015. AN69 membrane filters were used for CVVH. Prefilter, postfilter,and plasma NGAL measurements were taken at 10 mins, 4 hours and 8 hours (T 10 min, T 4 h, T 8 h) after CVVH...
April 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29605073/non-intensive-care-unit-management-of-acute-liver-failure
#9
REVIEW
Andres F Carrion, Paul Martin
Acute liver failure (ALF) is an uncommon syndrome with a highly variable and unpredictable clinical course. The initial diagnostic evaluation is typically performed in a non-intensive care unit (ICU) setting, like the emergency department or general hospital ward. Prompt restoration of intravascular volume with intravenous fluids and correction of electrolyte, metabolic, and acid-base disturbances are important initial interventions in the management of ALF and can be safely accomplished in non-ICU settings in many patients...
May 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29575788/acute-kidney-injury-in-critically-ill-patients-a-prospective-randomized-study-of-tidal-peritoneal-dialysis-versus-continuous-renal-replacement-therapy
#10
Abdullah Al-Hwiesh, Ibrahiem Abdul-Rahman, Fredric Finkelstein, Jose Divino-Filho, Hatem Qutub, Nadia Al-Audah, Abdalla Abdelrahman, Nazeeh El-Fakhrany, Mohammed Nasr El-Din, Tamer El-Salamony, Abdulsalam Noor, Mohammed Al-Shahrani, Khalid Al-Otaibi
Few studies have discussed the role of peritoneal dialysis (PD) in managing acute kidney injury (AKI) in critically ill patients. The present study compares the outcome of AKI in intensive care unit (ICU) patients randomized to treatment with tidal PD (TPD) or continuous venovenous hemodiafiltration (CVVHDF). One hundred and twenty-five ICU patients with AKI were randomly allotted to CVVHDF, (Group A, N = 62) or TPD, (group B, N = 63). Cause and severity of renal injury were assessed at the time of initiating dialysis...
March 25, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29574429/placenta-accreta-complicated-with-peripartum-cardiomyopathy
#11
Yuditiya Purwosunu, Agrifa Hasiholan Haloho
A 33-year-old G2P1 was referred to our hospital due to placenta accreta. During perioperative preparations, the patient was diagnosed with having a peripartum cardiomyopathy. The patient underwent caesarean hysterectomy at 36 weeks with an associated 2 L blood loss. Haemodynamic maintenance and stabilisation during the operation were challenging, with the combinations of fluid therapy, blood transfusions as well as vasoactive, antifibrinolytic and haemostatic drug. Postoperatively, the patient was managed in the intensive care unit and was subsequently transferred to intermediate care after less than 24 hours' observation...
March 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29571640/comparison-of-clinical-outcomes-between-general-anesthesiologists-and-cardiac-anesthesiologists-in-the-management-of-left-ventricular-assist-device-patients-in-noncardiac-surgeries-and-procedures
#12
Tod A Brown, Jocelyn Kerpelman, Bethany J Wolf, Julie R McSwain
OBJECTIVE: To describe the authors' experience and comparative results after introducing noncardiac fellowship-trained anesthesiologists to a service previously managed by fellowship-trained cardiac anesthesiologists caring for left ventricular assist device (LVAD) patients undergoing low-risk noncardiac procedures with anesthesia. DESIGN: A retrospective chart review. SETTING: Single-site academic medical center in the United States. INTERVENTIONS: Anesthesia and intraoperative therapy...
February 12, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29556880/critical-care-management-of-peritonitis-in-a-low-resource-setting
#13
Jennifer Rickard, Christian Ngarambe, Leonard Ndayizeye, Blair Smart, Robert Riviello, Jean Paul Majyambere
BACKGROUND: Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS: Data were collected at a tertiary referral hospital in Rwanda on patients undergoing operation for peritonitis over a 6-month period. Data included epidemiology, hospital course and outcomes...
March 19, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29521264/application-of-eras-enhanced-recovery-after-surgery-and-laparoscopic-surgery-in-the-management-of-patients-with-bladder-cancer
#14
Rafael Uña Orejón, Estrella Mateo Torres, Iván Huercio Martínez, Cristina Jofré Escudero, Juan Gómez Rivas, Jesús Díez Sebastián, Maria Prado Ureta Tolsada
OBJECTIVE: The enhanced recovery after surgery program (ERAS) has become the base of perioperative management in various surgical specialties. However, limited data are available for radical cystectomy. METHODS: We have analyzed 124 patients undergoing radical cystectomy. For retrospective analysis, the patients were divided into two groups:Group A (n=72) included patients whose surgery was performed before the introduction of the ERAS protocol; and Group B (n=52) included patients who were treated following the items included in the ERAS protocol...
