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https://www.readbyqxmd.com/read/28731651/fluid-balance-and-length-of-mechanical-ventilation-in-children-admitted-to-a-single-pediatric-intensive-care-unit
#1
Solange Vidal, Augusto Pérez, Pablo Eulmesekian
INTRODUCTION: Associations between cumulative fluid balance and a prolonged duration of assisted mechanical ventilation have been described in adults. The aim of this study was to evaluate whether fluid balance in the first 48 hours of assisted mechanical ventilation initiation was associated with a prolonged duration of this process among children in the Pediatric Intensive Care Unit (PICU). METHODS: Retrospective cohort of patients in the PICU of Hospital Italiano de Buenos Aires, between 1/1/2010 and 6/30/2012...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28729329/fluids-in-sepsis-and-septic-shock-fissh-protocol-for-a-pilot-randomised-controlled-trial
#2
Bram Rochwerg, Tina Millen, Peggy Austin, Michelle Zeller, Frédérick D'Aragon, Roman Jaeschke, Marie-Hélène Masse, Sangeeta Mehta, Francois Lamontagne, Maureen Meade, Gordon Guyatt, Deborah J Cook
INTRODUCTION: Observational evidence suggests physiological benefits and lower mortality with lower chloride solutions; however, 0.9% saline remains the most widely used fluid worldwide. Given uncertainty regarding the association of lower chloride on mortality, it is unlikely that practice will change without direct randomised clinical trial (RCT) evidence. This pilot RCT will investigate the feasibility of a large-scale trial directly comparing low chloride with high chloride fluids in patients with septic shock...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28726362/early-hypertension-after-vasopressor-weaning-during-septic-shock-associated-factors-and-prognostic-significance
#3
Rostane Gaci, Jérémie Lemarie, Marie Conrad, Aurélie Cravoisy, Pierre E Bollaert, Sébastien Gibot
BACKGROUND: During septic shock, early development of hypertension after vasopressors weaning seems paradoxical. The aim of this study was to authenticate this empirical observation, identify associated factors and document its prognostic significance. METHODS: We conducted a descriptive, retrospective study in a medical ICU of a teaching hospital among adult patients with septic shock. RESULTS: From 01.01.2013 to 31.12.2014, 262 consecutive patients over 18 years of age were admitted because of septic shock; 195 of them were successfully weaned from vasopressors...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28725564/post-partum-streptococcal-toxic-shock-syndrome-associated-with-necrotizing-fasciitis
#4
Wei Chuan Chua, Mohd Zulfakar Mazlan, Saedah Ali, Sanihah Che Omar, Wan Mohd Nazaruddin Wan Hassan, S Praveena Seevaunnantum, Rhendra Hardy Mohd Zaini, Mohd Hasyizan Hassan, Alwi Muhd Besari, Zaidah Abd Rahman, Zeti Norfidiyati Salmuna Ayub, Sabrina Abd Ghani, Normalinda Yaacob, Wan Rosilawati Wan Rosli
We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Subsequently, she was treated for necrotizing fasciitis, complicated by septicemic shock and multiple organ failures...
2017: IDCases
https://www.readbyqxmd.com/read/28710197/cervical-shock-a-complication-of-incomplete-abortion
#5
Julian David Birch, Divyansh Gulati, Sachin Mandalia
A case of a 37-year-old female primagravida who attended the emergency department (ED) via ambulance in hypotensive shock. She was 10 weeks pregnant, but had an inevitable miscarriage confirmed in the local Early Pregnancy Unit 3 weeks previously. She was hypotension (90/60 mm Hg), bradycardic (45 bpm) and was peripherally shut down. A provisional diagnosis of haemorrhagic shock was made, but despite intravenous fluid challenges, she appeared to be deteriorating, so a major haemorrhage protocol was activated...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28709201/electrohydrodynamic-instability-of-ion-concentration-shock-wave-in-electrophoresis
#6
Rahul Gaur, Supreet Singh Bahga
Capillary electrophoresis techniques often involve ion-concentration shock waves in an electrolyte solution, propagating under the effect of an external electric field. These shock waves are characterized by self-sharpening gradients in ion concentrations and electrical conductivity that are collinear with the electric field. The coupling of electric field and fluid motion at the shock interface sometimes leads to an undesirable electrohydrodynamic (EHD) instability. Using linear stability analysis, we describe the motion of small-amplitude disturbances of an electrophoretic shock wave...
