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fluid volum and critical patient

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https://www.readbyqxmd.com/read/29779815/use-of-standard-enteral-formula-versus-enteric-formula-with-prebiotic-content-in-nutrition-therapy-a-randomized-controlled-study-among-neuro-critical-care-patients
#1
Piril Tuncay, Fatma Arpaci, Mutlu Doganay, Deniz Erdem, Arzu Sahna, Hulya Ergun, Dilek Atabey
OBJECTIVE: To compare use of standard enteral formula versus enteric formula with prebiotic content in terms of nutrition therapy related outcomes among neurocritical care patients. METHODS: A total of 46 adult neurocritical care patients who received nutrition therapy with standard enteral formula (SEF group; n = 23) or enteral formula with prebiotic content (EFPC group; n = 23) during their hospitalization in intensive care unit (ICU) were included in this prospective randomized controlled study...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29767451/feline-ureteral-obstructions-part-1-medical-management
#2
REVIEW
D L Clarke
Feline ureteral obstructions are an increasingly recognised and challenging diagnostic and management problem. Many cats with ureteral obstructions are critically ill at the time of diagnosis, especially if there is dysfunction of the contralateral kidney. They may present with varying severities of acute kidney injury, electrolyte disturbances, and may have comorbidities such as heart disease that complicate perioperative and long-term management. Medical management, which may consist of rehydration and restoration of intravascular volume with intravenous fluid therapy, osmotic diuresis, ureteral muscle relaxation, and antimicrobials for infection, is important in feline ureteral obstruction patients...
May 16, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29744563/diagnostic-workup-etiologies-and-management-of-acute-right-ventricle-failure-a-state-of-the-art-paper
#3
REVIEW
Antoine Vieillard-Baron, R Naeije, F Haddad, H J Bogaard, T M Bull, N Fletcher, T Lahm, S Magder, S Orde, G Schmidt, M R Pinsky
INTRODUCTION: This is a state-of-the-art article of the diagnostic process, etiologies and management of acute right ventricular (RV) failure in critically ill patients. It is based on a large review of previously published articles in the field, as well as the expertise of the authors. RESULTS: The authors propose the ten key points and directions for future research in the field. RV failure (RVF) is frequent in the ICU, magnified by the frequent need for positive pressure ventilation...
May 9, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29740391/impact-of-lesion-load-thresholds-on-alberta-stroke-program-early-computed-tomographic-score-in-diffusion-weighted-imaging
#4
Julian Schröder, Bastian Cheng, Caroline Malherbe, Martin Ebinger, Martin Köhrmann, Ona Wu, Dong-Wha Kang, David S Liebeskind, Thomas Tourdias, Oliver C Singer, Bruce Campbell, Marie Luby, Steven Warach, Jens Fiehler, André Kemmling, Jochen B Fiebach, Christian Gerloff, Götz Thomalla
Background and aims: Assessment of ischemic lesions on computed tomography or MRI diffusion-weighted imaging (DWI) using the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) is widely used to guide acute stroke treatment. However, it has never been defined how many voxels need to be affected to label a DWI-ASPECTS region ischemic. We aimed to assess the effect of various lesion load thresholds on DWI-ASPECTS and compare this automated analysis with visual rating. Materials and methods: We analyzed overlap of individual DWI lesions of 315 patients from the previously published predictive value of fluid-attenuated inversion recovery study with a probabilistic ASPECTS template derived from 221 CT images...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29727367/insidious-harm-of-medication-diluents-as-a-contributor-to-cumulative-volume-and-hyperchloremia-a-prospective-open-label-sequential-period-pilot-study
#5
Carolyn A Magee, Melissa L Thompson Bastin, Melanie E Laine, Brittany D Bissell, Gavin T Howington, Peter R Moran, Emily J McCleary, Gary D Owen, Lauren E Kane, Emily A Higdon, Cathy A Pierce, Peter E Morris, Alexander H Flannery
OBJECTIVES: Although the potential dangers of hyperchloremia from resuscitation fluids continue to emerge, no study to date has considered the contribution of medication diluents to cumulative volume and hyperchloremia. This study compares saline versus dextrose 5% in water as the primary medication diluent and the occurrence of hyperchloremia in critically ill patients. DESIGN: Prospective, open-label, sequential period pilot study. SETTING: Medical ICU of a large academic medical center...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29706809/effect-of-intravenous-infusion-dead-space-on-time-to-drug-delivery-in-infants
#6
Bryce G Gregerson, Alexa L Larsen, Seth M Kelly, Joshua D Sonnier, Andrew L Juergens
Infusion dead space is the internal volume of a catheter and tubing through which a fluid must pass before reaching a patient's intravenous space. It is a factor in time to delivery for intravenous administration and can be significant, depending on the volume and rate of infusion. A 10-kg infant was simulated, receiving an epinephrine infusion with a concentration of 20 mcg/mL at a rate of 0.1 mcg/kg/min, which equals 3 mL/h. Commonly used pediatric intravenous equipment was selected. The tubing was flushed with a dyed solution...
