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https://www.readbyqxmd.com/read/28315119/alterations-of-mg-2-after-hemorrhagic-shock
#1
Mun-Young Lee, Dong Kwon Yang, Shang-Jin Kim
Hemorrhagic shock is generally characterized by hemodynamic instability with cellular hypoxia and diminishing cellular function, resulting from an imbalance between systemic oxygen delivery and consumption and redistribution of fluid and electrolytes. Magnesium (Mg) is the fourth most abundant cation overall and second most abundant intracellular cation in the body and an essential cofactor for the energy production and cellular metabolism. Data for blood total Mg (tMg; free-ionized, protein-bound, and anion-bound forms) and free Mg(2+) levels after a traumatic injury are inconsistent and only limited information is available on hemorrhagic effects on free Mg(2+) as the physiologically active form...
March 17, 2017: Biological Trace Element Research
https://www.readbyqxmd.com/read/28314673/can-we-perform-rotational-atherectomy-in-patients-with-severe-aortic-stenosis-substudy-from-the-ocean-tavi-registry
#2
Toru Naganuma, Hiroyoshi Kawamoto, Kensuke Takagi, Hiroto Yabushita, Satoru Mitomo, Yusuke Watanabe, Shinichi Shirai, Motoharu Araki, Norio Tada, Futoshi Yamanaka, Masanori Yamamoto, Hirokazu Onishi, Sunao Nakamura, Akihiro Higashimori, Minoru Tabata, Kazuki Mizutani, Hiroshi Ueno, Kentaro Hayashida
PURPOSE: The aim of this study was to report the safety of coronary rotational atherectomy (RA) in patients with severe aortic stenosis (AS). RA in the clinical setting seems challenging because coronary slow flow leads to hemodynamic instability. METHODS: Between October 2013 and May 2016, 1401 patients in the Optimized transCathEter vAlvular iNtervention (OCEAN) registry in Japan underwent transcatheter aortic valve implantation (TAVI). The primary study endpoint was procedural success, defined as residual stenosis <20% with final Thrombolysis in Myocardial Infarction flow 3...
February 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28306583/successful-resuscitation-following-massive-obstetric-hemorrhage-in-a-patient-of-the-jehovah-s-witness-faith-a-case-report
#3
Richard M Hubbard, Jonathan H Waters, Mark H Yazer
Hemorrhage is a leading cause of maternal morbidity and mortality worldwide. It is especially difficult to treat in patients of the Jehovah's Witness faith because they refuse certain blood products. This case report describes the resuscitation of a parturient Jehovah's Witness whose postcesarean delivery course was complicated by massive hemorrhage from unrecognized arterial bleeding in the intensive care unit with significant hemodynamic instability that necessitated an emergency bedside laparotomy. Her hemoglobin nadir was 1...
March 16, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28302642/pregnancy-and-the-risk-of-spontaneous-coronary-artery-dissection-an-analysis-of-120-contemporary-cases
#4
Ofer Havakuk, Sorel Goland, Anil Mehra, Uri Elkayam
BACKGROUND: Because of the rarity of this condition, information on pregnancy-associated spontaneous coronary artery dissection is limited. We reviewed a large number of contemporary pregnancy-associated spontaneous coronary artery dissection cases in an attempt to define the clinical characteristics and provide management recommendations. METHODS AND RESULTS: A literature search for cases of pregnancy-associated spontaneous coronary artery dissection reported between 2000 and 2015 included 120 cases; 75% presented with ST-segment-elevation myocardial infarction, and 80% had anterior myocardial infarction...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28299219/spontaneous-rupture-of-pyometra-in-a-nonpregnant-young-woman
#5
Parvin Mostafa-Gharabaghi, Shima Bordbar, Shabnam Vazifekhah, Mohammad Naghavi-Behzad
A 40-year-old woman presented with severe vaginal bleeding. Initial workup with an abdominal sonography revealed endometrium for about 3 mm and free fluid in the abdomen. Hemodynamic instability with abdominal pain and free fluid in the abdomen prompted blood transfusion and laparotomy. There were about 1000 cc blood and clots in the abdomen at laparotomy. There was a longitudinal rupture from fundus up to cervix at the left side of the uterus. Tearing was in full thickness from serosa to endometrium. Scar of previous cesarean was transvers and not associated with this tearing...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28299212/hemorrhagic-shock-as-complication-of-intramural-intestinal-bleeding
#6
Asma Ben Ali, Mohamed Ali Cherif, Walid Mhajba, Hamdi Hamdène Doghri, Malek Hassouna, Youssef Zied El Hechmi, Zouheir Jerbi, Ines Ben Hassen, Mohamed Habib Daghfous
Introduction. Mural intestinal hematoma (MIH) is an uncommon complication of anticoagulant therapy. Hemorrhagic shock has been rarely reported as a revealing modality. Results. We report two cases of shock induced by mural intestinal hematoma in patients under oral anticoagulant for aortic prosthetic valve and atrial fibrillation. Patients were admitted to the ICU for gastrointestinal tract bleeding associated with hemodynamic instability. After resuscitation, an abdominal CT scan has confirmed the diagnosis showing an extensive hematoma...
