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Patient Temperature Management

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https://www.readbyqxmd.com/read/28099439/single-versus-serial-measurements-of-neuron-specific-enolase-and-prediction-of-poor-neurological-outcome-in-persistently-unconscious-patients-after-out-of-hospital-cardiac-arrest-a-ttm-trial-substudy
#1
Sebastian Wiberg, Christian Hassager, Pascal Stammet, Matilde Winther-Jensen, Jakob Hartvig Thomsen, David Erlinge, Michael Wanscher, Niklas Nielsen, Tommaso Pellis, Anders Åneman, Hans Friberg, Jan Hovdenes, Janneke Horn, Jørn Wetterslev, John Bro-Jeppesen, Matthew P Wise, Michael Kuiper, Tobias Cronberg, Yvan Gasche, Yvan Devaux, Jesper Kjaergaard
BACKGROUND: Prediction of neurological outcome is a crucial part of post cardiac arrest care and prediction in patients remaining unconscious and/or sedated after rewarming from targeted temperature management (TTM) remains difficult. Current guidelines suggest the use of serial measurements of the biomarker neuron-specific enolase (NSE) in combination with other predictors of outcome in patients admitted after out-of-hospital cardiac arrest (OHCA). This study sought to investigate the ability of NSE to predict poor outcome in patients remaining unconscious at day three after OHCA...
2017: PloS One
https://www.readbyqxmd.com/read/28099287/anesthetic-outcomes-of-children-with-arthrogryposis-syndromes-no-evidence-of-hyperthermia
#2
Stephen J Gleich, Michael Tien, Darrell R Schroeder, Andrew C Hanson, Randall Flick, Michael E Nemergut
BACKGROUND: Arthrogryposis syndromes are a heterogeneous group of disorders characterized by congenital joint contractures often requiring multiple surgeries during childhood to address skeletal and visceral abnormalities. Previous reports suggest that these children have increased perioperative risk, including hypermetabolic events discrete from malignant hyperthermia, difficult airway management, isolated hyperthermia, and difficult IV line placement. We sought to compare children with arthrogryposis multiplex congenita (AMC) versus the less severe, distal arthrogryposis syndromes (DAS) and to evaluate possible intraoperative hyperthermia of patients with AMC...
January 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28096576/role-of-edaravone-in-managemant-of-septic-peritonitis
#3
Ghada Fouad Elbaradey, Nagat Sayed Elshmaa, Hossam Hodeib
BACKGROUND AND AIMS: Sepsis is a complex rapidly progressive infectious disease that remain a major cause of morbidity and mortality in surgical patients and trauma victims. Edaravone a novel free radical scavenger was approved in 2001 in Japan for treatment of acute cerebral and myocardial infarction. Hence, in this work we attempt to evaluate its role in cases of septic peritonitis (SP). MATERIAL AND METHODS: This is a prospective randomized observer-blinded study carried out in surgical Intensive Care Unit (ICU) after approval by Hospital Ethical Committee...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28091756/-recommendation-on-temperature-management-after-cardiopulmonary-arrest-and-severe-traumatic-brain-injury-in-childhood-beyond-the-neonatal-period-statement-of-the-german-society-for-neonatology-and-pediatric-intensive-care-medicine%C3%A2-gnpi-and-the-scientific-working
#4
S Brenner, C Eich, G Rellensmann, M U Schuhmann, T Nicolai, F Hoffmann
The available data on the effectiveness of therapeutic hypothermia in different patient groups are heterogeneous. Although the benefits have been proven for some collectives, recommendations for the use of hypothermia treatment in other groups are based on less robust data and conclusions by analogy. This article gives a review of the current evidence of temperature management in all age groups and based on this state of knowledge, recommends active temperature management with the primary aim of strict normothermia (36-36...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28077534/reduced-mortality-by-meeting-guideline-criteria-before-using-recombinant-activated-factor-vii-in-severe-trauma-patients-with-massive-bleeding
