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Decompensated Shock

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https://www.readbyqxmd.com/read/28930955/comparison-of-compensatory-reserve-and-arterial-lactate-as-markers-of-shock-and-resuscitation
#1
Michael Craig Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwaca, David Wampler, Mark DeRosa, Brian J Eastridge
BACKGROUND: During traumatic hemorrhage, the ability to identify shock and intervene before decompensation is paramount to survival. Lactate is extremely sensitive to shock, and its clearance has been demonstrated a useful gauge of shock and resuscitation status. Though lactate can be measured in the field, logistical constraints render it impractical in certain environments. The compensatory reserve represents a new clinical measurement reflecting the remaining capacity to compensate for hypoperfusion...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28917560/outcomes-of-rescue-cardiopulmonary-support-for-periprocedural-acute-hemodynamic-decompensation-in-patients-undergoing-catheter-ablation-of-electrical-storm
#2
Andres Enriquez, Jackson Liang, Javier Gentile, Robert Schaller, Gregory Supple, David S Frankel, Fermin Garcia, Joyce Wald, Edo Y Birati, J Eduardo Rame, Christian Bermudez, David Callans, Francis Marchlinski, Pasquale Santangeli
BACKGROUND: In patients with ventricular tachycardia/fibrillation (VT/VF) electrical storm (ES) undergoing catheter ablation (CA), hypotension due to refractory VT/VF, use of anesthesia and cardiac stunning due to repeated ICD shocks might precipitate acute hemodynamic decompensation (AHD). OBJECTIVE: We evaluated the outcomes of emergent cardiopulmonary support with extracorporeal membrane oxygenation (ECMO) to rescue AHD in patients undergoing CA of ES. METHODS: Between 2010 and 2016, 21 patients with ES (VT in 11 and PVC-triggered VF in 10) were referred for CA and had periprocedural AHD requiring emergent ECMO support...
September 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28860348/assessment-of-sepsis-3-criteria-and-quick-sofa-in-patients-with-cirrhosis-and-bacterial-infections
#3
Salvatore Piano, Michele Bartoletti, Marta Tonon, Maurizio Baldassarre, Giada Chies, Antonietta Romano, Pierluigi Viale, Elia Vettore, Marco Domenicali, Marialuisa Stanco, Chiara Pilutti, Anna Chiara Frigo, Alessandra Brocca, Mauro Bernardi, Paolo Caraceni, Paolo Angeli
INTRODUCTION: Patients with cirrhosis have a high risk of sepsis, which confers a poor prognosis. The systemic inflammatory response syndrome (SIRS) criteria have several limitations in cirrhosis. Recently, new criteria for sepsis (Sepsis-3) have been suggested in the general population (increase of Sequential Organ Failure Assessment (SOFA) ≥2 points from baseline). Outside the intensive care unit (ICU), the quick SOFA (qSOFA (at least two among alteration in mental status, systolic blood pressure ≤100 mm Hg or respiratory rate ≥22/min)) was suggested to screen for sepsis...
August 31, 2017: Gut
https://www.readbyqxmd.com/read/28801782/common-pediatric-medical-emergencies-in-office-practice
#4
Bharat Mehra, Suresh Gupta
General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values...
August 12, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28765018/takotsubo-cardiomyopathy-triggered-by-venous-air-embolism-during-craniotomy-in-sitting-position-a-case-report
#5
Florian Raimann, Christian Senft, Jörg Honold, Kai Zacharowski, Volker Seifert, Jan Mersmann
BACKGROUND: Here we present a case of a stress induced cardiomyopathy (TakoTsubo cardiomyopathy) caused by a venous air embolism during a craniotomy in sitting position. CASE DESCRIPTION: A 69-year old female patient was admitted to the neurosurgical department and scheduled for elective resection of a cerebellar metastasis in sitting position. After craniotomy and opening of the posterior fossa a venous air embolism was detected via transesophageal echocardiography...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28762172/mechanical-circulatory-support-for-decompensated-heart-failure
#6
REVIEW
Tarique Al Musa, Colin Dominic Chue, Hoong Sern Lim
PURPOSE OF REVIEW: Cardiogenic shock from decompensated heart failure is associated with significant morbidity and mortality. Mechanical circulatory support (MCS) improves haemodynamics and reverses organ dysfunction in critically ill patients with cardiogenic shock. This paper summarises the main modalities of mechanical support and their physiological impact, practical considerations, advantages and disadvantages to facilitate a holistic approach in managing a potentially lethal pathology...
