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fluid overload in icu

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https://www.readbyqxmd.com/read/28209389/physical-stability-of-highly-concentrated-injectable-drugs-solutions-used-in-intensive-care-units
#1
M Closset, J D Hecq, L Soumoy, J Simar, E Gonzalez, L Charlet, C Declave, P Gillet, L Galanti
BACKGROUND: The intensive care department of the institution use drug solutions within higher concentration to avoid fluid overload. The purpose of the study is to prove the physical stability of different injectable drugs within high concentration (amiodarone 25mg/mL, isosorbide 0.60mg/mL, lorazepam 0.16mg/mL, noradrenalin 0.120 and 0.240mg/mL, salbutamol 0.06mg/mL and sodium valproate 12mg/mL) to ensure the patients safety. METHODS: Five of 30 or 50mL polypropylene syringes were prepared for each solution under aseptic conditions and stored at room temperature...
February 13, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/28196107/fluid-overload-and-survival-in-critically-ill-patients-with-acute-kidney-injury-receiving-continuous-renal-replacement-therapy
#2
Il Young Kim, Joo Hui Kim, Dong Won Lee, Soo Bong Lee, Harin Rhee, Eun Young Seong, Ihm Soo Kwak, Sang Heon Song
BACKGROUND: Fluid overload is known to be associated with increased mortality in patients with acute kidney injury (AKI) who are critically ill. In this study, we intended to uncover whether the adverse effect of fluid overload on survival could be applied to all of the patients with AKI who received continuous renal replacement therapy (CRRT). METHODS: We analyzed 341 patients with AKI who received CRRT in our intensive care units. The presence of fluid overload was defined as a minimum 10% increase in body weight from the baseline...
2017: PloS One
https://www.readbyqxmd.com/read/28159011/fluids-and-sepsis-changing-the-paradigm-of-fluid-therapy-a-case-report
#3
Hori Hariyanto, Corry Quando Yahya, Monika Widiastuti, Primartanto Wibowo, Oloan Eduard Tampubolon
BACKGROUND: Over the past 16 years, sepsis management has been guided by large-volume fluid administration to achieve certain hemodynamic optimization as advocated in the Rivers protocol. However, the safety of such practice has been questioned because large-volume fluid administration is associated with fluid overload and carries the worst outcome in patients with sepsis. Researchers in multiple studies have declared that using less fluid leads to increased survival, but they did not describe how to administer fluids in a timely and appropriate manner...
February 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28149027/sustained-low-efficiency-dialysis-in-septic-shock-hemodynamic-tolerability-and-efficacy
#4
Shakti Bedanta Mishra, Ratender Kumar Singh, Arvind Kumar Baronia, Banani Poddar, Afzal Azim, Mohan Gurjar
AIM OF THE STUDY: Acute kidney injury (AKI) in septic shock has poor outcomes. Sustained low-efficiency dialysis (SLED) is increasingly replacing continuous renal replacement therapy as the preferred modality in Intensive Care Units (ICUs). However, the essential aspects of hemodynamic tolerability and efficacy of SLED in septic shock AKI has been minimally studied. PATIENTS AND METHODS: We describe hemodynamic tolerability using modified vasopressor index (VI) and vasopressor dependency (VD) and efficacy using a combination of Kt/v, correction of acidosis, electrolyte, and fluid overload...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28143505/fluid-overload-is-an-independent-risk-factor-for-acute-kidney-injury-in-critically-ill-patients-results-of-a-cohort-study
#5
Nawal Salahuddin, Mustafa Sammani, Ammar Hamdan, Mini Joseph, Yasir Al-Nemary, Rawan Alquaiz, Ranim Dahli, Khalid Maghrabi
BACKGROUND: Acute Kidney injury (AKI) is common and increases mortality in the intensive care unit (ICU). We carried out this study to explore whether fluid overload is an independent risk factor for AKI. METHODS: Single-center prospective, observational study. Consecutively admitted, ICU patients were followed for development of AKI. Intravenous fluid volumes, daily fluid balances were measured, hourly urine volumes, daily creatinine levels were recorded. RESULTS: Three hundred thirty nine patients were included; AKI developed in 141 (41...