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29703051/balanced-10-hydroxyethyl-starch-compared-with-balanced-6-hydroxyethyl-starch-and-balanced-crystalloid-using-a-goal-directed-hemodynamic-algorithm-in-pancreatic-surgery-a-randomized-clinical-trial
#7
Julia Werner, Oliver Hunsicker, Anja Schneider, Henryk Stein, Christian von Heymann, Adrian Freitag, Aarne Feldheiser, Klaus-Dieter Wernecke, Claudia Spies
BACKGROUND: While hydroxyethyl starch (HES) solutions are not recommended any longer in critically ill patients, data on efficacy and safety during surgery are still limited. METHODS: In a randomized controlled trial 63 patients were assigned to receive 10% HES (130/0.42), 6% HES (130/0.42), or crystalloid within a goal-directed hemodynamic algorithm during pancreatic surgery. The primary endpoints were intraoperative volume of HES and time until fully on oral diet...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29693936/cardiac-point-of-care-using-ultrasound
#8
Mitsuharu Kodaka
Patients with cardiac disease have high mortality rates, mainly owing to shock. Therefore, evaluation of cardiac function is one of the most challenging issues in the intensive and critical care unit. Cardiac point-of-care tests using ultrasound, such as focus assessed transthoracic echo (FATE) and rapid ultrasound in shock (RUSH). are useful for diagnosis and initial care of such patients. The author will introduce first a basic FATE protocol of how to scan from position 1-4, including subcostal 4-chamber, apical 4-chamber, parasternal long and short axis, and pleural scanning...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29690735/-lay-emphasis-on-circulatory-state-research-after-fluid-resuscitation-in-early-burns
#9
Q Zhang, Y Q Tang
In this article, we discuss future development of circulatory state research after fluid resuscitation in early burns from its history and difficulties confronted. We believe that the Chinese fluid resuscitation formula to predict initial volume of fluid infusion of extensive burn patients is still useful and effective, while we should attach more importance to advances in the research of burn pathophysiology, basic theory and clinical practices of Chinese fluid resuscitation formula, so as to provide strategy of fluid resuscitation in early burns for international burn world...
