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https://www.readbyqxmd.com/read/27915164/can-the-cerebral-regional-oxygen-saturation-be-a-perfusion-parameter-in-shock
#1
Ashraf Al Tayar, Amr Abouelela, Khaja Mohiuddeen
INTRODUCTION: Shock, defined as a state of tissue hypoperfusion and the tissues reperfusion, is the main goal of management of shock. Increase in central venous saturation (CvSo2) and decrease in blood lactate level are useful in assessment of adequacy of tissue perfusion. Near-infrared spectroscopy is a noninvasive way to observe real-time changes in regional cerebral saturation and has been used in patients with different brain diseases. There is a small body of literature suggesting that cerebral regional oxygen saturation (CrSo2) monitoring added a value in assessment and management of intensive care unit (ICU) patients...
November 10, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#2
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27898550/severe-intraoperative-shock-related-to-mesenteric-traction-syndrome
#3
Alfredo Haack Couto, Hugo Siqueira, Pablo Pulcheira Brasileiro, Ismar Lima Cavalcanti, Rogério Luiz da Rocha Videira
Mesenteric traction syndrome is defined as arterial hypotension, facial flushing, and tachycardia related to mesenteric traction. We describe a case of mesenteric traction syndrome refractory to catecholamine and vasopressin infusions. The patient, who had Crohn disease, developed severe distributive shock after mesenteric traction while undergoing resection of an intestinal inflammatory mass, accompanied by facial flushing and unaltered readings for pulse oximetry, capnography, and bispectral index monitoring...
November 28, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27896787/extracorporeal-membrane-oxygenation-for-pheochromocytoma-induced-cardiogenic-shock
#4
Guillaume Hekimian, Fatima Kharcha, Nicolas Bréchot, Matthieu Schmidt, Cécile Ghander, Guillaume Lebreton, Xavier Girerd, Christophe Tresallet, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Alain Combes, Charles-Edouard Luyt
BACKGROUND: Pheochromocytoma, a rare catecholamine-producing tumor, might provoke stress-induced Takotsubo-like cardiomyopathy and severe cardiogenic shock. Because venoarterial-extracorporeal membrane oxygenation (VA-ECMO) rescue of pheochromocytoma-induced refractory cardiogenic shock has rarely been reported, we reviewed our ICU patients' presentations and outcomes. METHODS: All pheochromocytoma-induced refractory cardiogenic shock cases managed with VA-ECMO (January 2007-March 2015) were prospectively included and reviewed...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27894390/-effects-of-different-fluid-resuscitation-program-on-renal-function-in-swine-during-shock-stage-of-severe-burn
#5
G L Su, W X Huang, J Chen, D J Xue, J J Zhou
Objective: To explore the effects of different fluid resuscitation program on renal function in swine during shock stage of severe burn. Methods: Twenty-four Guangxi Bama miniature swine were inflicted with 40% total body surface area on the back, and then they were divided into four groups according to the random number table, with 6 swine in each group. At post injury hour (PIH) 2, swine in succinylated gelatin group (S), hydroxyethyl starch group (H), and allogeneic plasma group (A) were respectively resuscitated with succinylated gelatin, hydroxyethyl starch 130/0...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27893619/substituting-systolic-blood-pressure-with-shock-index-in-the-national-trauma-triage-protocol
#6
Ansab A Haider, Asad Azim, Peter Rhee, Narong Kulvatunyou, Kareem Ibraheem, Andrew Tang, Terence O'Keeffe, Hajira Iftikhar, Gary Vercruysse, Bellal Joseph
INTRODUCTION: The National Trauma Triage Protocol (NTTP) is an algorithm that guides emergency medical services providers through four decision steps to identify the patients that would benefit from trauma center care. The NTTP defines a systolic blood pressure (SBP) of less than 90 mm Hg as one of the criteria for trauma center need. The aim of our study was to determine the impact of substituting SBP of less than 90 mm Hg with shock index (SI) on triage performance. METHODS: A 2-year (2011-2012) retrospective analysis of all trauma patients 18 years or older in the National Trauma Databank was performed...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27892460/superstrength-of-nanograined-steel-with-nanoscale-intermetallic-precipitates-transformed-from-shock-compressed-martensitic-steel
#7
Hailiang Yu, Ming Yan, Cheng Lu, Anh Kiet Tieu, Huijun Li, Qiang Zhu, Ajit Godbole, Jintao Li, Lihong Su, Charlie Kong
An increasing number of industrial applications need superstrength steels. It is known that refined grains and nanoscale precipitates can increase strength. The hardest martensitic steel reported to date is C0.8 steel, whose nanohardness can reach 11.9 GPa through incremental interstitial solid solution strengthening. Here we report a nanograined (NG) steel dispersed with nanoscale precipitates which has an extraordinarily high hardness of 19.1 GPa. The NG steel (shock-compressed Armox 500T steel) was obtained under these conditions: high strain rate of 1...