February 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28072601/risk-factors-and-clinical-outcomes-associated-with-perioperative-transfusion-associated-circulatory-overload
#6
Leanne Clifford, Qing Jia, Arun Subramanian, Hemang Yadav, Darrell R Schroeder, Daryl J Kor
BACKGROUND: Transfusion-associated circulatory overload remains underappreciated in the perioperative environment. The authors aimed to characterize risk factors for perioperative transfusion-associated circulatory overload and better understand its impact on patient-important outcomes. METHODS: In this case-control study, 163 adults undergoing noncardiac surgery who developed perioperative transfusion-associated circulatory overload were matched with 726 transfused controls who did not develop respiratory complications...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28050895/passive-leg-raise-testing-effectively-reduces-fluid-administration-in-septic-shock-after-correction-of-non-compliance-to-test-results
#7
Arjanne Rameau, Eldert de With, Evert Christiaan Boerma
BACKGROUND: Fluid resuscitation is considered a cornerstone of shock treatment, but recent data have underlined the potential hazards of fluid overload. The passive leg raise (PLR) test has been introduced as one of many strategies to predict 'fluid responsiveness.' The use of PLR testing is applicable to a wide range of clinical situations and has the potential to reduce fluid administration, since PLR testing is based upon (reversible) autotransfusion. Despite these theoretical advantages, data on the net effect on fluid balance as a result of PLR testing remain scarce...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28027733/restricted-albumin-utilization-is-safe-and-cost-effective-in-a-cardiac-surgery-intensive-care-unit
#8
Joseph Rabin, Timothy Meyenburg, Ashleigh V Lowery, Michael Rouse, James S Gammie, Daniel Herr
BACKGROUND: Volume expansion is often necessary after cardiac surgery, and albumin is often administered. Albumin's high cost motivated an attempt to reduce its utilization. This study analyzes the impact limiting albumin infusion in a cardiac surgery intensive care unit. METHODS: This retrospective study analyzed albumin use between April 2014 and April 2015 in patients admitted to a cardiac surgery intensive care unit. During the first 9 months, there were no restrictions...
December 24, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#9
Sun-Kyung Park, Min Hur, Eunhee Kim, Won Ho Kim, Jung Bo Park, Youngwon Kim, Ji-Hyuk Yang, Tae-Gook Jun, Chung Su Kim
Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria...
2016: PloS One
https://www.readbyqxmd.com/read/27825364/mid-regional-pro-adrenomedullin-mr-proadm-a-marker-of-positive-fluid-balance-in-critically-ill-patients-results-of-the-envol-study
#10
Bernard Vigué, Pierre-Etienne Leblanc, Frédérique Moati, Eric Pussard, Hussam Foufa, Aurore Rodrigues, Samy Figueiredo, Anatole Harrois, Jean-Xavier Mazoit, Homa Rafi, Jacques Duranteau
BACKGROUND: The optimal control of blood volume without fluid overload is a main challenge in the daily care of intensive care unit (ICU) patients. Accordingly this study focused on the identification of biomarkers to help characterize fluid overload status. METHODS: Sixty-seven patients were studied from ICU admission to day 7 (D7). Blood and urine samples were taken daily and sodium and water balance strictly calculated resulting in a total cumulative assessment of ∆Na(+) and ∆H2O...