July 31, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28727607/new-onset-heart-failure-and-mortality-in-hospital-survivors-of-sepsis-related-left-ventricular-dysfunction
#7
Saraschandra Vallabhajosyula, Jacob C Jentzer, Jeffrey B Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T Poterucha, Kianoush Kashani, Joseph G Murphy, Ognjen Gajic, Rahul Kashyap
BACKGROUND: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72 hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28720296/urinary-heat-shock-protein-72-as-a-biomarker-of-acute-kidney-injury-in-dogs
#8
Yaron Bruchim, Yochai Avital, Michal Horowitz, Michal Mazaki-Tovi, Itamar Aroch, Gilad Segev
Early recognition of acute kidney injury (AKI) is important, as therapy is potentially more efficacious if instituted early in the course of disease. Urinary heat shock protein-72 to urinary creatinine ratio (uHSP72/uCr) was assessed as a diagnostic and prognostic marker in AKI in dogs. Fifty-three dogs were enrolled in five groups: healthy controls (n=11), urinary tract infection (n=10), chronic kidney disease (CKD; n=11), AKI (n=13), and acute decompensating CKD (n=8). Urinary heat shock protein-72 to urinary creatinine ratio was highest in the AKI group (P<0...
July 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28717513/unexpected-intensive-care-transfer-of-admitted-patients-with-severe-sepsis
#9
Gabriel Wardi, Arvin R Wali, Julian Villar, Vaishal Tolia, Christian Tomaszewski, Christian Sloane, Peter Fedullo, Jeremy R Beitler, Matthew Nolan, Daniel Lasoff, Rebecca E Sell
BACKGROUND: Patients with severe sepsis generally respond well to initial therapy administered in the emergency department (ED), but a subset later decompensate and require unexpected transfer to the intensive care unit (ICU). This study aimed to identify clinical factors that can predict patients at increased risk for delayed transfer to the ICU and the association of delayed ICU transfer with mortality. METHODS: This is a nested case-control study in a prospectively collected registry of patients with severe sepsis and septic shock at two EDs...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28614145/non-human-primate-rhesus-macaque-models-of-severe-pressure-targeted-hemorrhagic-and-poly-traumatic-hemorrhagic-shock
#10
Forest R Sheppard, Antoni R Macko, Jacob J Glaser, Philip J Vernon, Alexander J Burdette, R Madelaine Paredes, Craig A Koeller, Anthony E Pusateri, Douglas K Tadaki, Sylvain Cardin
BACKGROUND: We endeavored to develop clinically translatable non-human primate (NHP) models of severe poly-traumatic hemorrhagic shock. METHODS: NHPs were randomized into five pressure-targeted severe hemorrhagic shock (PTHS) ± additional injuries scenarios: 30-min PTHS (PTHS-30), 60-min PTHS (PTHS-60), PTHS-60 + soft tissue injury (PTHS-60+ST), PTHS-60+ST + femur fracture (PTHS-60+ST+FF) and decompensated PTHS+ST+FF (PTHS-D). Physiologic parameters were recorded and blood samples collected at five time points with animal observation through T = 24hrs...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28600092/mechanical-circulatory-support-in-acute-decompensated-heart-failure-and-shock
#11
REVIEW
Nishtha Sodhi, John M Lasala
An array of interventional therapeutics is available in the modern era, with uses depending on acute or chronic situations. This article focuses on support in acute decompensated heart failure and cardiogenic shock, including intra-aortic balloon pumps, continuous aortic flow augmentation, and extra-corporeal membrane oxygenation.