November 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27890015/the-involvement-of-regulatory-non-coding-rnas-in-sepsis-a-systematic-review
#8
Jeffery Ho, Hung Chan, Sunny H Wong, Maggie H T Wang, Jun Yu, Zhangang Xiao, Xiaodong Liu, Gordon Choi, Czarina C H Leung, Wai T Wong, Zheng Li, Tony Gin, Matthew T V Chan, William K K Wu
BACKGROUND: Sepsis coincides with altered gene expression in different tissues. Accumulating evidence has suggested that microRNAs, long non-coding RNAs, and circular RNAs are important molecules involved in the crosstalk with various pathways pertinent to innate immunity, mitochondrial functions, and apoptosis. METHODS: We searched articles indexed in PubMed (MEDLINE), EMBASE and Europe PubMed Central databases using the Medical Subject Heading (MeSH) or Title/Abstract words ("microRNA", "long non-coding RNA", "circular RNA", "sepsis" and/or "septic shock") from inception to Sep 2016...
November 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27886982/impact-of-norepinephrine-weight-based-dosing-compared-with-non-weight-based-dosing-in-achieving-time-to-goal-mean-arterial-pressure-in-obese-patients-with-septic-shock
#9
Nina Vadiei, Mitchell J Daley, Manasa S Murthy, Carrie S Shuman
BACKGROUND: Currently, a lack of standardization exists in norepinephrine dosing units, the first-line vasopressor for septic shock. Timely achievement of goal mean arterial pressure (MAP) is dependent on optimal vasopressor dosing. OBJECTIVE: To determine if weight-based dosing (WBD) of norepinephrine leads to earlier time to goal MAP compared with non-WBD in obese patients with septic shock. METHODS: This was a retrospective, multicenter cohort study...
November 24, 2016: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27884923/clinical-metrics-in-emergency-medicine-the-shock-index-and-the-probability-of-hospital-admission-and-inpatient-mortality
#10
Kamna S Balhara, Yu-Hsiang Hsieh, Bachar Hamade, Ryan Circh, Gabor D Kelen, Jamil D Bayram
STUDY OBJECTIVES: The shock index (SI), defined as the ratio of HR to systolic BP, has been studied as an alternative prognostic tool to traditional vital signs in specific disease states and subgroups of patients. However, literature regarding its utility in the general ED population is lacking. Our main objective was to determine the probability of admission and inpatient mortality based on the first measured SI at initial presentation in the general adult ED population in our tertiary care centre...
November 24, 2016: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/27879296/elevated-modified-shock-index-within-24-hours-of-icu-admission-is-an-early-indicator-of-mortality-in-the-critically-ill
#11
Nathan J Smischney, Mohamed O Seisa, Katherine J Heise, Darrell R Schroeder, Timothy J Weister, Daniel A Diedrich
PURPOSE: To assess whether exposure to modified shock index (MSI) in the first 24 hours of intensive care unit (ICU) admission is associated with increased in-hospital mortality. METHODS: Adult critically ill patients were included in a case-control design with 1:2 matching. Cases (death) and controls (alive) were abstracted by a reviewer blinded to exposure status (MSI). Cases were matched to controls on 3 factors-age, end-stage renal disease, and ICU admission diagnosis...
November 21, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27876563/preoperative-optimization-of-the-heart-failure-patient-undergoing-cardiac-surgery
#12
REVIEW
Maxime Pichette, Mark Liszkowski, Anique Ducharme
Heart failure patients who undergo cardiac surgery are exposed to significant perioperative complications and high mortality. We herein review the literature concerning preoperative optimization of these patients. Salient findings are that end-organ dysfunction and medication should be optimized before surgery. Specifically: (1) reversible causes of anemia should be treated and a preoperative hemoglobin level of 100 g/L obtained; (2) renal function and volume status should be optimized; (3) liver function must be carefully evaluated; (4) nutritional status should be assessed and cachexia treated to achieve a preoperative albumin level of at least 30 g/L and a body mass index > 20; and (5) medication adjustments performed, such as withholding inhibitors of the renin-angiotensin-aldosterone system before surgery and continuing, but not starting, β-blockers...
August 6, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27872122/polymyxin-b-immobilised-haemoperfusion-and-mortality-in-critically-ill-patients-with-sepsis-septic-shock-a-protocol-for-a-systematic-review-and-meta-analysis
#13
Tomoko Fujii, Riki Ganeko, Yuki Kataoka, Robin Featherstone, Sean M Bagshaw, Toshi A Furukawa
INTRODUCTION: Polymyxin-B immobilised haemoperfusion (PMX-HP) is a promising adjuvant strategy for the treatment of sepsis and septic shock. PMX-HP therapy works by clearing circulating endotoxin through binding to polymyxin-immobilised fibres during haemoperfusion. Small clinical trials have shown that PMX-HP therapy is associated with improved haemodynamic profile, oxygenation and survival. However, clear inferences have been largely inconclusive due to limitations in study design (eg, small, unblinded) and generalisability...
November 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27870298/health-effects-of-short-term-fluctuations-in-macroeconomic-conditions-the-case-of-hypertension-for-older-americans
#14
Marco Angrisani, Jinkook Lee
We investigate the health effects of short-term macroeconomic fluctuations as described by changes in unemployment rate, house, and stock market price indexes. The 'Great Recession' provides the opportunity to conduct this analysis as it involved contemporaneous shocks to the labor, housing, and stock markets. Using panel data from the Health and Retirement Study over the period 2004-2010, we relate changes in hypertension status to changes in state-level unemployment rate and house prices and to changes in stock market prices...