2017: Case Reports in Gastrointestinal Medicine
https://www.readbyqxmd.com/read/28299209/primitive-tumour-of-the-pulmonary-valve-discussion-of-the-differential-diagnosis
#7
A Hannecart, D Ndjekembo-Shango, F Vallot, O Simonet, M De Kock
There is a paucity of information concerning cardiac tumours of the pulmonary valve due to their rarity at this location. We report a case of a 47-year-old patient suffering from haemoptysis, asthenia, and acute kidney injury (AKI). A transthoracic echocardiography (TTE) revealed a mass on the pulmonary valve. Further diagnostic investigation was completed until he exhibited worsening hemodynamic instability. This case emphasizes the lack of information regarding the management of a pulmonary valve tumour.
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#8
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28290648/deep-venous-thrombosis-and-pulmonary-embolism-current-therapy
#9
Jason Wilbur, Brian Shian
Pulmonary embolism and deep venous thrombosis are the two most important manifestations of venous thromboembolism (VTE), which is the third most common life-threatening cardiovascular disease in the United States. Anticoagulation is the mainstay of VTE treatment. Most patients with deep venous thrombosis or low-risk pulmonary embolism can be treated in the outpatient setting with low-molecular-weight heparin and a vitamin K antagonist (warfarin) or direct-acting oral anticoagulants. Inpatient treatment of VTE begins with parenteral agents, preferably low-molecular-weight heparin...
March 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28289896/incidence-and-outcomes-of-acute-kidney-injury-in-patients-with-hepatocellular-carcinoma-after-liver-transplantation
#10
Xiaohong Chen, Xiaoqiang Ding, Bo Shen, Jie Teng, Jianzhou Zou, Ting Wang, Jian Zhou, Nan Chen, Boheng Zhang
PURPOSE: To describe the incidence and outcomes linked with acute kidney injury (AKI) after liver transplantation (LT) in hepatocellular carcinoma (HCC) patients. METHODS: From January 2003 to February 2011, HCC patients undergoing LT were retrospectively enrolled. Patient with a glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) was excluded. AKI was defined and classified according to the AKIN criteria. RESULTS: Of the 566 eligible patients, AKI was found in 109 (19...
March 13, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28284460/the-impact-of-prolonged-waiting-time-for-coronary-care-unit-admission-on-patients-with-non-st-elevation-acute-coronary-syndrome
#11
Chien-Chih Chen, I-Min Chiu, Fu-Jen Cheng, Kuan-Han Wu, Chao-Jui Li
BACKGROUND: The boarding of patients in the emergency department consumes nursing and physician resources, and may delay the evaluation of new patients. It may also contribute to poor cardiovascular outcomes in patients with acute coronary syndrome (ACS). This study analyzed the relationship between the delay in coronary care unit (CCU) admission and the clinical outcomes of patients with ACS with non-ST-segment elevation (NSTE-ACS). METHODS: Patients were divided into 2 groups according to the CCU waiting time (<12h and >12h)...
February 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279695/categorization-of-survival-and-death-after-cardiac-arrest
#12
E A Matthews, J Magid-Bernstein, A Presciutti, A Rodriguez, D Roh, S Park, J Claassen, S Agarwal
BACKGROUND: Most cardiac arrest (CA) patients remain comatose post-resuscitation, prompting goals-of-care (GOC) conversations. The impact of these conversations on patient outcomes has not been well described. METHODS: Patients (n=385) treated for CA in Columbia University ICUs between 2008-2015 were retrospectively categorized into various modes of survival and death based on documented GOC discussions. Patients were deemed "medically unstable" if there was evidence of hemodynamic instability at the time of discussion...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28276534/non-invasive-assessment-of-cerebral-blood-flow-and-oxygen-metabolism-in-neonates-during-hypothermic-cardiopulmonary-bypass-feasibility-and-clinical-implications
#13
Silvina L Ferradal, Koichi Yuki, Rutvi Vyas, Christopher G Ha, Francesca Yi, Christian Stopp, David Wypij, Henry H Cheng, Jane W Newburger, Aditya K Kaza, Maria A Franceschini, Barry D Kussman, P Ellen Grant
The neonatal brain is extremely vulnerable to injury during periods of hypoxia and/or ischemia. Risk of brain injury is increased during neonatal cardiac surgery, where pre-existing hemodynamic instability and metabolic abnormalities are combined with long periods of low cerebral blood flow and/or circulatory arrest. Our understanding of events associated with cerebral hypoxia-ischemia during cardiopulmonary bypass (CPB) remains limited, largely due to inadequate tools to quantify cerebral oxygen delivery and consumption non-invasively and in real-time...