#5
J-F Payen, M Berthet, C Genty, P Declety, D Garrigue-Huet, N Morel, P Bouzat, B Riou, J-L Bosson
BACKGROUND: Management of trauma patients with severe bleeding has led to criteria before considering use of recombinant activated factor VII (rFVIIa), including haemoglobin >8 g dl(-1), serum fibrinogen ≥1.0 g l(-1), platelets >50,000 x 10(9) l(-1), arterial pH ≥ 7.20, and body temperature ≥34 °C. We hypothesized that meeting these criteria is associated with improved outcomes. METHODS: In this prospective cohort study of 26 French trauma centres, subjects were included if they received rFVIIa for persistent massive bleeding despite appropriate care after severe blunt and/or penetrating trauma...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28072664/clinical-pathway-effectiveness-febrile-young-infant-clinical-pathway-in-a-pediatric-emergency-department
#6
Ashlee Lynn Murray, Elizabeth Alpern, Jane Lavelle, Cynthia Mollen
OBJECTIVE: Young infants are often treated in emergency departments (EDs) for febrile illnesses. Any delay in care or ineffective management could lead to increased patient morbidity and mortality. A standardized ED clinical pathway may improve care for these patients. The objective of this study is to evaluate the impact of a febrile young infant clinical pathway implemented in a large, urban children's hospital ED on the timeliness and consistency of care. METHODS: This study used a before-and-after retrospective observational study design comparing 2 separate periods: prepathway from September 2007 through August 2008 and postpathway from September 2009 through August 2010...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28071865/the-impact-of-evidence-based-sepsis-guidelines-on-emergency-department-clinical-practice-a-pre-post-medical-record-audit
#7
Bernadine Romero, Margaret Fry, Michael Roche
AIMS AND OBJECTIVES: The aim of this study was to explore the number of patients presenting with sepsis before and after guideline implementation; the impact of sepsis guidelines on triage assessment, Emergency Department management and time to antibiotics. BACKGROUND: Sepsis remains one of the leading causes of mortality and morbidity within hospitals. Globally, strategies have been implemented to reduce morbidity and mortality rates, which rely on the early recognition and management of sepsis...
January 10, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28057990/predictors-of-systemic-inflammatory-response-syndrome-following-percutaneous-nephrolithotomy
#8
Karunamoorthy Ramaraju, Arun Kumar Paranjothi, Dhinakar Babu Namperumalsamy, Ilamparuthi Chennakrishnan
INTRODUCTION AND OBJECTIVES: Sepsis remains one of the dreaded complications of percutaneous nephrolithotomy (PCNL). To analyze prospectively the preoperative and intraoperative factors that predict the occurrence of systemic inflammatory response syndrome (SIRS) in patients undergoing PCNL so that we can aggressively manage those patients from the preoperative period itself and avert the dangerous complications. MATERIALS AND METHODS: A prospective study was carried out between August 2012 and March 2013 including all patients who underwent PCNL...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28046040/impact-of-pre-analytical-time-on-the-recovery-of-pathogens-from-blood-cultures-results-from-a-large-retrospective-survey
#9
Claudia Venturelli, Elena Righi, Lucia Borsari, Gabriella Aggazzotti, Stefano Busani, Cristina Mussini, Fabio Rumpianesi, Gian Maria Rossolini, Massimo Girardis
BACKGROUND: Prompt identification of bloodstream pathogens is essential for optimal management of patients. Significant changes in analytical methods have improved the turnaround time for laboratory diagnosis. Less attention has been paid to the time elapsing from blood collection to incubation and to its potential effect on recovery of pathogens. We evaluated the performance of blood cultures collected under typical hospital conditions in relation to the length of their pre-analytical time...