July 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28566471/emergency-treatment-of-decompensated-aortic-stenosis
#12
Dario Bongiovanni, Constantin Kühl, Sabine Bleiziffer, Lynne Stecher, Felix Poch, Martin Greif, Julinda Mehilli, Steffen Massberg, Norbert Frey, Rüdiger Lange, Karl-Ludwig Laugwitz, Gerhard Schymik, Derk Frank, Christian Kupatt
OBJECTIVE: The optimal treatment of patients with acute and severe decompensation of aortic stenosis is unclear due to recent advances in transcatheter interventions and supportive therapies. Our aim was to assess the early outcome of emergency transcatheter aortic valve implantation (eTAVI) versus emergency balloon aortic valvuloplasty (eBAV) followed by TAVI under elective circumstances. METHODS: Emergency conditions were defined as: cardiogenic shock with requirement of catecholamine therapy, severe acute dyspnoea (NYHA IV), cardiac resuscitation or mechanic respiratory support...
May 31, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28543399/baroreceptor-stimulation-in-a-patient-with-preexisting-subcutaneous-implantable-cardioverter-defibrillator
#13
Kay F Weipert, Jens Andrick, Ritvan Chasan, Christopher Gemein, Astrid Most, Christian W Hamm, Damir Erkapic, Joern Schmitt
BACKGROUND: Many patients with severe heart failure (HF) have an indication for baroreflex activation therapy (BAT) and an ICD. Concerns about device-device interactions were addressed in a study with small sample size that concluded combined BAT and ICD therapy is safe. There are no published data, however, concerning device-device interactions between BAT and a subcutaneous ICD (S-ICD). Since BAT frequently interferes with surface ECG recordings there are doubts about compatibility of BAT and S-ICD devices...
May 24, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28538624/comparison-of-compensatory-reserve-and-arterial-lactate-as-markers-of-shock-and-resuscitation
#14
Michael Johnson, Abdul Alarhayem, Victor Convertino, Robert Carter, Kevin Chung, Ronald Stewart, John Myers, Daniel Dent, Lilian Liao, Ramon Cestero, Susannah Nicholson, Mark Muir, Martin Schwaca, David Wampler, Mark DeRosa, Brian Eastridge
BACKGROUND: During traumatic hemorrhage, the ability to identify shock and intervene prior to decompensation is paramount to survival. Lactate is extremely sensitive to shock and its clearance has been demonstrated a useful gauge of shock and resuscitation status. Though lactate can be measured in the field, logistical constraints render it impractical in certain environments. The Compensatory Reserve represents a new clinical measurement reflecting the remaining capacity to compensate for hypoperfusion...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28536660/sorafenib-associated-heart-failure-complicated-by-cardiogenic-shock-after-treatment-of-advanced-stage-hepatocellular-carcinoma-a-clinical-case-discussion
#15
Candace Wu, Kamal Shemisa
Background. Sorafenib, an oral tyrosine kinase inhibitor (TKI), targets multiple tyrosine kinase receptors (TKRs) involved in angiogenesis and tumor growth. Studies suggest that inhibition of TKR impacts cardiomyocyte survival. Inhibition of VEGF signaling interrupts angiogenesis and is associated with the development of hypertension and compensatory hypertrophy. Compensated hypertrophy ultimately leads to heart failure. Case Description. A 76-year-old man with a past medical history of systolic heart failure due to ischemic cardiomyopathy and stage IIIC hepatocellular carcinoma (HCC) presented with symptoms of decompensated heart failure...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28471885/extracorporeal-membrane-oxygenation-for-acute-decompensated-heart-failure
#16
Laurence Dangers, Nicholas Bréchot, Matthieu Schmidt, Guillaume Lebreton, Guillaume Hékimian, Ania Nieszkowska, Sébastien Besset, Jean-Louis Trouillet, Jean Chastre, Pascal Leprince, Alain Combes, Charles-Edouard Luyt
