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https://www.readbyqxmd.com/read/29792267/isotonic-fluids-for-volume-resuscitation-is-it-really-6-liters-of-one-half-a-dozen-of-another
#1
Christina M Wyatt, T Alp Ikizler
No abstract text is available yet for this article.
June 2018: Kidney International
https://www.readbyqxmd.com/read/29792218/sudden-cardiac-arrest-under-spinal-anesthesia-in-a-mission-hospital-a-case-report-and-review-of-the-literature
#2
Bamidele Johnson Alegbeleye
BACKGROUND: Sudden cardiac arrest following spinal anesthesia is relatively uncommon and a matter of grave concern for any anesthesiologist as well as clinicians in general. There have been, however, several reports of such cases in the literature. Careful patient selection, appropriate dosing of the local anesthetic, volume loading, close monitoring, and prompt intervention at the first sign of cardiovascular instability should improve outcomes. The rarity of occurrence and clinical curiosity of this entity suggest reporting of this unusual and possibly avoidable clinical event...
May 24, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29791724/resolving-ambiguities-in-sudep-classification
#3
Orrin Devinsky, Elizabeth Bundock, Dale Hesdorffer, Elizabeth Donner, Brian Moseley, Esma Cihan, Fizza Hussain, Daniel Friedman
OBJECTIVE: To examine the consistency of applying the Nashef et al (2012) criteria to classify sudden unexpected death in epilepsy (SUDEP). METHODS: We reviewed cases from the North American SUDEP Registry (n = 250) and Medical Examiner Offices (n = 1301: 698 Maryland, 457 New York City, 146 San Diego). Two epileptologists with expertise in SUDEP and epilepsy-related mortality independently reviewed medical records, scene investigation, autopsy, and toxicology and assigned a SUDEP class...
May 23, 2018: Epilepsia
https://www.readbyqxmd.com/read/29791315/incidence-of-early-onset-sepsis-in-infants-born-to-women-with-clinical-chorioamnionitis
#4
Tara M Randis, Madeline Murguia Rice, Leslie Myatt, Alan T N Tita, Kenneth J Leveno, Uma M Reddy, Michael W Varner, John M Thorp, Brian M Mercer, Mara J Dinsmoor, Susan M Ramin, Marshall W Carpenter, Philip Samuels, Anthony Sciscione, Jorge E Tolosa, George Saade, Yoram Sorokin
OBJECTIVE: To determine the frequency of sepsis and other adverse neonatal outcomes in women with a clinical diagnosis of chorioamnionitis. METHODS: We performed a secondary analysis of a multi-center placebo-controlled trial of vitamins C/E to prevent preeclampsia in low risk nulliparous women. Clinical chorioamnionitis was defined as either the "clinical diagnosis" of chorioamnionitis or antibiotic administration during labor because of an elevated temperature or uterine tenderness in the absence of another cause...
May 23, 2018: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/29790972/isolation-and-biological-characterization-of-mesenchymal-stem-cells-from-goose-dermis
#5
Jingjing Wang, Xulun Wu, Yanjie Zheng, Hebao Wen, Hongda Ji, Yuhua Zhao, Weijun Guan
The skin is a natural target of stem cell research because of its large size and easy accessibility. Cutaneous mesenchymal stem cells have shown to be a promising source of various adult stem cell or progenitor cell populations, which provide an important source of stem cell-based investigation. Nowadays, much work has been done on dermal-derived mesenchymal stem cells (DMSCs) from humans, mice, sheep, and other mammals, but the literature on avian species has been rarely reported. As an animal model, the goose is an endemic species abounding in dermal tissues which is important in the global economy...
May 21, 2018: Poultry Science
https://www.readbyqxmd.com/read/29790841/guidelines-for-the-management-of-paediatric-cholera-infection-a-systematic-review-of-the-evidence
#6
Phoebe C M Williams, James A Berkley
Background Vibrio cholerae is a highly motile Gram-negative bacterium which is responsible for 3 million cases of diarrhoeal illness and up to 100,000 deaths per year, with an increasing burden documented over the past decade. Current WHO guidelines for the treatment of paediatric cholera infection (tetracycline 12.5 mg/kg four times daily for 3 days) are based on data which are over a decade old. In an era of increasing antimicrobial resistance, updated review of the appropriate empirical therapy for cholera infection in children (taking account of susceptibility patterns, cost and the risk of adverse events) is necessary...
November 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29790148/prospective-pilot-study-of-cerebral-near-infrared-spectroscopy-monitoring-during-pre-hospital-anaesthesia
#7
S Ångerman, S Länkimäki, N Neuvonen, H Kirves, J Nurmi
BACKROUND: Near-infrared spectroscopy (NIRS) provides a non-invasive measure of cerebral tissue oxygenation. The literature on application of this method in pre-hospital setting is limited. The aims of this study were to determine the feasibility of cerebral NIRS during pre-hospital anaesthesia and to quantify the changes in front lobe regional oxygen saturation (rSO2 ) during the pre-hospital phase. METHODS: NIRS monitoring (Nonin SenSmart X-100) of front lobe regional oxygen saturation (rSO2) was initiated before induction of anaesthesia in 31 adult patients and continued until hospital arrival...