November 9, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27703807/the-development-of-intensive-care-unit-acquired-hypernatremia-is-not-explained-by-sodium-overload-or-water-deficit-a-retrospective-cohort-study-on-water-balance-and-sodium-handling
#11
M C O van IJzendoorn, H Buter, W P Kingma, G J Navis, E C Boerma
Background. ICU acquired hypernatremia (IAH, serum sodium concentration (sNa) ≥ 143 mmol/L) is mainly considered iatrogenic, induced by sodium overload and water deficit. Main goal of the current paper was to answer the following questions: Can the development of IAH indeed be explained by sodium intake and water balance? Or can it be explained by renal cation excretion? Methods. Two retrospective studies were conducted: a balance study in 97 ICU patients with and without IAH and a survey on renal cation excretion in 115 patients with IAH...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27686326/association-of-microcirculation-macrocirculation-and-severity-of-illness-in-septic-shock-a-prospective-observational-study-to-identify-microcirculatory-targets-potentially-suitable-for-guidance-of-hemodynamic-therapy
#12
Timo Sturm, Julia Leiblein, Verena Schneider-Lindner, Thomas Kirschning, Manfred Thiel
PURPOSE: Clinically unapparent microcirculatory impairment is common and has a negative impact on septic shock, but specific therapy is not established so far. This prospective observational study aimed at identifying candidate parameters for microcirculatory-guided hemodynamic therapy. CLINICALTRIALSGOV: NCT01530932. MATERIALS AND METHODS: Microcirculatory flow and postcapillary venous oxygen saturation were detected during vaso-occlusive testing (VOT) on days 1 (T0), 2 (T24), and 4 (T72) in 20 patients with septic shock at a surgical intensive care unit using a laser Doppler spectrophotometry system (O2C)...
September 29, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27608778/mortality-predictors-of-ards-in-medical-intensive-care-unit-of-a-tertiary-care-centre-in-a-tropical-country
#13
Rakesh Bhadade, Rosemarie de'Souza, Minal Harde, Dileep Asgaonkar, Nilesh Tuplondhe
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a clinical syndrome of severe dyspnoea of rapid onset, hypoxemia, and diffuse pulmonary infiltrates leading to respiratory failure in the absence of cardiac failure. We did the study to asses various aetiologies of ARDS, to determine the correlation between the diagnostic criteria, mortality predictors, need of mechanical ventilation and the outcome of patients. This was an observational, prospective study in medical intensive care unit (MICU) of a tertiary care hospital, over a period of 15 months...
November 2015: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27536694/fluid-management-for-critically-ill-patients-a-review-of-the-current-state-of-fluid-therapy-in-the-intensive-care-unit
#14
REVIEW
Erin Frazee, Kianoush Kashani
BACKGROUND: Intravenous fluids (IVF) are frequently utilized to restore intravascular volume in patients with distributive and hypovolemic shock. Although the benefits of the appropriate use of fluids in intensive care units (ICUs) and hospitals are well described, there is growing knowledge regarding the potential risks of volume overload and its impact on organ failure and mortality. To avoid volume overload and its associated complications, strategies to identify fluid responsiveness are developed and utilized more often among ICU patients...
June 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27484681/fluid-overload-in-the-icu-evaluation-and-management
#15
Rolando Claure-Del Granado, Ravindra L Mehta
BACKGROUND: Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients. DISCUSSION: In critically ill patients, in order to restore cardiac output, systemic blood pressure and renal perfusion an adequate fluid resuscitation is essential...
August 2, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27484449/point-of-care-neonatal-ultrasound-head-lung-gut-and-line-localization
#16
Chandra Rath, Pradeep Suryawanshi
CONTEXT: Knowledge and skills of heart, head, lung, gut and basic abdominal ultrasound is of immense utility to clinicians in their day-to-day patient management, and in acute events, in the absence of specialist service back-up. This review examines the potential role of clinician-performed ultrasound in the neonatal intensive care unit. EVIDENCE ACQUISITION: The bibliographic search of English-language literature was performed electronically using PubMed and EMBASE databases for the different topics we have covered under this review...
