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https://www.readbyqxmd.com/read/28622216/the-clinical-picture-of-severe-systemic-capillary-leak-syndrome-episodes-requiring-icu-admission
#1
Marc Pineton de Chambrun, Charles-Edouard Luyt, François Beloncle, Marie Gousseff, Wladimir Mauhin, Laurent Argaud, Stanislas Ledochowski, Anne-Sophie Moreau, Romain Sonneville, Bruno Verdière, Sybille Merceron, Nathalie Zappella, Mickael Landais, Damien Contou, Alexandre Demoule, Sylvie Paulus, Bertrand Souweine, Bernard Lecomte, Antoine Vieillard-Baron, Nicolas Terzi, Elie Azoulay, Raymond Friolet, Marc Puidupin, Jérôme Devaquet, Jean-Marc Mazou, Yannick Fedun, Jean-Paul Mira, Jean-Herlé Raphalen, Alain Combes, Zahir Amoura
OBJECTIVE: Systemic capillary-leak syndrome is a very rare cause of recurrent hypovolemic shock. Few data are available on its clinical manifestations, laboratory findings, and outcomes of those patients requiring ICU admission. This study was undertaken to describe the clinical pictures and ICU management of severe systemic capillary-leak syndrome episodes. DESIGN, SETTING, PATIENTS: This multicenter retrospective analysis concerned patients entered in the European Clarkson's disease (EurêClark) Registry and admitted to ICUs between May 1992 and February 2016...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28603721/helping-prometheus-liver-protection-in-acute-hemorrhagic-shock
#2
REVIEW
Nils T Veith, Tina Histing, Michael D Menger, Tim Pohlemann, Thomas Tschernig
Acute hemorrhagic hypovolemic shock is caused by a significant high blood loss and leads to hemodynamic instability. The decrease in intravascular volume results in cellular hypoxia and finally in damage to organs such as the liver and the kidney. The liver plays a decisive role in the development or prevention of multiple organ failure after hemorrhagic shock. Despite the large number of experimental studies, the knowledge of pathophysiological mechanisms in the liver after hemorrhagic shock is incomplete...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28584568/hypovolemic-shock-and-hemoperitoneum-from-spontaneous-avulsion-of-a-large-pedunculated-uterine-leiomyoma
#3
Daniel J Mizrahi, Chhavi Kaushik, Robert Adamo
Hemoperitoneum with hypovolemic shock from avulsion of a pedunculated leiomyoma is a rare but highly fatal condition that can occur spontaneously or as a result of trauma. We report a case of hemoperitoneum and hypovolemic shock secondary to a bleeding leiomyoma detected via computed tomography (CT) scan in a 39 year old premenopausal, gravida 0 female that presented with abdominal pain and became hemodynamically unstable in the emergency department. A preoperative bimanual exam revealed a mass consistent with a 20 week gestational uterus...
March 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/28579295/spontaneous-rupture-of-inferior-vena-cava
#4
Hyoung In Choi, Yeo Koon Kim, Sang Il Choi, Kyuseok Kim
Spontaneous ruptures of the inferior vena cava (IVC) are rare. The mortality rate is high associated with all IVC injuries despite prompt resuscitation or operation. We present a case of 68-year-old women with spontaneous IVC dissection, presented as acute chest pain. Chest CT demonstrated a large amount of hemopericardium, and dilated inferior vena cava (IVC), suggesting cardiac tampon. Subsequently, hypovolemic shock and cardiac arrest occurred. After resuscitation, abdomen CT angiography was taken to find bleeding focus...
May 26, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28574597/mortality-rates-are-lower-in-siad-than-in-hypervolaemic-or-hypovolaemic-hyponatraemia-results-of-a-prospective-observational-study
#5
Martín Cuesta, Aoife Garrahy, David Slattery, Saket Gupta, Anne Marie Hannon, Karen McGurren, Mark Sherlock, William Tormey, Christopher J Thompson
OBJECTIVE: Hyponatremia is associated with increased mortality, but the mortality associated specifically with SIAD is not known. We hypothesised that mortality in SIAD was elevated, but that it was less than in hypervolemic(HEN) or hypovolemic(HON) hyponatremia. DESIGN: Mortality rates are presented as risk ratios(RR),with 95% confidence intervals (CI), and compared to normonatremic controls(NN). METHODS: Prospective, single center, non-interventional study of all patients with hyponatremia(≤ 130 mmol/l) admitted to hospital...
June 2, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28537998/lactate-and-microcirculation-as-suitable-targets-for-hemodynamic-optimization-in-resuscitation-of-circulatory-shock
#6
Michael E Kiyatkin, Jan Bakker
PURPOSE OF REVIEW: A discussion of recent research exploring the feasibility of perfusion-guided resuscitation of acute circulatory failure with a focus on lactate and microcirculation. RECENT FINDINGS: Upon diagnosis of shock, hyperlactemia is associated with poor outcome and, under appropriate clinical circumstances, may reflect inadequate tissue perfusion. Persistent hyperlactemia despite resuscitation is even more strongly correlated with morbidity and mortality...
