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https://www.readbyqxmd.com/read/28212219/drug-infusion-systems-technologies-performance-and-pitfalls
#1
Uoo R Kim, Robert A Peterfreund, Mark A Lovich
This review aims to broadly describe drug infusion technologies and raise subtle but important issues arising from infusion therapy that can potentially lead to patient instability and morbidity. Advantages and disadvantages of gravity-dependent drug infusion are described and compared with electromechanical approaches for precise control of medication infusion, including large-volume peristaltic and syringe pumps. This review discusses how drugs and inert carriers interact within infusion systems and outlines several complexities and potential sources of drug error...
February 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28212201/health-sector-reform-emotional-exhaustion-and-nursing-burnout-a-retrospective-panel-study-in-iran
#2
Ahmad Kalateh Sadati, Farnaz Rahnavard, Seyed Taghi Heydari, Soroor Hemmati, Najmeh Ebrahimzadeh, Kamran Bagheri Lankarani
BACKGROUND: Nursing burnout is affected by various factors, including work overload. Since the inauguration of the Health Sector Evolution Plan (HSEP) in Iran in 2014, government hospitals have been required to provide health services to the public at all levels. This decision, however, has increased the volume of patients admitted to government hospitals. Because nurses are on the front line of health services, they are faced with a greater load of care provision. PURPOSE: This study aimed to evaluate nursing burnout before and after HSEP in Iran, with an emphasis on the differences between government and private hospitals...
February 16, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28194742/predictability-of-tricuspid-annular-plane-systolic-excursion-for-the-effectiveness-of-tolvaptan-in-patients-with-heart-failure
#3
Toru Niwa, Katsuhisa Waseda, Tomofumi Mizuno, Yusuke Nakano, Kentaro Mukai, Hirokazu Wakabayashi, Atsushi Watanabe, Hirohiko Ando, Hiroaki Takashima, Tetsuya Amano
BACKGROUND: There is no echocardiographic predictor of the effectiveness of tolvaptan in patients with heart failure (HF). The aim of this study was to investigate the echocardiographic predictor of responders to tolvaptan in patients with HF. METHODS: This observational study consisted of 62 consecutive in-hospital patients with HF who received tolvaptan with volume overload despite standard therapies. The echocardiography data were obtained within 1 week before the administration of tolvaptan...
February 13, 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/28185299/incremental-hemodialysis-a-european-perspective
#4
Kamonwan Tangvoraphonkchai, Andrew Davenport
Most patients initiating hemodialysis have residual renal function (RRF). Whereas RRF is monitored prior to commencing hemodialysis, once dialysis is started most centres simply rely on dialyzer urea clearance to determine adequate uremic toxin clearance and disregard the effect of RRF. However sustaining RRF is important for the dialysis patient, as RRF reduces inter-dialytic weight gains, increases middle molecule and protein bound toxin clearances and is associated with better quality of life assessments...
February 9, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28181258/cardiac-diastolic-and-autonomic-dysfunction-are-aggravated-by-central-chemoreflex-activation-in-hfpef-rats
#5
Camilo Toledo, David C Andrade, Claudia Lucero, Alexis Arce-Alvarez, Hugo S Díaz, Valentín Aliaga, Harold D Schultz, Noah J Marcus, Mónica Manríquez, Marcelo Faúndez, Rodrigo Del Rio
Heart failure (HF) patients with preserved ejection fraction (HFpEF) display irregular breathing, sympatho-vagal imbalance, arrhythmias, and diastolic dysfunction. It has been shown that tonic activation of central and peripheral chemoreflex pathway plays a pivotal role in the pathophysiology of HF with reduced ejection fraction. In contrast, no studies to date have addressed chemoreflex function or its effect on cardiac function in HFpEF. Therefore, we tested whether peripheral and central chemoreflexes are hyperactive in HFpEF and if chemoreflex activation exacerbates cardiac dysfunction and autonomic imbalance...
February 8, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28180202/applicability-and-technical-aspects-of-two-dimensional-ultrasonography-for-assessment-of-fetal-heart-function
#6
REVIEW
Nathalie Jeanne Bravo-Valenzuela, Alberto Borges Peixoto, Luciano Marcondes Nardozza, Alex Sandro Souza, Edward Araujo Júnior
In recent years, fetal echocardiography has been used for the screening and diagnosis of anatomical heart defects and for the detailed study of fetal cardiac function. This method is characterized by its easy implementation and good reproducibility, allowing the diagnosis of myocardial dysfunction even in its subclinical phase. The functional assessment of the fetal heart should be routinely performed in fetuses with congenital heart disease and those without anatomical malformation. Several extra-cardiac conditions may alter fetal cardiac function, by increased placental resistance, volume overload or hyperdynamic circulation, compression, or maternal systemic disease with involvement of the fetal myocardium...