November 2016: Health Economics
https://www.readbyqxmd.com/read/27869135/heat-stroke-internet-searches-can-be-a-new-heatwave-health-warning-surveillance-indicator
#15
Tiantian Li, Fan Ding, Qinghua Sun, Yi Zhang, Patrick L Kinney
The impact of major heatwave shocks on population morbidity and mortality has become an urgent public health concern. However, Current heatwave warning systems suffer from a lack of validation and an inability to provide accurate health risk warnings in a timely way. Here we conducted a correlation and linear regression analysis to test the relationship between heat stroke internet searches and heat stroke health outcomes in Shanghai, China, during the summer of 2013. We show that the resulting heatstroke index captures much of the variation in heat stroke cases and deaths...
November 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27868423/startle-potentiation-to-uncertain-threat-as-a-psychophysiological-indicator-of-fear-based-psychopathology-an-examination-across-multiple-internalizing-disorders
#16
Stephanie M Gorka, Lynne Lieberman, Stewart A Shankman, K Luan Phan
Heightened reactivity to uncertain threat (U-threat) is an important individual difference factor that may characterize fear-based internalizing psychopathologies (IPs) and distinguish them from distress/misery IPs. To date, however, the majority of existing research examining reactivity to U-threat has been within individuals with panic disorder and major depressive disorder (MDD) and no prior study has directly tested this hypothesis across multiple IPs. The current study therefore explored whether heightened reactivity to U-threat is a psychophysiological indicator of fear-based psychopathology across 5 groups: current (a) social anxiety disorder (SAD); (b) specific phobia (SP); (c) generalized anxiety disorder (GAD); (d) MDD; and (c) individuals with no history of psychopathology (controls)...
November 17, 2016: Journal of Abnormal Psychology
https://www.readbyqxmd.com/read/27867292/new-impella-cardiac-power-device-used-in-patient-with-cardiogenic-shock-due-to-nonischemic-cardiomyopathy
#17
Marek Cena, Frances Karam, Rajesh Ramineni, Wissam Khalife, Alejandro Barbagelata
The new percutaneous Impella CP (Cardiac Power; Abiomed, Inc., Danvers, MA) was designed to provide a higher level of support than Impella 2.5 (Abiomed, Inc.). We present the first documented case of a patient that was transitioned from the Impella 2.5 to Impella CP. A 48-year-old male patient with no medical history was transferred to our institution with a one day history of worsening shortness of breath. The patient was unstable and found to have monomorphic ventricular tachycardia at 220 beats/min that was cardioverted to normal sinus rhythm...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27866018/intravenous-beta-blockers-in-st-segment-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#18
Lee H Sterling, Kristian B Filion, Renee Atallah, Pauline Reynier, Mark J Eisenberg
BACKGROUND/OBJECTIVES: The role of intravenous (IV) beta-blockers in conjunction with percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains unclear. We therefore conducted a meta-analysis to assess their role in the acute phase of STEMI. METHODS: We systematically searched the Cochrane Libraries, Medline, and EMBASE for RCTs comparing IV beta-blockers with inactive controls in STEMI patients undergoing PCI. The primary outcome was left ventricular ejection fraction (LVEF)...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27865148/plasma-adrenomedullin-in-critically-ill-patients-with-sepsis-after-major-surgery-a-pilot-study
#19
Tim-Philipp Simon, Lukas Martin, Sabine Doemming, Andreas Humbs, Christian Bruells, Ruedger Kopp, Oliver Hartmann, Joachim Struck, Andreas Bergmann, Gernot Marx, Tobias Schuerholz
PURPOSE: Adrenomedullin is released by different tissues in hypoxia, oxidative stress, and inflammation and is found in general and medical patients and, recently, in sepsis patients in emergency departments. The aim of this study was to evaluate biologically active adrenomedullin that mirrors directly the active peptide levels in plasma of surgical intensive care unit (ICU) patients with sepsis. MATERIALS AND METHODS: In this single-center observational pilot trial, 42 ICU patients with sepsis and 14 patients after major surgery were included after sepsis diagnosis or ICU admission...
October 28, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27864821/effect-of-alterations-in-apoptotic-pathway-on-development-of-metabolic-syndrome-in-patients-with-psoriasis-vulgaris
#20
S Korkmaz, H Korkmaz
OBJECTIVES: The purpose of this study is to evaluate the role of changes in gene expression of apoptosis activators (BAX, cytocrome-c [cyt-c], and caspase-3) and apoptosis inhibitors (BCL2, survivin, cyclin D1 [CCND1], SOD, catalase 3 [CAT], glutathione synthetase [GS], heat shock protein [HSP]27, HSP60, HSP70, and HSP90) on the development of metabolic syndrome (MetS) in patients with psoriasis vulgarins. METHODS: Fifty patients with psoriasis were enrolled in the study, 25 of whom had MetS...
November 18, 2016: British Journal of Dermatology
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