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Hypovolemic

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https://www.readbyqxmd.com/read/29789177/hematuria-as-the-only-symptom-at-initial-presentation-of-hypovolemic-shock-caused-by-ruptured-renal-arteriovenous-malformations
#1
Yi-Jui Chang, Chu-Chung Chou, Chin-Fu Chang, Yan-Ren Lin
Gross hematuria is a very common complaint in emergency departments and outpatient clinics. Globally, the incidence of hematuria is 4 per 1000 patients per year. Infection, urolithiasis, and neoplasm are the most common etiologies. However, hematuria rarely causes hypovolemic shock or an emergent, life-threatening condition at the initial presentation. In this report, we describe the case of a 64-year-old man who suffered a life-threatening gross hematuria in a very short time due to ruptured renal arteriovenous malformations (AVMs)...
May 20, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29784591/accuracy-and-outcome-of-rapid-ultrasound-in-shock-and-hypotension-rush-in-egyptian-polytrauma-patients
#2
Adel Hamed Elbaih, Ahmed Mohamed Housseini, Mohamed E M Khalifa
PURPOSE: "Polytrauma" patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects modern trauma services and patient outcomes...
March 26, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29778416/the-use-of-the-shock-index-as-a-predictor-of-active-bleeding-in-trauma-patients
#3
Andrea Campos-Serra, Sandra Montmany-Vioque, Pere Rebasa-Cladera, Heura Llaquet-Bayo, Raquel Gràcia-Roman, Anna Colom-Gordillo, Salvador Navarro-Soto
INTRODUCTION: Vital signs indicate the presence of bleeding only after large amounts of blood have been lost, with high morbidity and mortality. The Shock Index (SI) is a hemorrhage indicator with a cut-off point for the risk of bleeding at 0.9. The aim of this study is to assess whether a cut-off of≥0.8 is more sensitive for detecting occult bleeding, providing for early initiation of therapeutic maneuvers. METHODS: SI analytical validation study of severe trauma patients older than 16 years of age...
May 16, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29775770/treatment-of-ruptured-vertebral-artery-dissection-and-abdominal-hemorrhage-associated-with-segmental-arterial-mediolysis-using-endovascular-coil-embolization-va-dissection-associated-with-sam
#4
Taiki Isaji, Tomotaka Ohshima, Sigeru Miyachi, Naoki Matsuo, Reo Kawaguchi, Masakazu Takayasu
BACKGROUND: Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. CASE DESCRIPTION: A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29749656/establishment-of-reference-values-of-the-caudal-vena-cava-by-fast-ultrasonography-through-different-views-in-healthy-dogs
#5
Elodie Darnis, Soren Boysen, Anne-Christine Merveille, Loïc Desquilbet, Serge Chalhoub, Kris Gommeren
BACKGROUND: Clinical assessment of intravascular volume status is challenging. In humans, ultrasonographic assessment of the inferior vena cava diameter, directly or as a ratio to the aortic diameter is used to estimate intravascular volume status. OBJECTIVES: To ultrasonographically obtain reference values (RV) for caudal vena cava diameter (CVCD ), area (CVCa ) and aortic ratios using 3 views in awake healthy dogs. ANIMALS: One hundred and twenty-six healthy adult dogs from clients, students, faculty, or staff...
May 10, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29748057/massive-bleeding-from-inferior-mesenteric-vein-with-hypovolemic-shock-a-rare-complication-of-acute-pancreatitis
#6
Sun Hwa Lee, Seong Jong Yun, Seokyong Ryu, Seung Woon Choi, Hye Jin Kim, Tae Kyung Kang, Sung Chan Oh, Suk Jin Cho
BACKGROUND: Acute pancreatitis may cause massive intra-abdominal bleeding as vascular complications caused by the erosion of a major pancreatic or peripancreatic vessel. In terms of treatment, the differentiation between arterial bleeding and venous bleeding using abdominal computed tomography (CT) angiography is important. In addition, hypovolemic shock caused by bleeding from the inferior mesenteric vein (IMV) in acute pancreatitis has not been reported. CASE REPORT: A 58-year-old man presented to our emergency department with complaints of abdominal pain of 10 hours' duration...