June 2017: Physical Review. E
https://www.readbyqxmd.com/read/28709157/hypotensive-resuscitation-with-hypertonic-saline-dextran-improves-survival-in-a-rat-model-of-hemorrhagic-shock-at-high-altitude
#7
Jingxiang Zhao, Guoxing You, Bo Wang, Zhenwei Sun, Zhen Wang, Sha Xia, Lian Zhao, Hong Zhou
OBJECTIVE: To compare the efficacy of hypotensive resuscitation with hypertonic saline dextran 70 (HSD) and lactated Ringer (LR) solutions in a rat model of hemorrhagic shock at a simulated altitude of 4,000 m. METHODS: Anesthetized rats were bled to maintain their mean arterial pressure (MAP) at 45 mm Hg for 1 h. The distal quarter of the tail was then amputated to allow free blood loss; rats were simultaneously resuscitated with 4 mL kg HSD (HSD group, n = 10) or 4 mL kg LR (LR group, n = 10), followed by hypotensive resuscitation with LR to maintain MAP at 55 to 60 mm Hg for 1 h...
August 2017: Shock
https://www.readbyqxmd.com/read/28692675/cardio-haemodynamic-assessment-and-venous-lactate-in-severe-dengue-relationship-with-recurrent-shock-and-respiratory-distress
#8
Sophie Yacoub, Trieu Huynh Trung, Phung Khanh Lam, Vuong Huynh Ngoc Thien, Duong Ha Thi Hai, Tu Qui Phan, Oanh Pham Kieu Nguyet, Nguyen Than Ha Quyen, Cameron Paul Simmons, Christopher Broyd, Gavin Robert Screaton, Bridget Wills
BACKGROUND: Dengue can cause plasma leakage that may lead to dengue shock syndrome (DSS). In approximately 30% of DSS cases, recurrent episodes of shock occur. These patients have a higher risk of fluid overload, respiratory distress and poor outcomes. We investigated the association of echocardiographically-derived cardiac function and intravascular volume parameters plus lactate levels, with the outcomes of recurrent shock and respiratory distress in severe dengue. METHODS/PRINCIPLE FINDINGS: We performed a prospective observational study in Paediatric and adult ICU, at the Hospital for Tropical Diseases (HTD), Ho Chi Minh City, Vietnam...
July 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28688729/cellular-mechanosensing-of-the-biophysical-microenvironment-a-review-of-mathematical-models-of-biophysical-regulation-of-cell-responses
#9
REVIEW
Bo Cheng, Min Lin, Guoyou Huang, Yuhui Li, Baohua Ji, Guy M Genin, Vikram S Deshpande, Tian Jian Lu, Feng Xu
Cells in vivo reside within complex microenvironments composed of both biochemical and biophysical cues. The dynamic feedback between cells and their microenvironments hinges upon biophysical cues that regulate critical cellular behaviors. Understanding this regulation from sensing to reaction to feedback is therefore critical, and a large effort is afoot to identify and mathematically model the fundamental mechanobiological mechanisms underlying this regulation. This review provides a critical perspective on recent progress in mathematical models for the responses of cells to the biophysical cues in their microenvironments, including dynamic strain, osmotic shock, fluid shear stress, mechanical force, matrix rigidity, porosity, and matrix shape...
