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https://www.readbyqxmd.com/read/28526086/comparison-of-fluid-balance-and-hemodynamic-and-metabolic-effects-of-sodium-lactate-versus-sodium-bicarbonate-versus-0-9-nacl-in-porcine-endotoxic-shock-a-randomized-open-label-controlled-study
#1
Thibault Duburcq, Arthur Durand, Anne-Frédérique Dessein, Joseph Vamecq, Jean-Claude Vienne, Dries Dobbelaere, Karine Mention, Claire Douillard, Patrice Maboudou, Valery Gmyr, François Pattou, Mercé Jourdain, Fabienne Tamion, Julien Poissy, Daniel Mathieu, Raphaël Favory
BACKGROUND: Sodium lactate has been shown to improve hemodynamics and avoid fluid overload. The objective of this study was to confirm a beneficial effect on fluid balance with sodium lactate infusion and to specify whether the advantage of lactate is related to a negative chloride balance, its particular metabolism, or simply its energy load. METHODS: This was an interventional, randomized, open-label, controlled experimental study. Fifteen female "large white" pigs (2 months old) were challenged with intravenous infusion of Escherichia coli endotoxin...
May 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28524671/chiral-shock-waves
#2
Srimoyee Sen, Naoki Yamamoto
We study the shock waves in relativistic chiral matter. We argue that the conventional Rankine-Hugoinot relations are modified due to the presence of chiral transport phenomena. We show that the entropy discontinuity in a weak shock wave is quadratic in the pressure discontinuity when the effect of chiral transport becomes sufficiently large. We also show that rarefaction shock waves, which do not exist in usual nonchiral fluids, can appear in chiral matter. The direction of shock wave propagation is found to be completely determined by the direction of the vorticity and the chirality of fermions...
May 5, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28514322/relationship-between-a-sepsis-intervention-bundle-and-in-hospital-mortality-among-hospitalized-patients-a-retrospective-analysis-of-real-world-data
#3
Priya A Prasad, Erica R Shea, Stephen Shiboski, Mary C Sullivan, Ralph Gonzales, David Shimabukuro
BACKGROUND: Sepsis is a systemic response to infection that can lead to tissue damage, organ failure, and death. Efforts have been made to develop evidence-based intervention bundles to identify and manage sepsis early in the course of the disease to decrease sepsis-related morbidity and mortality. We evaluated the relationship between a minimally invasive sepsis intervention bundle and in-hospital mortality using robust methods for observational data. METHODS: We performed a retrospective cohort study at the University of California, San Francisco, Medical Center among adult patients discharged between January 1, 2012, and December 31, 2014, and who received a diagnosis of severe sepsis/septic shock (SS/SS)...
May 12, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28509668/norepinephrine-in-septic-shock-when-and-how-much
#4
Olfa Hamzaoui, Thomas W L Scheeren, Jean-Louis Teboul
PURPOSE OF REVIEW: Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension because of depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension of when high doses of norepinephrine are required to reach the target. RECENT FINDINGS: Recent literature has reported benefits of early administration of norepinephrine because of the following reasons: profound and durable hypotension is an independent factor of increased mortality, early administration of norepinephrine increases cardiac output, improves microcirculation and avoid fluid overload...
May 13, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28503840/a-critical-note-on-treatment-of-a-severe-diltiazem-intoxication-high-dose-calcium-and-glucagon-infusions
#5
N M Van Veggel, G J Van der Veen, T C Jansen, E M Westerman
The morbidity and mortality of a severe calcium channel blocker intoxication is high due to serious toxic cardiac effects. Its treatment is supported by low-quality evidence from heterogeneous literature. We describe a case of a severe diltiazem intoxication and critically appraise the efficacy and role of high-dose calcium and glucagon infusions. A 53-year-old woman was admitted to the emergency department with a cardiogenic shock with complete AV block, not responding to atropine, isoprenaline and an external pacemaker...