May 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29732372/the-role-of-failing-autonomic-nervous-system-on-life-threatening-idiopathic-systemic-capillary-leak-syndrome
#7
Riccardo Colombo, Maddalena Alessandra Wu, Emanuele Catena, Andrea Perotti, Tommaso Fossali, Federico Cioffi, Roberto Rech, Antonio Castelli, Marco Cicardi
Idiopathic systemic capillary leak syndrome (ISCLS) is a rare disease that involves the endothelium and microcirculation, leading to an abrupt shift of fluids and proteins from the intravascular to the interstitial compartment. The consequence of the capillary leakage is a life-threatening hypovolemic shock that can lead to lethal multiple organ dysfunction. The autonomic nervous system (ANS) is central in regulating the cardiovascular response to hypovolemia, but ANS modulation in ISCLS has not yet been investigated...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29710689/pulmonary-hemodynamic-effects-and-pulmonary-arterial-compliance-during-hypovolemic-shock-and-reinfusion-with-human-relaxin-2-serelaxin-treatment-in-a-sheep-model
#8
René Schiffner, Thomas Lehmann, Sabine J Bischoff, Timo Zippelius, Marius Nistor, Martin Schmidt
BACKGROUND: Previous studies on the recombinant form of human relaxin-2 (serelaxin) have shown a decrease of pulmonary hemodynamics after serelaxin injection. Currently, the effect of serelaxin treatment during hypovolemia in a large animal model remains mostly unknown. METHODS: 12 sheep were randomly assigned to a sham or serelaxin (30μg/kg serelaxin) group and underwent right heart catheterization. 50% of the estimated total blood volume were removed to induce hypovolemia, and subsequently retransfused 20 min later (reinfusion)...
April 14, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29701420/lumbar-cerebrospinal-fluid-drainage-in-endovascular-aortic-repair-reference-centre-experience
#9
Ana Margarida Martins, Marisa Silva, Maria de Lurdes Castro, Ana Ferro
INTRODUCTION: Spinal cord ischemia (SCI) and the resulting paraplegia are one of the most feared postoperative complications after thoraco-abdominal aortic surgery, with an incidence 4,3-8,0% after thoracic endovascular aortic repair (TEVAR), increasing patients morbi-mortality. Lumbar cerebrospinal fluid (CSF) drainage catheter is recommended as preventive measure in high risk patients. OBJECTIVE: To evaluate the efficiency and safety of CSF drainage catheter as preventive or therapeutic measure in endovascular aortic repair (EAR)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29700771/atraumatic-tension-hemothorax-associated-with-ruptured-aneurysm-of-intercostal-artery-azygous-fistula-a-case-report
#10
Takashi Nakayama, Hirofumi Uehara, Marie Osawa, Yukichi Tanahashi, Hiroshi Kondo, Masafumi Kawamura
Atraumatic tension hemothorax is extremely rare. We report a case of 62-year-old woman presented with obstructive and hypovolemic shock status by tension hemothorax due to ruptured aneurysm of congenital intercostal artery-azygous fistula. Contrast-enhanced computed tomography and aortography revealed an aberrant 12th intercostal artery flowing into the aneurysm with a fistula draining into the azygous vein and the rupture of aneurysm. Our experience indicates that the rupture of congenital arteriovenous fistulas (AVFs) of systemic circulation in the thoracic cavity might cause not only hypovolemic shock but also atraumatic tension hemothorax...
April 26, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29693936/cardiac-point-of-care-using-ultrasound
#11
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/29687945/severe-lactic-acidosis-and-hypoglycemia-due-to-acute-metformin-intoxication-in-a-dog
#12
Yu Ueda, Christine Wong, Angela Borchers
OBJECTIVE: To report a case of severe lactic acidosis and hypoglycemia due to acute metformin intoxication in a dog. CASE SUMMARY: A female neutered Rat Terrier was presented for an acute onset of seizure-like episodes, weakness, and vomiting approximately 14 hours after ingestion of 198 mg/kg of metformin. The dog was found to be laterally recumbent, paddling, and unresponsive shortly before presentation. On physical exam, the dog was in hypovolemic shock and hypothermic...
April 24, 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29681937/sheehan-s-syndrome-revisited-underlying-autoimmunity-or-hypoperfusion
#13
José Gerardo González-González, Omar David Borjas-Almaguer, Alejandro Salcido-Montenegro, René Rodríguez-Guajardo, Anasofia Elizondo-Plazas, Roberto Montes-de-Oca-Luna, René Rodríguez-Gutiérrez
Sheehan's syndrome remains a frequent obstetric complication with an uncertain pathophysiology. We aimed to assess the incidence of hypopituitarism (≥2 hormonal axis impairment) within the first six postchildbirth months and to determine the existence of anti-pituitary antibodies. From 2015 to 2017, adult pregnant women, who developed moderate to severe postpartum hemorrhage (PPH), were consecutively included in the study. Pituitary function was assessed 4 and 24 weeks after PPH. At the end of the study, anti-pituitary antibodies were assessed...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29676705/-a-man-with-a-black-oesophagus
#14
G J Boersen, E C T Geijteman, D H Schweitzer
An 85-year-old man came to the emergency room because of vomiting a black fluid and melaena. He was hypotensive and had severe anaemia. We suspected an upper digestive tract bleeding and a gastroscopy was performed, which showed necrosis of the entire oesophagus. Within 24 hours of admission the patient died of hypovolemic shock.