OBJECTIVE: Long-term outcomes of patients treated with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure (i.e., cardiogenic shock complicating chronic cardiomyopathy) have not yet been reported. This study was undertaken to describe their outcomes and determine mortality-associated factors. DESIGN: Retrospective analysis of data prospectively collected. SETTING: Twenty-six-bed tertiary hospital ICU. PATIENTS: One hundred five patients implanted with venoarterial-extracorporeal membrane oxygenation for acute decompensated heart failure...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28463462/clinical-phenotypes-and-outcome-of-patients-hospitalized-for-acute-heart-failure-the-esc-heart-failure-long-term-registry
#17
Ovidiu Chioncel, Alexandre Mebazaa, Veli-Pekka Harjola, Andrew J Coats, Massimo Francesco Piepoli, Maria G Crespo-Leiro, Cecile Laroche, Petar M Seferovic, Stefan D Anker, Roberto Ferrari, Frank Ruschitzka, Silvia Lopez-Fernandez, Daniela Miani, Gerasimos Filippatos, Aldo P Maggioni
AIMS: To identify differences in clinical epidemiology, in-hospital management and 1-year outcomes among patients hospitalized for acute heart failure (AHF) and enrolled in the European Society of Cardiology Heart Failure Long-Term (ESC-HF-LT) Registry, stratified by clinical profile at admission. METHODS AND RESULTS: The ESC-HF-LT Registry is a prospective, observational study collecting hospitalization and 1-year follow-up data from 6629 AHF patients. Among AHF patients enrolled in the registry, 13...
April 30, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28433485/in-hospital-mortality-in-cirrhotic-patients-at-a-tertiary-care-center
#18
R Zubieta-Rodríguez, J Gómez-Correa, R Rodríguez-Amaya, K A Ariza-Mejia, N A Toloza-Cuta
INTRODUCTION: Cirrhosis of the liver is known for its high risk of mortality associated with episodes of acute decompensation. There is an even greater risk in patients that present with acute-on-chronic liver failure. The identification of patients at higher risk for adverse outcomes can aid in making the clinical decisions that will improve the prognosis for these patients. AIMS: To determine in-hospital mortality and evaluate the epidemiologic and clinical characteristics of patients with cirrhosis of the liver seen at a tertiary referral hospital...
April 19, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28425407/persistence-of-virologic-response-after-liver-transplant-in-hepatitis-c-patients-treated-with-ledipasvir-sofosbuvir-plus-ribavirin-pretransplant
#19
Eric M Yoshida, Paul Kwo, Kosh Agarwal, Christophe Duvoux, François Durand, Markus Peck-Radosavljevic, Leslie Lilly, Bernard Willems, Hugo Vargas, Princy Kumar, Robert S Brown, Yves Horsmans, Shampa De-Oertel, Sarah Arterburn, Hadas Dvory-Sobol, Diana M Brainard, John G McHutchison, Norah Terrault, Mario Rizzetto, Beat Müllhaupt
INTRODUCTION: Recurrence of HCV infection in patients with chronic hepatitis C virus (HCV) at the time of liver transplantation is nearly universal and reduces the likelihood of graft and patient survival. MATERIALS AND METHODS: We evaluated outcomes of 17 patients (16 with HCV genotype 1 and 1 with genotype 4) who received up to 12 or 24 weeks of ledipasvir/sofosbuvir plus ribavirin prior to or up to the time of liver transplant in the SOLAR-1 and SOLAR-2 trials...
May 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28411694/predictors-of-failure-and-complications-of-catheter-directed-interventions-for-pulmonary-embolism
#20
Efthymios D Avgerinos, Adham N Abou Ali, Nathan L Liang, Elizabeth Genovese, Michael J Singh, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: Catheter-directed interventions (CDIs) are increasingly performed for acute pulmonary embolism (PE) as they are presumed to provide similar therapeutic benefits to systemic thrombolysis while decreasing the dose of thrombolytic required and the associated risks. This study aimed to identify factors associated with CDI failure and to describe anticipated complications. METHODS: Consecutive patients who underwent CDI for massive or submassive PE between 2009 and 2015 were identified; outcomes and complications were retrospectively collected...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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