May 15, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28501864/first-line-support-by-intra-aortic-balloon-pump-in-non-ischaemic-cardiogenic-shock-in-the-era-of-modern-ventricular-assist-devices
#6
Corstiaan A den Uil, Giorgia Galli, Lucia S Jewbali, Kadir Caliskan, Olivier C Manintveld, Jasper J Brugts, Nicolas M van Mieghem, Mattie J Lenzen, Eric Boersma, Alina A Constantinescu
OBJECTIVES: Little is known about circulatory support in cardiogenic shock (CS) from other causes than the acute coronary syndrome or after cardiotomy. We evaluated the effects of first-line intra-aortic balloon pump (IABP) support in this subpopulation of CS patients. METHODS: A retrospective study was performed in 27 patients with CS from end-stage cardiomyopathy supported firstly by IABP in the years 2011-2016. RESULTS: At 24 h, lactate decreased from 3...
May 13, 2017: Cardiology
https://www.readbyqxmd.com/read/28501489/hydroxyethyl-starch-130-0-4-compared-with-0-9-nacl-administered-to-greyhounds-with-haemorrhagic-shock
#7
Duana McBride, Anthea L Raisis, Giselle Hosgood, Lisa Smart
OBJECTIVE: To determine the cardiovascular and acid-base effects of 6% hydroxyethyl starch (HES) 130/0.4 and 0.9% sodium chloride (NaCl) administered to anaesthetized greyhounds with haemorrhagic shock. STUDY DESIGN: Prospective, experimental, complete randomized block design. ANIMALS: Twelve healthy adult greyhounds. METHODS: After 60 minutes of isoflurane anaesthesia, 48 mL kg(-1) of blood was removed to induce hypotension...
March 6, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28493871/ileus-in-children-presenting-with-diarrhea-and-severe-acute-malnutrition-a-chart-review
#8
Mohammod Jobayer Chisti, Abu Smsb Shahid, K M Shahunja, Pradip Kumar Bardhan, Abu Syeed Golam Faruque, Lubaba Shahrin, Sumon Kumar Das, Dipesh Kumar Barua, Md Iqbal Hossain, Tahmeed Ahmed
BACKGROUND: Severely malnourished children aged under five years requiring hospital admission for diarrheal illness frequently develop ileus during hospitalization with often fatal outcomes. However, there is no data on risk factors and outcome of ileus in such children. We intended to evaluate predictive factors for ileus during hospitalization and their outcomes. METHODOLOGY/PRINCIPAL FINDINGS: This was a retrospective chart review that enrolled severely malnourished children under five years old with diarrhea, admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh between April 2011 and August 2012...
May 11, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28493077/lung-protective-effects-of-low-volume-resuscitation-and-pharmacologic-treatment-of-swine-subjected-to-polytrauma-and-hemorrhagic-shock
#9
Vahagn C Nikolian, Baihong Pan, Tomaz Mesar, Isabel S Dennahy, Patrick E Georgoff, Xiuzhen Duan, Baoling Liu, Xizi Wu, Michael J Duggan, Hasan B Alam, Yongqing Li
Hemorrhage is a common cause of death in the battlefield. Valproic acid (VPA) has been associated with improved outcomes in multiple models of trauma, when combined with isotonic fluid resuscitation. However, isotonic fluid administered in this setting is logistically impractical and may be associated with complications. In this study, we sought to evaluate the feasibility and immunologic impact of combining VPA treatment with low-volume hypertonic saline (HTS). In vivo: female Yorkshire swine were subjected to hemorrhage (40% total blood volume) and polytrauma (rib fracture and delayed liver injury)...
May 10, 2017: Inflammation
https://www.readbyqxmd.com/read/28487990/inhibition-of-btk-protects-lungs-from-trauma-hemorrhagic-shock-induced-injury-in-rats
#10
Xinwei Liu, Jingdong Zhang, Wenfeng Han, Yu Wang, Yunen Liu, Yubiao Zhang, Dapeng Zhou, Liangbi Xiang
The present study aimed to investigate the role of Bruton's tyrosine kinase (BTK) in the pathogenesis of lung injury induced by trauma‑hemorrhagic shock (THS), and to examine the pulmonary protective effects of BTK inhibition. Male Sprague‑Dawley rats were divided into four groups (n=12/group): i) A Sham group, which received surgery without induced trauma; ii) a THS‑induced injury group; iii) a THS‑induced injury group that also received treatment with the BTK inhibitor LFM‑A13 prior to trauma induction; and iv) a Sham group that was pretreated with LFM‑A13 prior to surgery but did not receive induced trauma...