June 21, 2017: Physics of Life Reviews
https://www.readbyqxmd.com/read/28685464/hemoglobin-based-oxygen-carrier-hboc-development-in-trauma-previous-regulatory-challenges-lessons-learned-and-a-path-forward
#10
Peter E Keipert
Historically, hemoglobin-based oxygen carriers (HBOCs) were being developed as "blood substitutes," despite their transient circulatory half-life (~ 24 h) vs. transfused red blood cells (RBCs). More recently, HBOC commercial development focused on "oxygen therapeutic" indications to provide a temporary oxygenation bridge until medical or surgical interventions (including RBC transfusion, if required) can be initiated. This included the early trauma trials with HemAssist (®) (BAXTER), Hemopure (®) (BIOPURE) and PolyHeme (®) (NORTHFIELD) for resuscitating hypotensive shock...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28680501/methods-of-hearing-preservation-during-cochlear-implantation
#11
REVIEW
Ahmed Khater, Mohammad Waheed El-Anwar
Introduction  Recent advances in surgical techniques and electrode design have made residual hearing preservation during cochlear implantation (CI) possible, achievable, and desirable. Objectives  The objective of this study was to review the literature regarding methods used for hearing preservation during CI surgery. Data Synthesis  We performed a search in the LILACS, MEDLINE, SciELO, PubMed databases, and Cochrane Library, using the keywords CI, hearing preservation, CI electrode design, and CI soft surgery...
July 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/28679464/linoleic-la-and-linolenic-ala-acid-concentrations-in-follicular-fluid-of-prepubertal-goats-and-their-effect-on-oocyte-in-vitro-maturation-and-embryo-development
#12
Montserrat Roura, María G Catalá, Sandra Soto-Heras, Sondes Hammami, Dolors Izquierdo, Ali Fouladi-Nashta, Maria-Teresa Paramio
In this study we assessed the concentration of linoleic acid (LA) and linolenic acid (ALA) in follicular fluid of prepubertal goats according to follicle size (<3mm or ≥3mm) by gas chromatography and tested the addition of different LA and ALA (LA:ALA) concentration ratios (50:50, 100:50 and 200:50µM) to the IVM medium on embryo development, mitochondrial activity, ATP concentration and relative gene expression (RPL19, ribosomal protein L19; SLC2A1, facilitated glucose transporter 1; ATF4, activating transcription factor 4; GPX1, glutathione peroxidase 1; HSPA5, heat-shock protein family A 70 kDa; GAPDH, glyceraldehyde-3-phosphate dehydrogenase; DNMT1, DNA methyltransferase 1; GCLC, glutamate-cysteine ligase catalytic subunit; SOD1, superoxide dismutase 1)...
July 6, 2017: Reproduction, Fertility, and Development
https://www.readbyqxmd.com/read/28678921/identification-of-ige-and-igg1-specific-antigens-in-echinococcus-granulosus-cyst-fluid
#13
S Li, R Qian, S Wang, J Ye, H Zheng
Cystic echinococcosis (CE) is an anthropozoonotic disease with worldwide distribution and is caused by the cestode Echinococcus granulosus. Anaphylactic shock induced by CE rupture is a serious complication especially in patients with hydatid infections, as the resulting leakage of fluid contains highly toxic endogenous antigen. We aimed to isolate and identify the antigens of specific IgE and IgG1 (sIgE and sIgG1) in E. granulosus cyst fluid (EgCF). Crude antigen for EgCF was prepared from E. granulosus-infected sheep liver...
July 3, 2017: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/28677812/alanyl%C3%A2-glutamine-prophylactically-protects-against-lipopolysaccharide%C3%A2-induced-acute-lung-injury-by-enhancing-the-expression-of-hsp70
#14
Haitang Wang, Yinv Dong, Yehua Cai
At present, the timing of glutamine administration remains controversial. The aim of the present study was to confirm the early protective mechanisms of alanyl‑glutamine (Ala‑Gln) against lipopolysaccharide (LPS)‑induced lung injury, as well as to detect the best time for Ala‑Gln usage. A total of 60 adult Wistar rats were randomly divided into 6 groups: The control group (C), the LPS‑induced shock group (LPS), the pre‑Ala‑Gln treated group (A1) and the pre‑Gln treated group (G1), which separately received 4...
