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Fluids managment

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https://www.readbyqxmd.com/read/29691755/my-patient-has-received-fluid-how-to-assess-its-efficacy-and-side-effects
#1
REVIEW
Xavier Monnet, Jean-Louis Teboul
Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to look for possible adverse effects. Like for any drug, this step should not be missed. Basically, volume expansion is aimed at improving tissue oxygenation and organ function. To assess this final result, clinical signs are often unhelpful. The increase in urine output in case of acute kidney injury is a poor marker of the kidney perfusion improvement...
April 24, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29691161/experiences-and-perspectives-of-dietary-management-among-patients-on-hemodialysis-an-interview-study
#2
Jessica Stevenson, Allison Tong, Talia Gutman, Katrina L Campbell, Jonathan C Craig, Mark A Brown, Vincent W Lee
OBJECTIVES: Diet and fluid management can reduce mortality, serious comorbidities, and debilitating symptoms in patients on hemodialysis, but restrictions may also be a major burden, and nonadherence remains high. We aimed to describe the perspectives and experiences of patients on hemodialysis regarding their dietary management to understand both facilitators and barriers to adherence and to identify strategies to improve care. DESIGN AND METHODS: Semi-structured interviews were conducted with 35 people on maintenance hemodialysis from six dialysis units in New South Wales, Australia...
April 21, 2018: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/29691067/point-of-care-ultrasound-identifies-urinoma-complicating-simple-renal-colic-a-case-series-and-literature-review
#3
Christopher Thom, Matthew Eisenstat, James Moak
BACKGROUND: Renal colic is a frequently encountered diagnosis among emergency department patients. Point-of-care (POC) ultrasound has taken on an increasingly important role in the diagnostic strategy of this disease, as it has been shown to be an effective modality for diagnosis and for guiding management. The primary pathology that the emergency physician will evaluate for in cases of suspected renal colic is hydronephrosis, which is a dilatation of the renal pelvis and calyces resulting from a distal obstruction such as a ureteral stone...
April 21, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29688821/risk-of-postoperative-complications-in-patients-with-obstructive-sleep-apnea-following-skull-base-surgery
#4
Phillip Huyett, Ryan J Soose, Amy E Schell, Juan C Fernandez-Miranda, Paul A Gardner, Carl H Snyderman, Eric W Wang
Objectives Obstructive sleep apnea (OSA) presents several challenges in skull base surgery, including increased intracranial pressure, worsened OSA with nasal packing, and avoidance of positive airway pressure (PAP) therapy postoperatively. The objective of this study was to examine the risk of postoperative complications in a skull base population with OSA in which PAP therapy is withheld. Study Design Retrospective cohort study. Setting Tertiary care hospital. Subjects and Methods Medical records of 414 adult patients undergoing anterior skull base procedures between January 1, 2014, and January 7, 2017, were retrospectively reviewed...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29688512/greater-fluid-overload-and-lower-interdialytic-weight-gain-are-independently-associated-with-mortality-in-a-large-international-hemodialysis-population
#5
Manfred Hecking, Ulrich Moissl, Bernd Genser, Hugh Rayner, Indranil Dasgupta, Stefano Stuard, Andrea Stopper, Charles Chazot, Franklin W Maddux, Bernard Canaud, Friedrich K Port, Carmine Zoccali, Peter Wabel
Background: Fluid overload and interdialytic weight gain (IDWG) are discrete components of the dynamic fluid balance in haemodialysis patients. We aimed to disentangle their relationship, and the prognostic importance of two clinically distinct, bioimpedance spectroscopy (BIS)-derived measures, pre-dialysis and post-dialysis fluid overload (FOpre and FOpost) versus IDWG. Methods: We conducted a retrospective cohort study on 38 614 incident patients with one or more BIS measurement within 90 days of haemodialysis initiation (1 October 2010 through 28 February 2015)...
April 20, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29686989/enhanced-recovery-after-surgery-protocols-in-major-urologic-surgery
#6
REVIEW
Natalija Vukovic, Ljubomir Dinic
The purpose of the review: The analysis of the components of enhanced recovery after surgery (ERAS) protocols in urologic surgery. Recent findings: ERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29686958/temporal-lobe-cystic-collection-and-associated-oedema-a-rare-complication-of-translabyrinthine-resection-of-vestibular-schwannoma
#7
Abdurrahman Raeiq
Vestibular schwannomas (VS) are benign tumours arising from the vestibulocochlear nerve. Among the management options available, surgical resection is often considered, especially if lesions are enlarging or symptomatic. Translabyrinthine (TL) resection of a vestibular schwannoma is one of three basic approaches available to the surgeon. Complications generally associated with this approach can include cerebrospinal fluid (CSF) leak, hearing and balance issues, infection, and facial nerve palsies. We present the case of a patient with a previously unreported type of complication: that of cystic CSF collection within the temporal lobe and associated oedema...