March 2018: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/29492547/are-slow-waves-of-intracranial-pressure-suppressed-by-general-anaesthesia
#15
Despina Afroditi Lalou, Marek Czosnyka, Joseph Donnelly, Andrea Lavinio, John D Pickard, Matthew Garnett, Zofia Czosnyka
OBJECTIVES: Slow waves of intracranial pressure (ICP) are spontaneous oscillations with a frequency of 0.3-4 cycles/min. They are often associated with pathological conditions, following vasomotor activity in the cranial enclosure. This study quantifies the effects of general anaesthesia (GA) on the magnitude of B-waves compared with natural sleep and the conscious state. MATERIALS AND METHODS: Four groups of 30 patients each were formed to assess the magnitude of slow waves...
2018: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/29474273/damage-control-resuscitation-in-pediatric-trauma
#16
Meghan Gilley, Suzanne Beno
PURPOSE OF REVIEW: Damage control resuscitation is an overall management strategy used in trauma patients to rapidly restore physiologic stability, while mitigating hypothermia, coagulopathy and acidosis. We review the evidence and current practice of damage control resuscitation in pediatric trauma patients with a specific focus on fluid management. RECENT FINDINGS: There have been a number of studies over the last several years examining crystalloid fluid resuscitation, balanced blood product transfusion practice and hemostatic agents in pediatric trauma...
February 22, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29468335/use-of-speckle-tracking-strain-in-preload-dependent-patients-need-for-cautious-interpretation
#17
C Nafati, M Gardette, M Leone, L Reydellet, V Blasco, A Lannelongue, F Sayagh, S Wiramus, F Antonini, J Albanèse, L Zieleskiewicz
BACKGROUND: In critical patients, left ventricular ejection fraction and fractional shortening are used to reflect left ventricular systolic function. An emerging technique, two-dimensional-strain echocardiography, allows assessment of the left ventricle systolic longitudinal deformation (global longitudinal strain) and the speed at which this deformation occurs (systolic strain rate). This technique is of increasing use in critical patients in intensive care units and in the peri-operative period where preload constantly varies...
February 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29468069/utility-of-sofa-score-management-and-outcomes-of-sepsis-in-southeast-asia-a-multinational-multicenter-prospective-observational-study
#18
Khie Chen Lie, Chuen-Yen Lau, Nguyen Van Vinh Chau, T Eoin West, Direk Limmathurotsakul
Background: Sepsis is a global threat but insufficiently studied in Southeast Asia. The objective was to evaluate management, outcomes, adherence to sepsis bundles, and mortality prediction of maximum Sequential Organ Failure Assessment (SOFA) scores in patients with community-acquired sepsis in Southeast Asia. Methods: We prospectively recruited hospitalized adults within 24 h of admission with community-acquired infection at nine public hospitals in Indonesia ( n  = 3), Thailand ( n  = 3), and Vietnam ( n  = 3)...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29458908/is-pregnancy-associated-plasma-protein-a-papp-a-a-marker-for-adverse-perinatal-outcomes-in-preterm-isolated-oligohydramnios-cases
#19
Gulten Ozgen, Burcu Dincgez Cakmak, Betul Dundar, Fatma Nurgul Tasgoz, Feyza Bayram, Burak Karadag
OBJECTIVE: Isolated oligohydramnios is defined as an amniotic fluid index below five centimeter with no other coexisting condition. There are still controversies about the management and pregnancy outcomes. A marker predicting these is crucial. Low pregnancy associated plasma protein-A levels were reported to be related with adverse pregnancy outcomes. We aimed to determine the role of first trimester pregnancy associated plasma protein-A for poor outcomes in preterm isolated oligohydramnios cases...
February 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29456597/insertion-rates-and-complications-of-central-lines-in-the-uk-population-a-pilot-study
#20
Adrian Vk Wong, Nitin Arora, Olusegun Olusanya, Ben Sharif, Robert M Lundin, A Dhadda, S Clarke, R Siviter, M Argent, Gavin Denton, Anna Dennis, Angela Day, Tamas Szakmany
Background: Central venous catheters are inserted ubiquitously in critical care and have roles in drug administration, fluid management and renal replacement therapy. They are also associated with numerous complications. The true number of central venous catheters inserted per year and the proportion of them associated with complications are unknown in the UK. Methods: We performed a prospective audit at five hospitals, as a feasibility pilot for a larger, nationwide audit...
February 2018: Journal of the Intensive Care Society
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