January 31, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28166084/unexpected-complication-of-cocaine-associated-anti-neutrophil-cytoplasmic-antibody-vasculitis-related-to-persistent-in-hospital-cocaine-use
#7
Travis D Olives, Rebecca L Kornas, Russell Fujisawa, Jon B Cole
INTRODUCTION: Levamisole-adulterated cocaine has been implicated in anti-neutrophil cytoplasmic antibody (ANCA) vasculitis. We present a case of spontaneous intraperitoneal hemorrhage, an unexpectedly severe complication of cocaine-related ANCA vasculitis, developing late during hospitalization. CASE REPORT: An adult male with a history of hepatitis C, distant cocaine use, and limited health care presented to a local emergency department (ED) with volume overload, renal failure, hyperkalemia and non-anion gap metabolic acidosis...
February 3, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28163434/aortic-and-pulmonary-artery-calcification-an-unusual-manifestation-of-twin-to-twin-transfusion-syndrome
#8
Sumitra Venkatesh, J Sanyukta, S Jain, S S Prabhu, S Kulkarni
Twin-to-twin transfusion syndrome (TTTS) at times complicates monochorionic twin gestations, resulting in conditions ranging from discordant sizes to fetal demise of one baby. Various types of cardiac defects have been described in the recipient twin of this syndrome. Isolated great artery calcification, i.e. aortic and pulmonary artery calcification is one such uncommon condition associated with TTTS. Calcification of the walls of great vessels may be due to chronic vascular injury sustained as a result of circulatory volume overload in the recipient twin...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28159011/fluids-and-sepsis-changing-the-paradigm-of-fluid-therapy-a-case-report
#9
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/28153194/fluid-overload-in-peritoneal-dialysis-patients
#10
REVIEW
Yong-Lim Kim, Wim Van Biesen
Volume management in peritoneal dialysis patients is of importance, as both volume overload and dehydration are associated with worse outcomes. When assessing volume status, it is important to understand that different techniques measure different fluid compartments (intracellular vs extracellular vs circulating volume) and the impact of cardiac function. Attention to salt restriction and diuretics can help to maintain euvolemia without need for hypertonic bags. Glycaemia should be monitored to avoid thirst...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153193/low-gdp-solution-and-glucose-sparing-strategies-for-peritoneal-dialysis
#11
REVIEW
Cheuk Chun Szeto, David W Johnson
Long-term exposure to a high glucose concentration in conventional peritoneal dialysis (PD) solution has a number of direct and indirect (via glucose degradation products [GDP]) detrimental effects on the peritoneal membrane, as well as systemic metabolism. Glucose- or GDP-sparing strategies often are hypothesized to confer clinical benefits to PD patients. Icodextrin (glucose polymer) solution improves peritoneal ultrafiltration and reduces the risk of fluid overload, but these beneficial effects are probably the result of better fluid removal rather than being glucose sparing...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28153192/current-challenges-and-opportunities-in-pd
#12
REVIEW
Philip Kam-Tao Li, Vickie Wai-Ki Kwong
Despite the gradual increased use of peritoneal dialysis (PD) globally around the world, it is recognized that a number of areas in PD as a renal-replacement therapy require attention and improvements. The current challenges in PD include how to tackle technique failure and sustain long-term PD, manage and prevent peritoneal infections, malnutrition and inflammation, cardiovascular mortality, volume overload, glucose exposure, adequacy of solute removal, peritoneal access, peritoneal physiology and changes with long-term PD, patient fatigue, psychosocial issues, and care of elderly patients on PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28152673/effects-of-adding-a-weekly-eccentric-overload-training-session-on-strength-and-athletic-performance-in-team-handball-players
#13
Rafael Sabido, Jose Luis HernáNdez-Davó, Javier Botella, Angel Navarro, Julio Tous-Fajardo
To investigate the influence of adding a weekly eccentric-overload training (EOT) session in several athletic performance's tests, 18 team-handball players were assigned either to an EOT (n = 11) or a Control (n = 7) group. Both groups continued to perform the same habitual strength training, but the EOT group added one session/week during a 7-week training programme consisting of four sets of eight repetitions for the bilateral half-squat and unilateral lunge exercises. The test battery included handball throwing velocity, maximum dynamic strength (1RM), countermovement jump (CMJ), 20 m sprint, triple hop for distance, and eccentric/concentric power in both the half-squat and lunge exercises...