February 21, 2018: Curēus
https://www.readbyqxmd.com/read/29686797/porencephalic-cyst-a-rare-cause-of-new-onset-seizure-in-an-adult
#8
Anam Qureshi, Asad Jehangir, Eugene P York
We present a case of a 56-year-old male with a history of perinatal intracerebral hemorrhage who presented to the emergency department after a witnessed new-onset generalized tonic-clonic seizure. Computerized tomography and magnetic resonance imaging of the head revealed a large frontal lobe porencephalic cyst, with encephalomalacia in the right parietal lobe and temporal lobe (the patient did not have any prior cranial imaging). The patient has subsequently remained seizure-free on levetiracetam. Porencephalic cyst is a rare condition of cerebrospinal fluid accumulation in the brain parenchyma that is usually related to perinatal vascular events...
2018: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29685796/fluids-and-organ-dysfunction-a-narrative-review-of-the-literature-and-discussion-of-5-controversial-topics
#9
Adam J Kingeter, Meredith A Kingeter, Andrew D Shaw
Evidence-based clinical decision making is at the forefront of modern cardiothoracic anesthesia practice. Therefore, as a field, cardiac anesthesiologist should strive to ensure that the available evidence is of the highest possible quality. In this narrative review, 5 important topics that the authors believe require additional investigation in cardiothoracic anesthesia and critical care related to fluid therapy and organ dysfunction are outlined briefly. In particular, the authors believe that the areas of pulmonary artery catheter use, restrictive versus liberal transfusion strategies, cardiopulmonary bypass prime composition, colloid use in resuscitation and its effects on acute kidney injury, and management of acute kidney injury after cardiac surgery hold many unanswered questions and opportunities for continued improvement in the specialty of cardiac anesthesia...
March 13, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29685445/insights-into-the-knowledge-practices-and-training-needs-of-veterinarians-working-with-smallholder-livestock-producers-in-australia
#10
L Hayes, S Britton, G Weerasinghe, R G Woodgate, M Hernandez-Jover
The location of properties holding livestock is fluid; edging towards the boundaries of urban Australia, increasing the likelihood that veterinarians will be exposed to livestock as part of the provision of routine veterinary services. This study was conducted to ascertain the challenges, knowledge level and training needs of veterinarians working within this landscape, with the ultimate aim of informing the development of resources and training to better equip them in this capacity. For this purpose, a cross-sectional study, using a self-administered questionnaire was conducted among Australian veterinarians...
June 1, 2018: Preventive Veterinary Medicine
https://www.readbyqxmd.com/read/29683483/randomized-clinical-trial-of-elective-resection-versus-observation-in-diverticulitis-with-extraluminal-air-or-abscess-initially-managed-conservatively
#11
K You, R Bendl, C Taut, R Sullivan, M Gachabayov, R Bergamaschi
BACKGROUND: The aim of this RCT was to determine whether elective resection following successful non-operative management of a first episode of acute sigmoid diverticulitis complicated by extraluminal air with or without abscess is superior to observation in terms of recurrence rates. METHODS: This was a single-centre, sequential design RCT. Patients were randomized to elective surgery or observation following non-operative management and colonoscopy. Non-operative management included nil by mouth, intravenous fluids, intravenous antibiotics, CT with intravenous contrast on arrival at hospital, and repeat CT with intravenous and rectal contrast on day 3 in hospital...
April 23, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29682549/preliminary-exploration-of-epidemiologic-and-hemodynamic-characteristics-of-restrictive-filling-diastolic-dysfunction-based-on-echocardiography-in-critically-ill-patients-a-retrospective-study
#12
Yi Li, Wanhong Yin, Yao Qin, Xueying Zeng, Tongjuan Zou, Xiaoting Wang, Yangong Chao, Lina Zhang, Yan Kang, Chinese Critical Ultrasound Study Group Ccusg
Objective: To preliminarily describe the epidemiologic and hemodynamic characteristics of critically ill patients with restrictive filling diastolic dysfunction based on echocardiography. Setting: A retrospective study. Methods: Epidemiologic characteristics of patients with restrictive filling diastolic dysfunction in ICU were described; clinical and hemodynamic data were preliminarily summarized and compared between patients with and without restrictive filling diastolic dysfunction; most of the data were based on echocardiography...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29682071/intraoperative-rupture-cerebral-aneurysm-and-computational-flow-dynamics
#13
Ilya Senko, Anton Shatokhin, Ishu Bishnoi, Yasuhiro Yamada, Riki Tanaka, Daisuke Suyama, Tukasa Kawase, Yoko Kato
Intraoperative aneurysmal rupture (IAR) is the most fearsome complication of aneurysm surgery. IAR associates with high morbidity and mortality. In recent years, we have many studies regarding using computational fluid dynamics (CFD) in aneurysm surgery. CFD helps in calculating the velocity of blood flowing in the aneurysm sac, the pressure in the aneurysm sac, and wall shear stress (WSS). CFD also helps in predicting nature of aneurysm wall and thus may warn about different intraoperative microscopy findings in aneurysms...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682015/spinal-cerebrospinal-fluid-drainage-for-prevention-of-vasospasm-in-aneurysmal-subarachnoid-hemorrhage-a-prospective-randomized-controlled-study