October 8, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27467522/association-of-fluid-accumulation-with-clinical-outcomes-in-critically-ill-children-with-severe-sepsis
#17
Jiao Chen, Xiaozhong Li, Zhenjiang Bai, Fang Fang, Jun Hua, Ying Li, Jian Pan, Jian Wang, Xing Feng, Yanhong Li
OBJECTIVE: To evaluate whether early and acquired daily fluid overload (FO), as well as fluctuations in fluid accumulation, were associated with adverse outcomes in critically ill children with severe sepsis. METHODS: This study enrolled 202 children in a pediatric intensive care unit (PICU) with severe sepsis. Early fluid overload was defined as ≥5% fluid accumulation occurring in the first 24 hours of PICU admission. The maximum daily fluid accumulation ≥5% occurring during the next 6 days in patients with at least 48 hours of PICU stay was defined as PICU-acquired daily fluid overload...
2016: PloS One
https://www.readbyqxmd.com/read/27433308/novel-use-of-an-ultrafiltration-device-as-an-alternative-method-for-fluid-removal-in-critically-ill-pediatric-patients-with-cardiac-disease-a-case-series
#18
Sujata Chakravarti, Yasir Al-Qaqaa, Meghan Faulkner, Puneet Bhatla, Michael Argilla, Michelle Ramirez
Fluid overload (FO) is a common complication for pediatric patients in the intensive care unit. When conventional therapy fails, hemodialysis or peritoneal dialysis is classically used for fluid removal. Unfortunately, these therapies are often associated with cardiovascular or respiratory instability. Ultrafiltration, using devices such as the Aquadex™ system (Baxter Healthcare, Deerfield, IL, USA), is an effective tool for fluid removal in adult patients with congestive heart failure. As compared to hemodialysis, ultrafiltration can be performed using smaller catheters, and the extracorporeal volume and minimal blood flow rates are lower...
June 15, 2016: Pediatric Reports
https://www.readbyqxmd.com/read/27343912/syndecan-1-improves-severe-acute-kidney-injury-prediction-after-pediatric-cardiac-surgery
#19
Candice Torres de Melo Bezerra Cavalcante, Klébia Magalhães Castelo Branco, Valdester Cavalcante Pinto Júnior, Gdayllon Cavalcante Meneses, Fernanda Macedo de Oliveira Neves, Nayana Maria Gomes de Souza, Kiarelle Lourenço Penaforte, Alice Maria Costa Martins, Alexandre Braga Libório
OBJECTIVE: Acute kidney injury is a common occurrence after pediatric cardiac surgery and is associated with adverse patient outcomes. Syndecan-1 is a biomarker of endothelial glycocalyx damage, and its early increment after surgery can be associated with acute kidney injury. METHODS: We performed a prospective cohort study with 289 patients aged less than 18 years who underwent cardiac surgery at 1 reference institution. Postoperative plasma syndecan-1 was collected within the first 2 hours after cardiac surgery...
July 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27334608/the-dose-response-multicentre-investigation-on-fluid-assessment-doremifa-in-critically-ill-patients
#20
F Garzotto, M Ostermann, D Martín-Langerwerf, M Sánchez-Sánchez, J Teng, R Robert, A Marinho, M E Herrera-Gutierrez, H J Mao, D Benavente, E Kipnis, A Lorenzin, D Marcelli, C Tetta, C Ronco
BACKGROUND: The previously published "Dose Response Multicentre International Collaborative Initiative (DoReMi)" study concluded that the high mortality of critically ill patients with acute kidney injury (AKI) was unlikely to be related to an inadequate dose of renal replacement therapy (RRT) and other factors were contributing. This follow-up study aimed to investigate the impact of daily fluid balance and fluid accumulation on mortality of critically ill patients without AKI (N-AKI), with AKI (AKI) and with AKI on RRT (AKI-RRT) receiving an adequate dose of RRT...
June 23, 2016: Critical Care: the Official Journal of the Critical Care Forum
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