March 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28274882/vacuum-sealing-drainage-as-a-pre-surgical-adjunct-in-the-treatment-of-complex-open-hand-injuries-report-of-17-cases
#14
Xiao-Feng Niu, Jian-Hua Yi, Guo-Qin Zha, Jun Hu, Yun-Jiang Liu, Liang-Bao Xiao
BACKGROUND: Few studies have been conducted to explore the use of the vacuum sealing drainage (VSD) technique in complex hand injuries. The aim of this study was to report outcomes in patients with complex hand injuries receiving VSD as a coadjuvant treatment prior to second-stage surgery. METHODS: This case series study retrospectively reviewed the patients who underwent VSD for treatment of hand injuries. Inclusion criteria for the study were: (1) traumatic soft tissue defects of the hand and wrist, accompanied by different degrees of injury and exposure of bone, tendon, or blood vessel; (2) the wound surface of hand and wrist was seriously contaminated and direct wound closure was not possible; and (3) the soft tissues of hand and wrist were seriously lacerated or avulsed, and showed necrosis or acute infection...
March 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28273741/endovascular-management-for-significant-iatrogenic-portal-vein-bleeding
#15
Jong Woo Kim, Ji Hoon Shin, Jonathan K Park, Hyun-Ki Yoon, Gi-Young Ko, Dong Il Gwon, Jin Hyoung Kim, Kyu-Bo Sung
Background Despite conservative treatment, hemorrhage from an intrahepatic branch of the portal vein can cause hemodynamic instability requiring urgent intervention. Purpose To retrospectively report the outcomes of hemodynamically significant portal vein bleeding after endovascular management. Material and Methods During a period of 15 years, four patients (2 men, 2 women; median age, 70.5 years) underwent angiography and embolization for iatrogenic portal vein bleeding. Causes of hemorrhage, angiographic findings, endovascular treatment, and complications were reported...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28270914/sepsis-induced-cardiac-dysfunction-and-%C3%AE-adrenergic-blockade-therapy-for-sepsis
#16
REVIEW
Takeshi Suzuki, Yuta Suzuki, Jun Okuda, Takuya Kurazumi, Tomohiro Suhara, Tomomi Ueda, Hiromasa Nagata, Hiroshi Morisaki
Despite recent advances in medical care, mortality due to sepsis, defined as life-threatening organ dysfunction caused by a dysregulated host response to infection, remains high. Fluid resuscitation and vasopressors are the first-line treatment for sepsis in order to optimize hemodynamic instability caused by vasodilation and increased vascular permeability. However, these therapies, aimed at maintaining blood pressure and blood flow to vital organs, could have deleterious cardiac effects, as cardiomyocyte damage occurs in the early stages of sepsis...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28268794/analysis-and-experimental-simulation-of-blood-pressure-signal-distortions-observed-on-intensive-care-patients-monitored-by-a-catheter-in-radial-artery
#17
Lisa Guigue, Carole Lavault, Francis Grimbert, Yves Lavault, Norbert Noury, Francois R Boucher
The follow-up of patients with hemodynamic instability in intensive care units most often requires blood pressure measurement using a fluid-filled catheter in the radial artery and a fluid-filled tubing connected to a pressure transducer. However, in this usual setup major distortions frequently occur that may alter the pressure signal. Underdamping and overdamping have been well described whereas other types of distortions, including attenuations and varied envelopes of pulse pressure, have been less studied...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268121/spontaneous-hemothorax-a-rare-face-of-vertebral-osteochondroma
#18
Sarah Sainte, Herbert Decaluwé, Peter Vanbrabant
BACKGROUND: Osteochondroma is the most common benign tumor of the bone. It is usually asymptomatic, but complications may result from mechanical injury to adjacent anatomic structures, such as the diaphragm and lung, when located intrathoracically. CASE REPORT: We report the unusual occurrence of a large hemothorax and lacerated right diaphragm in a 41-year-old woman caused by vertebral osteochondroma affecting the eleventh thoracic vertebra. Thoracoscopic exploration with resection of the osteochondroma and repair of the diaphragm was performed...
March 3, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28267980/postoperative-extracorporeal-membrane-oxygenation-support-for-acute-type-a-aortic-dissection
#19
Ting-Wei Lin, Meng-Ta Tsai, Yu-Ning Hu, Wei-Hung Lin, Wei-Ming Wang, Chwan-Yau Luo, Jun-Neng Roan
BACKGROUND: Few studies have investigated the use of postoperative extracorporeal membrane oxygenation (ECMO) in acute type A aortic dissection (aTAAD). We identified aTAAD surgical patients at risk of ECMO implantation postoperatively and analyzed the prognosis of these patients. METHODS: We retrospectively reviewed 162 consecutive aTAAD patients undergoing operations from January 2008 to December 2015. Patient data were analyzed for risk factors leading to an ECMO requirement...
March 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28267230/keep-the-pressure-correlation-of-hemodynamic-instability-after-reperfusion-and-severity-of-acute-kidney-injury-following-liver-transplantation
#20
Jonas Roller, Matthias Glanemann
Acute renal dysfunction and kidney failure represent frequent complications in patients after liver transplantation. Indeed, postoperative acute kidney injury (AKI) may occur in up to 60% and is associated with significantly increased postoperative mortality [1], however, the pathogenesis of AKI is yet not fully understood. To date it is not possible to identify patients with an increased risk for AKI prior to transplantation, thus, the treatment remains clinically challenging. This article is protected by copyright...
March 7, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
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