February 2, 2017: European Journal of Sport Science
https://www.readbyqxmd.com/read/28144400/cutting-edge-clinical-applications-in-cardiovascular-magnetic-resonance
#14
EDITORIAL
Carlo N De Cecco, Giuseppe Muscogiuri, Akos Varga-Szemes, U Joseph Schoepf
Today, the use of cardiovascular magnetic resonance (CMR) is widespread in clinical practice. The increased need to evaluate of subtle myocardial changes, coronary artery anatomy, and hemodynamic assessment has prompted the development of novel CMR techniques including T1 and T2 mapping, non-contrast angiography and four dimensional (4D) flow. T1 mapping is suitable for diagnosing pathologies affecting extracellular volume such as myocarditis, diffuse myocardial fibrosis and amyloidosis, and is a promising diagnostic tool for patients with iron overload and Fabry disease...
January 28, 2017: World Journal of Radiology
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
#15
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/28135785/changes-in-cardiac-output-and-incidence-of-volume-overload-in-cirrhotics-receiving-20-albumin-infusion
#16
Saggere Muralikrishna Shasthry, Manoj Kumar, Jelen Singh Khumuckham, Shiv Kumar Sarin
Cirrhotic patients are prone to develop volume over load, have increased capillary permeability and latent or overt cardiomyopathy. Whether albumin infusion causes volume overload in cirrhotics has not been adequately studied PATIENTS AND METHODS: Ninety nine consecutive cirrhotic patients receiving 1gm per kg albumin infusion were evaluated for development of volume overload. Clinical, echocardiographic and hemodynamic changes were closely monitored during and after albumin infusion RESULTS: Thirty (30.30%) patients developed volume overload...
January 30, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28135411/use-of-cryopoor-plasma-for-albumin-replacement-and-continuous-antimicrobial-infusion-for-treatment-of-septic-peritonitis-in-a-dog
#17
Meaghan K Ropski, Julien Guillaumin, Andrea A Monnig, Katy Townsend, Mary A McLoughlin
OBJECTIVE: To report the successful management of a dog with septic peritonitis and septic shock secondary to enterectomy dehiscence using novel techniques for identification of intestinal dehiscence and for septic shock treatment. CASE SUMMARY: A 5-year-old castrated male Bernese Mountain Dog presented for lethargy 6 days following enterotomy for foreign body obstruction. Septic peritonitis was identified due to dehiscence of the enterotomy site, and resection and anastomosis were performed using a gastrointestinal anastomosis and thoracoabdominal stapling device...
January 30, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28135002/ischemia-reperfusion
#18
Theodore Kalogeris, Christopher P Baines, Maike Krenz, Ronald J Korthuis
Ischemic disorders, such as myocardial infarction, stroke, and peripheral vascular disease, are the most common causes of debilitating disease and death in westernized cultures. The extent of tissue injury relates directly to the extent of blood flow reduction and to the length of the ischemic period, which influence the levels to which cellular ATP and intracellular pH are reduced. By impairing ATPase-dependent ion transport, ischemia causes intracellular and mitochondrial calcium levels to increase (calcium overload)...
December 6, 2016: Comprehensive Physiology
https://www.readbyqxmd.com/read/28132006/ultrasound-and-nicom-in-the-assessment-of-fluid-responsiveness-in-patients-with-mild-sepsis-in-the-emergency-department-a-pilot-study
#19
Martha Oord, Tycho J Olgers, Mirjam Doff-Holman, Mark P M Harms, Jack J M Ligtenberg, Jan C Ter Maaten
OBJECTIVE: We investigated whether combining the caval index, assessment of the global contractility of the heart and measurement of stroke volume with Noninvasive Cardiac Output Monitoring (NICOM) can aid in fluid management in the emergency department (ED) in patients with sepsis. SETTING: A prospective observational single-centre pilot study in a tertiary care centre. PRIMARY AND SECONDARY OUTCOMES: Ultrasound was used to assess the caval index, heart contractility and presence of B-lines in the lungs...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28124862/fluid-management-in-thoracic-anesthesia
#20
Mert Şentürk, Mukadder Orhan Sungur, Zerrin Sungur
Fluid management during thoracic anesthesia remains as a challenge for the anesthesiologists. The "safe zone" between volume overload (risk of pulmonary edema) and hypovolemia (potential risk of renal failure) is hard to determine and narrow. Relationship between peroperative fluid administration and postoperative lung injury has been clearly demonstrated but lung injury can even occur after the most restrictive management. Multiple hit hypothesis and endothelial glycocalyx in addition to revised Starling equation can help us understand this dilemma...
January 25, 2017: Minerva Anestesiologica
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