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29622332/emergency-department-management-of-pediatric-shock
#15
REVIEW
Jenny Mendelson
Shock, a state of inadequate oxygen delivery to tissues resulting in anaerobic metabolism, lactate accumulation, and end-organ dysfunction, is common in children in emergency department. Shock can be divided into 4 categories: hypovolemic, distributive, cardiogenic, and obstructive. Early recognition of shock can be made with close attention to historical clues, physical examination and vital sign abnormalities. Early and aggressive treatment can prevent or reverse organ dysfunction and improve morbidity and mortality...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29606267/-which-biological-parameters-for-volemic-status-estimation
#16
Marion Vallet, Acil Jaafar, Pierre-Yves Charles, Ivan Tack
INTRODUCTION: Estimation of volemic status can be useful in the diagnosis of some hydro-electrolytic disorders such as hyponatremia and dyskalemia. As a matter of fact, clinical examination and classical biological parameters are not discriminant enough. The aim of this study was to determine the biological parameters that are better correlated to volemic status. METHOD: Volemic status was established using extracellular fluid volume, measured by apparent distribution of inuline, in non-edematous patients and without cardiac or hepatic insufficiency...
April 2018: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29594318/adrenal-crisis-after-first-infusion-of-zoledronic-acid-a-case-report
#17
M Smrecnik, Z Kavcic Trsinar, T Kocjan
Patients with Addison's disease are at greater risk of having reduced bone mineral density and hip fractures and are thus more likely to receive a bisphosphonate than their peers. Potent intravenous bisphosphonates could provoke an acute phase reaction. An 80-year-old female with Addison's disease received her first infusion of zoledronic acid for osteoporosis at our outpatient clinic around noon. Despite doubling her usual afternoon hydrocortisone dose, she became feverish, nauseous, extremely weak, and hypotensive over the night...
March 28, 2018: Osteoporosis International
https://www.readbyqxmd.com/read/29593879/the-role-of-desmopressin-in-the-management-of-severe-hypovolemic-hyponatremia-a-single-center-comparative-analysis
#18
Frank L Ward, Sheldon W Tobe, David M J Naimark
Background: The role of desmopressin (DDAVP) to prevent or treat rapid serum sodium concentration ([Na]s) correction during hyponatremia management remains unclear. Objective: To assess DDAVP use during the first 48 hours of severe, hypovolemic hyponatremia management. The primary study hypothesis was that the use of DDAVP would slow the rate of [Na]s correction compared with those not receiving DDAVP. Design: A retrospective, observational, comparison study...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29570479/effects-of-arm-elevation-on-radial-artery-pressure-a-new-method-to-distinguish-hypovolemic-shock-and-septic-shock-from-hypotension
#19
Zhiyi Xie, Zhenyu Zhang, Yuan Xu, Hua Zhou, Sheng Wu, Zhong Wang
OBJECTIVES: In this prospective observational study, we investigated the variability in radial artery invasive blood pressure associated with arm elevation in patients with different hemodynamic types. PATIENTS AND METHODS: We carried out a prospective observational study using data from 73 general anesthesia hepatobiliary postoperative adult patients admitted to an ICU over a 1-year period. A standard procedure was used for the arm elevation test. The value of invasive radial arterial pressure was recorded at baseline, and 30 and 60 s after the arm had been raised from 0° to 90°...
March 22, 2018: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/29562027/epidemiological-profile-of-maternal-mortality
#20
Ana Claudia Sierra Martins, Lélia Souza Silva
OBJECTIVE: To know the epidemiological profile of maternal mortality in Juiz de Fora, a city in the state of Minas Gerais. Data collection was carried out from April to December 2016. METHOD: Summary of a confidential investigation of maternal mortality on deaths occurred from January 1st, 2005 to December 31, 2015. RESULTS: Eighty-five deaths of women residing in Juiz de Fora were identified and analyzed. The age group was between 20 and 36 years...
2018: Revista Brasileira de Enfermagem
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