#14
Sachin Anil Borkar, Manmohanjit Singh, Shashank Sharad Kale, Ashish Suri, Poodipedi Sarat Chandra, Rajender Kumar, Bhawani Shankar Sharma, Shailesh Gaikwad, Ashok Kumar Mahapatra
Introduction: Cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH) is a major cause of mortality and morbidity. Despite various treatment modalities, the optimal management of vasospasm remains elusive. In this regard; we undertook a prospective, randomized controlled study to evaluate the effectiveness of lumbar cerebrospinal fluid drainage (LCSFD) for prevention of cerebral vasospasm and its sequelae. Materials and Methods: Patients with aneurysmal SAH who met the inclusion criteria were randomized into two groups - Group I (30 patients) underwent LCSFD whereas Group II (30 patients) did not undergo LCSFD...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29682010/craniofacial-trauma-in-pediatric-patients-following-winnowing-blade-injury-review-of-literature
#15
REVIEW
Harsha Huliyappa, Balakrishna Ojha, Anil Chandra, Sunil Kumar Singh, Chhitij Srivastava
In developing countries, during the harvest season, winnower blade injuries occur very frequently in children and results in lifelong disability. Nine children were managed during 1 month, all resulting due to winnower blade induced craniofacial trauma. PubMed search for "fan blade injury" showed two case series and three case reports. In our study, 88% had compound depressed fracture; brain matter leak in 56%, cerebrospinal fluid (CSF) leak alone in 22%. 66.7% had injury involving the frontal bone...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29681447/acute-pancreatitis-in-a-patient-with-maple-syrup-urine-disease-a-management-paradox
#16
Nina B Gold, Jennifer A Blumenthal, Ann E Wessel, Deborah R Stein, Adam Scott, Victor L Fox, Amy Turner, Amy Kritzer, Farrah Rajabi, Katherine Peeler, Wen-Hann Tan
Maple syrup urine disease (MSUD) is an inborn error of metabolism that causes elevated leucine in the setting of acute illnesses. We describe an 8-year-old boy with MSUD who developed acute pancreatitis and subsequent leucinosis. This case highlights the complexities of fluid management in patients with MSUD.
April 19, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29681395/chugging-in-patients-on-veno-venous-extracorporeal-membrane-oxygenation-an-under-recognized-driver-of-intravenous-fluid-administration-in-patients-with-acute-respiratory-distress-syndrome
#17
James M Walter, Chitaru Kurihara, Thomas C Corbridge, Ankit Bharat
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications. OBJECTIVES: To provide an example of a common complication, circuit "chugging," and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS. METHODS: We use a clinical case to illustrate chugging and discuss potential management strategies...
April 19, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29680874/utility-and-proposed-algorithm-of-csf-flow-cytometry-in-hematologic-malignancies
#18
Bernard Tawfik, Larry Brown, Frankling Fuda, Weina Chen, Shuang Niu, Joseph Sailors, Navid Sadeghi
In patients with hematologic malignancies, multiparameter flow cytometry (FCM) offers greater sensitivity than cytology in detecting malignant cells in the initial cerebrospinal fluid (CSF) specimen. However, the role of FCM in assessment of subsequent specimens is unclear. We developed an algorithm to reduce the number of low-yield FCM tests without significant impact on clinically meaningful results. Patients with hematologic malignancies were studied in a derivation cohort, and the following algorithm was developed: (1) cytology and FCM on all initial samples, (2) cytology on all subsequent samples, and (3) FCM on subsequent samples only if previous FCM was positive...
April 21, 2018: Annals of Hematology
https://www.readbyqxmd.com/read/29680680/pneumolabyrinth-intracochlear-and-vestibular-fluid-loss-after-cochlear-implantation
#19
Hideaki Moteki, Yasunari Fujinaga, Tetsuya Goto, Shin-Ichi Usami
The present case was a 38-year-old male who presented with progressive hearing loss, resulting in profound bilateral hearing loss. He had a past history of childhood medulloblastoma, which was treated with posterior fossa craniotomy and radiotherapy. A ventriculoperitoneal (VP) shunt was put in place to manage the hydrocephalus. Cochlear implantation (CI) was carried out on his right ear by a standard procedure. At CI activation, the electric impedance of the electrode was very high, and computed tomography revealed that there was no area of liquid density, suggesting depletion of the perilymph in the cochlea and vestibule...
April 18, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29680334/open-heart-surgery-for-management-of-right-auricular-thrombus-related-to-central-venous-catheterization
#20
A F Ribeiro, I S Neto, I Maia, C Dias
Central venous catheters are widely used in critically ill patients; however, they are also associated with increased morbidity and mortality. The literature may underestimate the incidence of catheter-inducible right atrial thrombi that are asymptomatic but potentially life threatening. The recognized risk factors for its development include infections related to the catheter, endothelial injury secondary to mechanical and chemical damage induced by certain medications and infused fluids. The characteristics of the patient and the catheter, such as size, material, type, location and ease of insertion, as well as the duration of placement play an additional role...
April 19, 2018: Revista Española de Anestesiología y Reanimación
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