May 9, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28485321/monitoring-changes-in-hepatic-venous-velocities-flow-after-a-fluid-challenge-can-identify-shock-patients-who-lack-fluid-responsiveness
#11
Wei Du, Xiao-Ting Wang, Yun Long, Da-Wei Liu
BACKGROUND: Evaluating the hemodynamic status and predicting fluid responsiveness are important in critical ultrasound assessment of shock patients. Transthoracic echocardiography with noninvasive diagnostic parameters allows the assessment of volume responsiveness. This study aimed to assess the hemodynamic changes in the liver and systemic hemodynamic changes during fluid challenge and during passive leg raising (PLR) by measuring hepatic venous flow (HVF) velocity. METHODS: This is an open-label study in a tertiary teaching hospital...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28478877/microvascular-fluid-resuscitation-in-circulatory-shock
#12
REVIEW
Shannan K Hamlin, Penelope Z Strauss, Hsin-Mei Chen, LaDonna Christy
The microcirculation is responsible for blood flow regulation and red blood cell distribution throughout individual organs. Patients with circulatory shock have acute failure of the cardiovascular system in which there is insufficient delivery of oxygen to meet metabolic tissue requirements. All subtypes of shock pathophysiology have a hypovolemic component. Fluid resuscitation guided by systemic hemodynamic end points is a common intervention. Evidence shows that microcirculatory shock persists even after optimization of macrocirculatory hemodynamics...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28476929/the-case-of-the-mysterious-vanishing-spleen-autosplenectomy-complicating-pneumococcal-sepsis
#13
Georgina Moritz, Megan Jenkins, Dushyant Shetty, Julie Blundell
A 57-year-old previously healthy fisherman was admitted in fulminant pneumococcal septic shock, with disseminated intravascular coagulation, requiring aggressive management including bilateral below-knee amputations for ischaemic necrosis. He began to recover and was discharged for rehabilitation, however during his convalescence was found to be hypercalcaemic. No malignancy was found on CT scan, but it was noted that his spleen was absent, replaced by a 4 cm smooth-walled, fluid-filled lesion. This was unexpected as an ultrasound in intensive care 10 weeks previously had demonstrated a normal spleen...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28474097/advanced-hemodynamic-monitoring-in-intensive-care-medicine-a%C3%A2-german-web-based-survey-study
#14
B Saugel, P C Reese, J Y Wagner, M Buerke, W Huber, S Kluge, R Prondzinsky
BACKGROUND: Advanced hemodynamic monitoring is recommended in patients with complex circulatory shock. OBJECTIVES: To evaluate the current attitudes and beliefs among German intensivists, regarding advanced hemodynamic monitoring, the actual hemodynamic management in clinical practice, and the barriers to using it. MATERIALS AND METHODS: Web-based survey among members of the German Society of Medical Intensive Care and Emergency Medicine. RESULTS: Of 284 respondents, 249 (87%) agreed that further hemodynamic assessment is needed to determine the type of circulatory shock if no clear clinical diagnosis can be made...
May 4, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28472699/outcomes-of-patients-with-severe-infection-in-uganda-according-to-adherence-to-the-world-health-organization-s-integrated-management-of-adolescent-and-adult-illness-fluid-resuscitation-guidelines
#15
Abdallah Amir, Kacie J Saulters, Rose Muhindo, Christopher C Moore
PURPOSE: We determined outcomes in hospitalized patients in Uganda with World Health Organization's Integrated Management of Adolescent and Adult Illness (IMAI) defined septic shock (IMAI-shock) or severe respiratory distress without shock (IMAI-SRD) based on whether they received recommended fluid resuscitation according to IMAI guidelines. MATERIALS AND METHODS: We performed a secondary analysis of a prospective cohort of adult septic patients in Uganda that included the volume of fluids patients received during the first 6h of resuscitation...