May 22, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28533582/angular-ectopic-pregnancy-presenting-as-rupture-of-lateral-wall-of-the-uterus-late-presentation-in-gestation-week-20
#7
Malihe Hasanzadeh, Salme Dadgar, Yalda Arian, Yousef Yousefi
The differential diagnosis of acute abdominal pain in pregnancy is broad and can be complicated by atypical manifestations that are due to the anatomic distortions and physiologic changes of pregnancy. Due to the lack of clinical understanding, angular pregnancy does not appear to be recognized as a clinical entity and many cases are likely to go undiagnosed. This is a case report of a 34-year-old woman who was referred to the obstetrics emergency department with sudden abdominal pain and in a state of hypovolemic shock...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28515029/tolvaptan-utilization-in-children-with-chronic-hyponatremia-due-to-inappropriate-antidiuretic-hormone-secretion-siadh-three-case-reports-and-review-of-the-literature
#8
Gerdi Tuli, Daniele Tessaris, Luisa De Sanctis, Patrizia Matarazzo
Hyponatremia is the most common electrolyte disorder among hospitalized patients and it is sometimes considered as a poor outcome predictor. Its correction is thus indicated, even in asymptomatic patients. The conventional treatment is represented by fluid restriction in presence of euvolemia or hypervolemia; whereas loop diuretics are used in some hypervolemic conditions (cardiac heart failure, liver cirrhosis and nephrotic syndrome) and intravenous isotonic or hypertonic solution are administered in hypovolemic conditions...
May 17, 2017: Journal of Clinical Research in Pediatric Endocrinology
https://www.readbyqxmd.com/read/28513529/total-gastric-necrosis-a-case-report-and-literature-review
#9
G Huang, Y Jin
Total gastric necrosis is a rare disease and easy to misdiagnose. Here we report a rare case of total gastric necrosis. The patient, an 89-year-old male, had epigastric pain for 5 days. He was transferred to our hospital because of intraperitoneal hemorrhage and hypovolemic shock. We performed an emergency laparotomy. During the surgery, we found a total of 3500ml unclotted blood in the abdomen, splenic infarction and gastric necrosis. Total gastrectomy with Roux-en-Y esophagojejunostromy and splenectomy was performed...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28499381/experience-in-the-use-of-non-pneumatic-anti-shock-garment-nasg-in-the-management-of-postpartum-haemorrhage-with-hypovolemic-shock-in-the-fundaci%C3%A3-n-valle-del-lili-cali-colombia
#10
María Fernanda Escobar, Carlos Eduardo Füchtner, Javier Andrés Carvajal, Albaro José Nieto, Adriana Messa, Sara Sofía Escobar, Angélica María Monroy, Angélica María Forero, José David Casallas, Marcela Granados, Suellen Miller
BACKGROUND: The aim of this case series is to describe the experience of using the non-pneumatic anti-shock garment (NASG) in the management of severe Postpartum hemorrhage (PPH) and shock, and the value of implementing this concept in high-complexity obstetric hospitals. METHODS: Descriptive case series of 77 women that received NASG in the management of PPH with severe hypovolemic shock from June 2014 to December 2015. Vital signs, shock index (SI), the lactic acid value and the base deficit were compared before and after NASG application...
May 12, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28478877/microvascular-fluid-resuscitation-in-circulatory-shock
#11
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/28460647/-cannot-ventilate-cannot-intubate-situation-after-penetration-of-the-tongue-root-through-to-the-epipharynx-by-a-surfboard-a-case-report
#12
Yuko Ono, Miha Kunii, Tomohiro Miura, Kazuaki Shinohara
BACKGROUND: Surfing is an increasingly popular activity and surfing-related injuries have increased accordingly. However, to the best of our knowledge, there are no reports of penetrating upper airway injuries in surfers. We present a "cannot ventilate, cannot intubate" situation following penetrating neck injury by a surfboard fin. CASE PRESENTATION: A previously healthy 29-year-old Japanese man was swept off his board by a large wave and his left mandible, tongue root, and right epipharynx were penetrated by the surfboard fin...
May 1, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28458879/rare-cause-of-massive-lower-gastrointestinal-bleeding-due-to-primary-isolated-ilio-rectal-fistula
#13
Nuttapon Arpornsujaritkun, Chairat Supsamutchai, Wiwat Thirapanich, Pitichote Hiranyatheb, Namsiri Biadul
Massive lower gastrointestinal from primary isolated ilio-rectal fistula is a rare condition and difficult to diagnosis and emergency surgery for this situation has a high mortality rate. This report describes a successful operation in an 88-year-old man at present with massive lower gastrointestinal hemorrhage from ilio-rectal fistula and hypovolemic shock. Underlying diseases are prostate cancer, hypertension, dyslipidemia, aortic stenosis, mitral valve stenosis and chronic renal disease. Operative treatment is to explore laparotomy with internal iliac artery ligation and rectal resection...