2017: PloS One
https://www.readbyqxmd.com/read/28027250/important-developments-in-burn-care
#10
Kevin J Zuo, Abelardo Medina, Edward E Tredget
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Explain the epidemiology of severe burn injury in the context of socioeconomic status, gender, age, and burn cause. 2. Describe challenges with burn depth evaluation and novel methods of adjunctive assessment. 3. Summarize the survival and functional outcomes of severe burn injury. 4. State strategies of fluid resuscitation, endpoints to guide fluid titration, and sequelae of overresuscitation. 5. Recognize preventative measures of sepsis...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28024548/canadian-cardiovascular-society-canadian-cardiovascular-critical-care-society-canadian-association-of-interventional-cardiology-position-statement-on-the-optimal-care-of-the-postarrest-patient
#11
Graham C Wong, Sean van Diepen, Craig Ainsworth, Rakesh C Arora, Jean G Diodati, Mark Liszkowski, Michael Love, Chris Overgaard, Greg Schnell, Jean-Francois Tanguay, George Wells, Michel Le May
Out of hospital cardiac arrest (OHCA) is associated with a low rate of survival to hospital discharge and high rates of neurological morbidity among survivors. Programmatic efforts to institute and integrate OHCA best care practices from the bystander response through to the in-hospital phase have been associated with improved patient outcomes. This Canadian Cardiovascular Society position statement was developed to provide comprehensive yet practical recommendations to guide the in-hospital care of OHCA patients...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28018093/clinico-radiological-improvement-in-an-immunocompetent-patient-presented-with-scedosporium-apiospermum-osteomyelitis
#12
Rahul Mohan, T S Gopakumar
Scedosporium apiospermum is frequently found as a saprophyte in soil, sewage and contaminated water. Its manifestations in immunocompetent patients are usually localised and in immunodeficient patients, it causes invasive systemic diseases. We are reporting the case of a 40-year-old male, who presented with pain, oedema and multiple discharging sinuses over the lateral aspect of the left foot with history of thorn prick. On examination, there were multiple active sinuses with tenderness and local rise in temperature...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28017681/exposure-to-short-photoperiod-regime-reduces-ventral-subicular-lesion-induced-anxiety-like-behavior-in-wistar-rats
#13
Duttagupta Subhadeep, B N Srikumar, B S Shankaranarayana Rao, Bindu M Kutty
Neurodegeneration of hippocampal structures is implicated in Alzheimer's disease (AD). Patients with AD exhibit 'sundown syndrome' featuring mood swings and anxiety. Although there are studies demonstrating circadian rhythm disruption associated with sundown phenomenon, the mechanisms underlying the emotional disturbances remain elusive. In the present study, we examined the relationship between subiculum (a key hippocampal output structure) and anxiety. Our study demonstrates that bilateral ventral subicular lesion (VSL) leads to anxiogenic behavior...
December 23, 2016: Physiology & Behavior
https://www.readbyqxmd.com/read/28011672/inflamed-human-carotid-plaques-evaluated-by-pet-ct-exhibit-increased-temperature-insights-from-an-in-vivo-study
#14
Konstantinos Toutouzas, Iosif Koutagiar, Georgios Benetos, Constantina Aggeli, Alexandros Georgakopoulos, Emmanouil Athanasiadis, Nikoletta Pianou, Sofoklis Trachanellis, Nikolaos Patelis, George Agrogiannis, Pavlos Kafouris, Konstantinos Filis, Nikolaos Bessias, Christos Klonaris, George Spyrou, Eleftherios Tsiamis, Elias Siores, Efstratios Patsouris, Dennis Cokkinos, Dimitrios Tousoulis, Constantinos D Anagnostopoulos
AIMS: To explore the relationship between temperature measurements derived by microwave radiometry (MWR) and carotid flurodeoxyglucose (FDG) uptake and assess their association with histological and immunohistochemistry findings in patients with high-grade carotid stenosis. METHODS AND RESULTS: In 21 patients undergoing carotid endarterectomy, carotid inflammation was evaluated by both FDG positron emission/computed tomography (FDG-PET/CT) imaging and MWR measurements...
December 23, 2016: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28009772/acute-kidney-injury-following-exploratory-laparotomy-and-temporary-abdominal-closure
#15
Tyler J Loftus, Azra Bihorac, Tezcan Ozrazgat-Baslanti, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: Acute kidney injury (AKI) following exploratory laparotomy and temporary abdominal closure (TAC) is poorly understood but clinically significant. We hypothesized that the prevalence of AKI would be highest 96 hours following TAC, early hypoxemia would predict AKI, and that AKI would be an independent predictor of mortality. METHODS: We performed a retrospective analysis of 251 acute care surgery patients managed with TAC by negative pressure wound therapy (NPWT)...
December 22, 2016: Shock
https://www.readbyqxmd.com/read/27993840/simultaneous-determination-of-valproic-acid-and-its-major-metabolites-by-uhplc-ms-ms-in-chinese-patients-application-to-therapeutic-drug-monitoring
#16
Mingming Zhao, Ti Zhang, Guofei Li, Feng Qiu, Yaxin Sun, Limei Zhao
A specific and sensitive Ultra-high Performance Liquid Chromatography-tandem Mass spectrometry (UHPLC-MS/MS) method was developed for the simultaneous determination of the concentrations of valproic acid (VPA) and its clinically relevant metabolites (4-ene-VPA, 2,4-diene-VPA and 2-ene-VPA) in human serum. After solid-phase extraction, VPA, its metabolites and the internal standard were subjected to chromatographic separation by gradient elution of acetonitrile and 10 mM ammonium acetate as mobile phase at a flow rate of 0...