April 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29688917/large-volume-fluid-resuscitation-for-severe-acute-pancreatitis-is-associated-with-reduced-mortality-a-multicenter-retrospective-study
#10
Takahiro Yamashita, Masayasu Horibe, Masamitsu Sanui, Mitsuhito Sasaki, Hirotaka Sawano, Takashi Goto, Tsukasa Ikeura, Tsuyoshi Hamada, Takuya Oda, Hideto Yasuda, Yuki Ogura, Dai Miyazaki, Kaoru Hirose, Katsuya Kitamura, Nobutaka Chiba, Tetsu Ozaki, Toshitaka Koinuma, Taku Oshima, Tomonori Yamamoto, Morihisa Hirota, Yukiko Masuda, Natsuko Tokuhira, Mioko Kobayashi, Shinjiro Saito, Junko Izai, Alan K Lefor, Eisuke Iwasaki, Takanori Kanai, Toshihiko Mayumi
BACKGROUND AND AIMS: Although fluid resuscitation is critical in acute pancreatitis, the optimal fluid volume is unknown. The aim of this study is to evaluate the association between the volume of fluid administered and clinical outcomes in patients with severe acute pancreatitis (SAP). METHODS: We conducted a multicenter retrospective study at 44 institutions in Japan. Inclusion criteria were age 18 years or older, and diagnosed with SAP from 2009 to 2013. Patients were stratified into 2 groups: administered fluid volume <6000 and ≥6000 mL in the first 24 hours...
April 23, 2018: Journal of Clinical Gastroenterology
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
#11
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/29680878/quantitative-computed-tomography-in-comparison-with-transpulmonary-thermodilution-for-the-estimation-of-pulmonary-fluid-status-a-clinical-study-in-critically-ill-patients
#12
Bernd Saugel, Moritz Wildgruber, Albrecht Staudt, Michael Dieckmeyer, Konstantin Holzapfel, Georgios Kaissis, Mikhail Y Kirov, Vsevolod V Kuzkov, Roland M Schmid, Wolfgang Huber
Extravascular lung water (index) (EVLW(I)) can be estimated using transpulmonary thermodilution (TPTD). Computed tomography (CT) with quantitative analysis of lung tissue density has been proposed to quantify pulmonary edema. We compared variables of pulmonary fluid status assessed using quantitative CT and TPTD in critically ill patients. In 21 intensive care unit patients, we performed TPTD measurements directly before and after chest CT. Based on the density data of segmented CT images we calculated the tissue volume (TV), tissue volume index (TVI), and the mean weighted index of voxel aqueous density (VMWaq)...
April 21, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29677005/maged2-a-novel-form-of-antenatal-bartter-s-syndrome
#13
Martin Kömhoff, Kamel Laghmani
PURPOSE OF REVIEW: Antenatal Bartter's syndrome (aBS) is the most severe form of Bartter's syndrome, requiring close follow-up, in particular during the neonatal period, primarily because of prematurity. The recent identification of a novel and very severe form of aBS merits an update on this topic. RECENT FINDING: Despite the identification of several genes involved in Bartter's syndrome, about 20% of patients clinically diagnosed with aBS remained without genetic explanation for decades...
April 18, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29618325/chylopericardium-in-a-child-with-iga-nephropathy-a-case-report
#14
Yu-Lin Kang, Yun Cui, Ying Wu, Shen Hao, Xin-Yu Kuang, Yu-Cai Zhang, Wen-Yan Huang, Guang-Hua Zhu
BACKGROUND: Chylopericardium effusion is characterized by the accumulation of milky effusion in the pericardium. It is often idiopathic but it can be secondary to trauma, chest radiation, tuberculosis and malignancy. If cardiac tamponade ensues, it becomes life-threatening. Herein we describe chylopericardium tamponade in a child with IgA nephropathy. To the best of our knowledge, this is the first reported case of chylopericardium tamponade in IgA nephropathy. CASE PRESENTATION: A 6 years old boy with IgA nephropathy presented with dyspnea, orthopnea, pretibial pitting edema, ascites and fever...
April 5, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29614588/-the-effect-of-continuous-veno-venous-hemofiltration-on-neutrophil-gelatinase-associated-lipocalin-plasma-levels-in-critically-ill-patients-with-acute-kidney-injury
#15
H Wang, N Cui, Y K Zhou, W Cheng, L Li, Y Long, D W Liu
Objective: To evaluate the effect of continuous veno venous hemofiltration (CVVH) on neutrophil gelatinase associated lipocalin (NGAL) in critically ill patients with acute kidney injury (AKI). Methods: Critically ill patients with AKI who needed CVVH and admitted to Department of Critical Care Medicine of Peking Union Medical College Hospital were enrolled prospectively from January 2015 to June 2015. AN69 membrane filters were used for CVVH. Prefilter, postfilter,and plasma NGAL measurements were taken at 10 mins, 4 hours and 8 hours (T 10 min, T 4 h, T 8 h) after CVVH...