June 30, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28673224/fluid-resuscitation-in-critically-ill-patients-timing-and-dose-matters
#15
K Lall, G Roberts, U Buehner
Fluid management is a complex subject in healthcare, particularly when pertaining to critically ill patients. Following a literature search on international recommendations regarding fluid administration for shocked patients, an audit was undertaken at Rotorua Public Hospital, New Zealand, to assess how the local fluid resuscitation strategy could be improved. The first part of the audit looked at the fluid resuscitation approach used to treat shocked patients admitted to the ICU of Rotorua Hospital in 2014 and changes required to achieve best practice recommendations...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28672146/stroke-volume-guided-resuscitation-in-severe-sepsis-and-septic-shock-improves-outcomes
#16
Heath E Latham, Charles D Bengtson, Lewis Satterwhite, Mindy Stites, Dipti P Subramaniam, G John Chen, Steven Q Simpson
To determine whether stroke volume (SV) guided fluid resuscitation in patients with severe sepsis and septic shock alters Intensive Care Unit (ICU) fluid balance and secondary outcomes, this retrospective cohort study evaluated consecutive patients admitted to an ICU with the primary diagnosis of severe sepsis or septic shock. Cohorts were based on fluid resuscitation guided by changes in SV or by usual care (UC). The SV group comprised 100 patients, with 91 patients in the UC group. Net fluid balance for the ICU stay was lower in the SV group (1...
June 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28671898/patterns-and-outcomes-associated-with-timeliness-of-initial-crystalloid-resuscitation-in-a-prospective-sepsis-and-septic-shock-cohort
#17
Daniel E Leisman, Chananya Goldman, Martin E Doerfler, Kevin D Masick, Susan Dries, Eric Hamilton, Mangala Narasimhan, Gulrukh Zaidi, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The objectives of this study were to 1) assess patterns of early crystalloid resuscitation provided to sepsis and septic shock patients at initial presentation and 2) determine the association between time to initial crystalloid resuscitation with hospital mortality, mechanical ventilation, ICU utilization, and length of stay. DESIGN: Consecutive-sample observational cohort. SETTING: Nine tertiary and community hospitals over 1...
June 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28670061/thoracentesis-reverting-cardiac-tamponade-physiology-in-a-patient-with-myxedema-coma-and-large-pleural-effusion
#18
Monia E Werlang, Mario R Pimentel, Jose L Diaz-Gomez
A large pleural effusion causing cardiac tamponade physiology and severe hemodynamic compromise is an uncommon event. We report a case of a 53-year-old woman with severe hypothyroidism presenting with myxedema coma and refractory shock. Her hemodynamic status failed to respond to fluid resuscitation and vasopressors. A transthoracic echocardiogram and chest radiograph demonstrated a pericardial fluid accumulation associated with a large left-sided pleural effusion. Thoracostomy tube insertion resulted in prompt improvement of the patient's hemodynamic status...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28655385/no-impact-of-surviving-sepsis-campaign-care-bundles-in-reducing-sepsis-associated-acute-kidney-injury%C3%A2
#19
Xosé Pérez-Fernández, Joan Sabater-Riera, Josep Ballus-Noguera, Paola Cárdenas-Campos, Gabriel Moreno-González, Virginia Alonso-Juste, Vicente Corral-Velez, Diana Gutierrez-Arámbula, Victor Gumucio-Sanguino, Antoni Betbesé-Roig, Kathleen D Liu
BACKGROUND: The impact of Surviving Sepsis Campaign (SSC) care bundles in reducing sepsis-associated acute kidney injury (SA-AKI) was evaluated. METHODS: We conducted an observational single-center cohort study. Accomplishment of SSC care bundles was registered in all patients with severe sepsis admitted to the critical care department of a university hospital during three different periods. The main outcome measured was SA-AKI incidence defined as any worsening of AKI stage within the first 7 days from onset of sepsis...
June 28, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28653239/adapted-eras-pathway-vs-standard-care-in-patients-with-perforated-duodenal-ulcer-a-randomized-controlled-trial
#20
Subair Mohsina, Dasarathan Shanmugam, Sathasivam Sureshkumar, Pankaj Kundra, T Mahalakshmy, Vikram Kate
OBJECTIVES: The objective of this study was to evaluate the feasibility and efficacy of ERAS pathways in patients undergoing emergency simple closure of perforated duodenal ulcer (PDU). METHODS: This single-center, prospective, open-labeled, superiority, RCT was carried out from August 2014 to July 2016. Patients of PDU undergoing open simple closure were randomized preoperatively in 1:1 ratio into standard care and adapted ERAS group. Patients with refractory shock, ASA class ≥3, and perforation size ≥1 cm were excluded...
June 26, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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