April 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28433485/in-hospital-mortality-in-cirrhotic-patients-at-a-tertiary-care-center
#14
R Zubieta-Rodríguez, J Gómez-Correa, R Rodríguez-Amaya, K A Ariza-Mejia, N A Toloza-Cuta
INTRODUCTION: Cirrhosis of the liver is known for its high risk of mortality associated with episodes of acute decompensation. There is an even greater risk in patients that present with acute-on-chronic liver failure. The identification of patients at higher risk for adverse outcomes can aid in making the clinical decisions that will improve the prognosis for these patients. AIMS: To determine in-hospital mortality and evaluate the epidemiologic and clinical characteristics of patients with cirrhosis of the liver seen at a tertiary referral hospital...
April 19, 2017: Revista de Gastroenterología de México
https://www.readbyqxmd.com/read/28430698/the-right-ventricle-is-dilated-during-resuscitation-from-cardiac-arrest-caused-by-hypovolemia-a-porcine-ultrasound-study
#15
Rasmus Aagaard, Asger Granfeldt, Morten T Bøtker, Troels Mygind-Klausen, Hans Kirkegaard, Bo Løfgren
OBJECTIVES: Dilation of the right ventricle during cardiac arrest and resuscitation may be inherent to cardiac arrest rather than being associated with certain causes of arrest such as pulmonary embolism. This study aimed to compare right ventricle diameter during resuscitation from cardiac arrest caused by hypovolemia, hyperkalemia, or primary arrhythmia (i.e., ventricular fibrillation). DESIGN: Thirty pigs were anesthetized and then randomized to cardiac arrest induced by three diffrent methods...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28424084/durable-complete-remission-with-aromatase-inhibitor-therapy-in-a-patient-with-metastatic-uterine-carcinosarcoma-with-poor-performance-status-and-coagulation-disorders-a-case-report
#16
P Martin-Romano, M Jurado, M A Idoate, L Arbea, J L Hernandez-Lizoain, D Cano, J A Paramo, S Martin-Algarra
BACKGROUND: Chemotherapy is considered the most appropriate treatment for metastatic uterine sarcoma, despite its limited efficacy. No other treatment has been conclusively proved to be a real alternative, but some reports suggest that anti-hormonal therapy could be active in a small subset of patients. We report the case of a patient with metastatic uterine carcinosarcoma with positive hormonal receptors and a complete pathological response. CASE PRESENTATION: A 54-year-old white woman presented to our emergency room with hypovolemic shock and serious vaginal bleeding...
April 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28414396/postural-tachycardia-syndrome-diagnosis-and-management-in-adolescents-and-young-adults
#17
Geoffrey L Heyer
Postural tachycardia syndrome (POTS) represents a common form of orthostatic intolerance that disproportionately affects young women from puberty through adulthood. Patients with POTS have day-to-day orthostatic symptoms with the hallmark feature of an excessive, sustained, and symptomatic rise in heart rate during orthostatic testing. Although considerable overlap exists, three subtypes of POTS have been described: neuropathic, hyperadrenergic, and hypovolemic forms. The wide spectrum of symptoms and comorbidities can make treatment particularly challenging...
April 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28385881/quantitative-measurement-of-csf-in-patients-with-spontaneous-intracranial-hypotension
#18
H-C Chen, P-L Chen, Y-H Tsai, C-H Chen, C C-C Chen, J-W Chai
BACKGROUND AND PURPOSE: CSF hypovolemia is a core feature of spontaneous intracranial hypotension. Spontaneous intracranial hypotension is characterized by orthostatic headache and radiologic manifestations, including CSF along the neural sleeves, diffuse pachymeningeal enhancement, and/or venous engorgement. However, these characteristics are only qualitative. Quantifying intraspinal CSF volumes could improve spontaneous intracranial hypotension diagnosis and evaluation of hypovolemic statuses in patients with spontaneous intracranial hypotension...
April 6, 2017: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/28383428/secondary-aorto-esophageal-fistula-after-esophagectomy-treated-with-endovascular-treatment-a-case-report
#19
Wangang Ren, Yuxiang He, Xiaohang Wang, Zhongmin Peng
RATIONALE: Aorto-esophageal fistula (AEF), a postoperative complication of esophagectomy, constitutes a very small percentage of all cases presenting with AEF; however, it is associated with a high mortality rate. Acute massive hemorrhage is the single largest cause of death in patients developing AEF. There is a lack of consensus on the optimal treatment of AEF. PATIENT CONCERNS: We present 3 cases secondary to esophagectomy due to lower thoracic esophageal carcinoma...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28380062/different-effects-of-fluid-loading-with-saline-gelatine-hydroxyethyl-starch-or-albumin-solutions-on-acid-base-status-in-the-critically-ill
#20
Angélique M E Spoelstra-de Man, Annemieke Smorenberg, A B Johan Groeneveld
INTRODUCTION: Fluid administration in critically ill patients may affect acid-base balance. However, the effect of the fluid type used for resuscitation on acid-base balance remains controversial. METHODS: We studied the effect of fluid resuscitation of normal saline and the colloids gelatine 4%, hydroxyethyl starch (HES) 6%, and albumin 5% on acid-base balance in 115 clinically hypovolemic critically ill patients during a 90 minute filling pressure-guided fluid challenge by a post-hoc analysis of a prospective randomized clinical trial...
2017: PloS One
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