May 22, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29790068/neuritin-attenuates-neuronal-apoptosis-mediated-by-endoplasmic-reticulum-stress-in-vitro
#8
Xiaokun Sun, Linzhi Dai, Hang Zhang, Xuejun He, Fandi Hou, Wengao He, Shijun Tang, Dong Zhao
Neuritin is an extracellular glycophosphatidylinositol-linked protein that promotes neuronal survival, differentiation, function, and repair, but the exact mechanism of this neuroprotective effect remains unclear. Meanwhile, endoplasmic reticulum stress (ERS) induced apoptosis is attracting increased attention. In this work, we hypothesized that neuritin inhibited ERS to protect cortical neurons. To check this hypothesis, we exposed primary cultured cortical neurons to oxygen and glucose deprivation (OGD) for 45 min followed by reperfusion (R) to activate ERS...
May 22, 2018: Neurochemical Research
https://www.readbyqxmd.com/read/29789983/principles-of-fluid-management-and-stewardship-in-septic-shock-it-is-time-to-consider-the-four-d-s-and-the-four-phases-of-fluid-therapy
#9
REVIEW
Manu L N G Malbrain, Niels Van Regenmortel, Bernd Saugel, Brecht De Tavernier, Pieter-Jan Van Gaal, Olivier Joannes-Boyau, Jean-Louis Teboul, Todd W Rice, Monty Mythen, Xavier Monnet
In patients with septic shock, the administration of fluids during initial hemodynamic resuscitation remains a major therapeutic challenge. We are faced with many open questions regarding the type, dose and timing of intravenous fluid administration. There are only four major indications for intravenous fluid administration: aside from resuscitation, intravenous fluids have many other uses including maintenance and replacement of total body water and electrolytes, as carriers for medications and for parenteral nutrition...
May 22, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#10
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29789860/gastric-perforation-following-cardiopulmonary-resuscitation
#11
Ashish Verma, Muhammad Hassaan Shahid, John Wesley Boldt
No abstract text is available yet for this article.
May 22, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29789465/efficacy-safety-and-usability-of-remifentanil-as-premedication-for-insure-in-preterm-neonates
#12
Hadiyah Y Audil, Sara Tse, Chad Pezzano, Amy Mitchell-van Steele, Joaquim M B Pinheiro
Background : We previously reported a 67% extubation failure with INSURE (Intubation, Surfactant, Extubation) using morphine as analgosedative premedication. Remifentanil, a rapid- and short-acting narcotic, might be ideal for INSURE, but efficacy and safety data for this indication are limited. Objectives : To assess whether remifentanil premedication increases extubation success rates compared with morphine, and to evaluate remifentanil's safety and usability in a teaching hospital context. Methods : Retrospective review of remifentanil orders for premedication, at a large teaching hospital neonatal intensive care unit (NICU)...
May 22, 2018: Children
https://www.readbyqxmd.com/read/29789199/survival-after-in-hospital-cardiac-arrest-among-cerebrovascular-disease-patients
#13
REVIEW
Corey R Fehnel, Alissa Trepman, Dale Steele, Muhib A Khan, Brian Silver, Susan L Mitchell
Stroke is a leading cause of death and disability, and while preferences for cardiopulmonary resuscitation (CPR) are frequently discussed, there is limited evidence detailing outcomes after CPR among acute cerebrovascular neurology (inclusive of stroke, subarachnoid hemorrhage (SAH)) patients. Systematic review and meta-analysis of PubMed and Cochrane libraries from January 1990 to December 2016 was conducted among stroke patients undergoing in-hospital CPR. Primary data from studies meeting inclusion criteria at two levels were extracted: 1) studies reporting survival to hospital discharge after CPR with cerebrovascular primary admitting diagnosis, and 2) studies reporting survival to hospital discharge after CPR with cerebrovascular comorbidity...
May 19, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29789056/the-six-hour-window-how-the-community-hospital-nursery-can-optimize-outcomes-of-the-infant-with-suspected-hypoxic-ischemic-encephalopathy
#14
Dafina Ibrani, Shanon Molacavage
Perinatal hypoxia is a devastating event before, during, or immediately after birth that deprives an infant's vital organs of oxygen. This injury at birth often requires a complex resuscitation and increases the newborn's risk of hypoxic-ischemic encephalopathy (HIE). The resuscitation team in a community hospital nursery may have less experience with complex resuscitation and post-resuscitation care of this infant than a NICU. This article provides the neonatal nurse in a Level I or Level II nursery with information about resuscitation and post-resuscitation care of an infant at risk of HIE while awaiting transport to a NICU for therapeutic cooling...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29789053/management-of-meconium-stained-newborns-in-the-delivery-room
#15
Chintan Kiritkumar Gandhi
The approach to the management of meconium-stained newborns in the delivery room has been changing for over 40 years. The goal is to prevent meconium aspiration syndrome (MAS) and complications related to MAS. For decades, airway obstruction was believed to be a major component of MAS and, consequently, suction maneuvers to remove meconium from the airways were recommended to decrease the frequency and severity of MAS. Initial recommendations were based on observational studies. However, the incidence of MAS and mortality related to MAS has declined since the 1970s, mostly because of a decrease in the number of postterm deliveries...