April 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29610713/ultrasound-for-volume-assessment-in-patients-with-shock-effectiveness-of-an-educational-intervention-for-fourth-year-medical-students
#16
Paul Kukulski, Michael Ward, Keme Carter
Objective Shock is a common emergency condition with high morbidity and mortality, and judicious fluid resuscitation can significantly affect outcomes. The use of a bedside echocardiogram and evaluation of the inferior vena cava (IVC) via ultrasound (US) for collapsibility can predict volume status. Additionally, the Association of American Medical Colleges (AAMC) Entrustable Professional Activities (EPA) 10 states that residents need to be able to address a patient with a critical illness, including hypotension, on Day 1 of residency...
January 30, 2018: Curēus
https://www.readbyqxmd.com/read/29597227/from-continuous-renal-replacement-therapies-to-multiple-organ-support-therapy
#17
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco, Gaetano La Manna
The incidence of the multiple organ dysfunction syndrome (MODS) is rapidly increasing in intensive care units (ICU). It usually combines with sepsis and is the most frequent cause of death in the ICU patients. The nature of the ICU patients has changed in the last years. It includes a variety of patients with severe cases due to major surgical interventions, trauma, hemodynamic instability, sepsis, and so on but also older people than previous times. All these situations can easily lead to MODS. In the prior years, the only available and efficient therapy was renal replacement therapy (RRT) for treating acute renal failure, but the development of technology also gives us devices to support the other systems...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597221/technical-complications-of-continuous-renal-replacement-therapy
#18
Zaccaria Ricci, Stefano Romagnoli
Continuous renal replacement therapy (CRRT) is commonly applied in critically ill patients affected by severe acute kidney injury for solute and volume control and to optimize acid-base and electrolytes balance. Although CRRT represents a life-saving procedure for these patients, it is a representation of a non-physiologic artificial kidney and the potential benefits of the treatment could be hampered by clinical and technical side effects. Different parts of the CRRT system can be a source of technical complications...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597220/extra-renal-indications-for-continuous-renal-replacement-therapy
#19
Suvi T Vaara, Rinaldo Bellomo
Continuous renal replacement therapy (CRRT) has many potential indications that extend beyond the traditional removal of uremic waste products. Many of these stem from the capacity of CRRT to remove middle-sized molecules and its suitability for haemodynamically unstable patients. Using CRRT for immunomodulation to remove circulating plasma cytokines has created great enthusiasm and, in the past, immunomodulation was a frequently reported indication for commencing CRRT. Unfortunately, recent evidence from randomized controlled trials has been discouraging, and CRRT cannot be recommended for immunomodulation...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29593868/recommendations-for-active-correction-of-hypernatremia-in-volume-resuscitated-shock-or-sepsis-patients-should-be-taken-with-a-grain-of-salt-a-systematic-review
#20
REVIEW
Joseph W Quinn, Kerry Sewell, Dell E Simmons
Background: Healthcare-acquired hypernatremia (serum sodium >145 mEq/dL) is common among critically ill and other hospitalized patients and is usually treated with hypotonic fluid and/or diuretics to correct a "free water deficit." However, many hypernatremic patients are eu- or hypervolemic, and an evolving body of literature emphasizes the importance of rapidly returning critically ill patients to a neutral fluid balance after resuscitation. Objective: We searched for any randomized- or observational-controlled studies evaluating the impact of active interventions intended to correct hypernatremia to eunatremia on any outcome in volume-resuscitated patients with shock and/or sepsis...
2018: SAGE Open Medicine
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