December 19, 2016: Journal of Chromatographic Science
https://www.readbyqxmd.com/read/27993631/infectious-complications-after-out-of-hospital-cardiac-arrest-a-comparison-between-two-target-temperatures
#17
Josef Dankiewicz, Niklas Nielsen, Adam Linder, Michael Kuiper, Matthew P Wise, Tobias Cronberg, David Erlinge, Yvan Gasche, Matthew B Harmon, Christian Hassager, Janneke Horn, Jesper Kjaergaard, Tommaso Pellis, Pascal Stammet, Johan Undén, Michael Wanscher, Jørn Wetterslev, Anders Åneman, Susann Ullén, Nicole P Juffermans, Hans Friberg
BACKGROUND: It has been suggested that target temperature management (TTM) increases the probability of infectious complications after cardiac arrest. We aimed to compare the incidence of pneumonia, severe sepsis and septic shock after out-of-hospital cardiac arrest (OHCA) in patients with two target temperatures and to describe changes in biomarkers and possible mortality associated with these infectious complications. METHODS: Post-Hoc analysis of the TTM-trial which randomized patients resuscitated from OHCA to a target temperature of 33 °C or 36 °C...
December 16, 2016: Resuscitation
https://www.readbyqxmd.com/read/27988254/targeted-temperature-management-after-cardiac-arrest-with-anaphylaxis
#18
Woon Jeong Lee, Dae Hee Kim, Seon Hee Woo, Seung Hwan Seol, Seung Pill Choi
Fatal anaphylaxis is uncommon but not rare. Extrapolated mortality rates are 0.52% of total anaphylaxis patients Bock et al. (Jan. 2001) [1]. Nevertheless, compared with the incidence of the other cardiac arrest events, the incidence of cardiac arrest due to anaphylaxis is relatively small. As a result, the effect using targeted temperature management after anaphylaxis is not clearly understood. We report the case of a 63-year-old man who developed cardiac arrest after ingestion of two pieces of peach. He was resuscitated and his circulation returned spontaneously after approximately 11min of cardiopulmonary resuscitation, but he was unresponsive and had fixed dilated pupils...
December 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27987398/relationship-between-timing-of-cooling-and-outcomes-in-adult-comatose-cardiac-arrest-patients-treated-with-targeted-temperature-management
#19
Byung Kook Lee, Kyung Woon Jeung, Yong Hun Jung, Dong Hun Lee, Sung Min Lee, Yong Soo Cho, Tag Heo, Jong Geun Yun, Yong Il Min
AIM OF THE STUDY: Studies examining associations between time to target temperature and outcomes in cardiac arrest patients who underwent targeted temperature management (TTM) have shown inconsistent results. We examined these associations separately for time from restoration of spontaneous circulation to TTM initiation (pre-induction time) and time from TTM initiation to target temperature (induction time). Furthermore, we examined whether critical time thresholds exist if there is an association...
December 14, 2016: Resuscitation
https://www.readbyqxmd.com/read/27982758/burst-suppression-in-hypothermia-after-cardiac-arrest-because-of-drowning-treated-with-targeted-temperature-management-a-case-report
#20
Tomoya Okazaki, Toru Hifumi, Satoshi Egawa, Hideyuki Hamaya, Natsuyo Shinohara, Shohei Kawamoto, Takuma Iwaki, Kohei Tsukahara, Kenya Kawakita, Takashi Kusaka, Yasuhiro Kuroda
Outcomes of cardiac arrest (CA) because of drowning in children are generally poor, but some reports show that cases with post-CA hypothermia because of drowning exhibit good recovery when treated with targeted temperature management (TTM). However, because electroencephalogram (EEG) findings are not reported in those cases, a complete examination of brain damage has not been performed during TTM. Here we report a case of a 15-month-old boy with post-CA hypothermia recovery after treating with TTM, along with EEG findings...
December 16, 2016: Therapeutic Hypothermia and Temperature Management
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