May 1, 2018: Neonatal Network: NN
https://www.readbyqxmd.com/read/29789000/spontaneous-splenic-rupture-complicating-primary-varicella-zoster-infection-a-case-report
#16
Aarthy Uthayakumar, David Harrington
BACKGROUND: Primary varicella zoster virus (VZV) infection is a common illness, predominantly affecting children. Its course is typically benign, although severe complications have been described. Splenic rupture is an extremely rare and potentially fatal complication of primary VZV infection, with only a handful of cases reported in the literature. CASE PRESENTATION: A 32-year-old Romanian man with no significant past medical history, presented with a 2 day history of sudden onset, worsening generalised abdominal pain and a 1 day history of vomiting...
May 22, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29788845/brain-perfusion-evaluated-by-regional-tissue-oxygenation-as-a-possible-quality-indicator-of-ongoing-cardiopulmonary-resuscitation-an-experimental-porcine-cardiac-arrest-study
#17
Tomáš Bouček, Mikuláš Mlček, Petra Krupičková, Michal Huptych, Tomáš Belza, Otomar Kittnar, Aleš Linhart, Jan Bělohlávek
INTRODUCTION: Relationship between regional tissue oxygenation (rSO2 ) and microcirculatory changes during cardiac arrest (CA) are still unclear. Therefore, we designed an experimental study to correlate rSO2 , microcirculation and systemic hemodynamic parameters in a porcine model of CA. METHODS: Ventricular fibrillation was induced in 24 female pigs (50±3kg) and left for three minutes untreated followed by five minutes of mechanical CPR. Regional and peripheral saturations were assessed by near-infrared spectroscopy, sublingual microcirculation by Sidestream Dark Field technology and continuous hemodynamic parameters, including systemic blood pressure (MAP) and carotid blood flow (CF), during baseline, CA and CPR periods...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788842/veno-arterio-venous-ecmo-for-septic-cardiomyopathy-a-single-centre-experience
#18
Dominik J Vogel, Josie Murray, Adam Z Czapran, Luigi Camporota, Nicholas Ioannou, Chris I S Meadows, Peter B Sherren, Kathleen Daly, Nigel Gooby, Nicholas Barrett
INTRODUCTION: The role of extracorporeal support for patients with septic shock remains unclear. METHODS: We conducted a retrospective analysis of our single-centre experience with veno-arterio-venous extracorporeal membrane oxygenation (VAV ECMO) in adult patients with severe respiratory failure and septic cardiomyopathy. Clinical data was extracted from electronic medical records including a dedicated ECMO referral and follow-up database. RESULTS: Twelve patients were commenced on VAV ECMO for septic cardiomyopathy for a median of four days (IQR 3...
May 2018: Perfusion
https://www.readbyqxmd.com/read/29788135/the-hepatic-glucocorticoid-receptor-is-crucial-for-cortisol-homeostasis-and-sepsis-survival-in-humans-and-male-mice
#19
Marc Jenniskens, Ruben Weckx, Thomas Dufour, Sarah Vander Perre, Lies Pauwels, Sarah Derde, Arno Téblick, Fabian Güiza, Greet Van den Berghe, Lies Langouche
Sepsis is hallmarked by hypercortisolemia, a stress response that is essential for survival. This elevation in plasma cortisol is partially brought about by suppressed hepatic cortisol breakdown. We now demonstrated that a controlled downregulation of the hepatic glucocorticoid receptor (hepatic GR) is crucial herein. In a mouse model of fluid-resuscitated, antibiotic-treated abdominal sepsis and in human ICU patients, sepsis reduced hepatic GR expression and signaling, but increased (free) plasma cortisol/corticosterone, explained by suppressed cortisol/corticosterone binding proteins and A-ring-reductases...
May 17, 2018: Endocrinology
https://www.readbyqxmd.com/read/29787743/persistence-of-central-venous-oxygen-desaturation-during-early-sepsis-is-associated-with-higher-mortality-a-retrospective-analysis-of-the-albios-trial
#20
Alessandro Protti, Serge Masson, Roberto Latini, Roberto Fumagalli, Marilena Romero, Carla Pessina, Giovanni Pasetti, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Pietro Caironi
BACKGROUND: Relevance of low (<70%) central venous oxygen saturation (ScvO2 ) during early sepsis has been recently questioned by three negative trials (ProCESS, ARISE and ProMISe) on early goal-directed therapy (EGDT). However, subjects included in those trials had ScvO2 at enrolment as high as 71±13%, 73±11% and 70±12%. Herein we assessed the association between ScvO2 <70% at six hours and 90-day mortality in subjects enrolled in the ALBIOS trial, focusing on those with initial ScvO2 <70%...
May 19, 2018: Chest
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