April 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28471112/immune-recovery-after-fluid-resuscitation-in-rats-with-severe-hemorrhagic-shock
#16
Feng Yao, Yuan-Qiang Lu, Jiu-Kun Jiang, Lin-Hui Gu, Han-Zhou Mou
OBJECTIVE: To investigate the effects of resuscitation with normal saline (NS), hypertonic saline (HTS), and hydroxyethyl starch (HES) on regulatory T cells (Tregs), helper T 1 (Th1)/Th2 and cytotoxic T 1 (Tc1)/Tc2 profiles in the treatment of hemorrhagic shock. METHODS: Rats subjected to severe hemorrhagic shock were resuscitated for 30 min with NS (n=8), HTS (n=8), or HES (n=8); sham (n=8) and naive control (n=8) groups were used for comparison. Following fluid resuscitation, the whole shed blood was reinfused for 30 min, and the rats were observed with continuous hemodynamic monitoring for 120 min...
May 2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/28468633/myocardial-and-haemodynamic-responses-to-two-fluid-regimens-in-african-children-with-severe-malnutrition-and-hypovolaemic-shock-afrim-study
#17
Nchafatso Obonyo, Bernadette Brent, Peter Olupot-Olupot, Michael Boele van Hensbroek, Irene Kuipers, Sidney Wong, Kenji Shiino, Jonathan Chan, John Fraser, Job B M van Woensel, Kathryn Maitland
BACKGROUND: Fluid therapy in severely malnourished children is hypothesized to be deleterious owing to compromised cardiac function. We evaluated World Health Organization (WHO) fluid resuscitation guidelines for hypovolaemic shock using myocardial and haemodynamic function and safety endpoints. METHODS: A prospective observational study of two sequential fluid management strategies was conducted at two East African hospitals. Eligible participants were severely malnourished children, aged 6-60 months, with hypovolaemic shock secondary to gastroenteritis...
May 3, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28463946/a-rare-cause-of-shock-in-an-infant-cor-triatriatum
#18
Tatyana Vayngortin, Howard Rosenfeld, Karim Mansour
Congenital heart disease can be difficult to diagnose in infants because they often present with nonspecific symptoms. Their clinical presentation can resemble that of respiratory infections or sepsis, yet typical treatments for these conditions such as fluid resuscitation may worsen their course. We report a case of an 8-week-old boy who had several weeks of viral symptoms and eventually presented to the emergency department in shock. An echocardiogram revealed the diagnosis of cor triatriatum, a rare congenital heart disease that requires urgent surgical repair...
May 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28460808/emergency-department-septic-shock-patient-mortality-with-refractory-hypotension-vs-hyperlactatemia-a-retrospective-cohort-study
#19
Michael D April, Chase Donaldson, Lloyd I Tannenbaum, Tyler Moore, Jose Aguirre, Alexander Pingree, James H Lantry
BACKGROUND: Our objective was to compare in-hospital mortality among emergency department (ED) patients meeting trial-based criteria for septic shock based upon whether presenting with refractory hypotension (systolic blood pressure<90mmHg after 1L intravenous fluid bolus) versus hyperlactatemia (initial lactate≥4mmol/L). METHODS: We conducted a retrospective cohort analysis by chart review of ED patients admitted to an intensive care unit with suspected infection during 1 August 2012-28 February 2015...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28460634/acute-kidney-injury-during-pregnancy-and-puerperium-a-retrospective-study-in-a-single-center
#20
Chunhong Huang, Shanying Chen
BACKGROUND: Acute kidney injury (AKI) is rare in women during pregnancy and puerperium, however, it is related to increased morbidity and mortality rates. OBJECTIVE: The aim of this study was to investigate the incidence, characteristics, and outcomes of AKI during pregnancy and puerperium in a Chinese population. METHODS: In this study, pregnant women discharged from hospital between January 2008 and June 2015 were screened. AKI was defined if the level of serum creatitine >70...
May 1, 2017: BMC Nephrology
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