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Shock index

Hiroyuki Yamada, Tatsuo Tsukamoto, Hiromichi Narumiya, Kazumasa Oda, Satoshi Higaki, Ryoji Iizuka, Motoko Yanagita, Masako Deguchi
BACKGROUND: Direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP) could improve the hemodynamic status of septic shock patients. As PMX-DHP is an invasive and costly procedure, it is desirable to estimate the therapeutic effect before performing the therapy. However, it is still unclear when this therapy should be started and what type of sepsis it should be employed for. In this study, we retrospectively examined the clinical effect of patients treated with PMX-DHP by using central venous pressure (CVP)...
2016: Journal of Intensive Care
S Ram Kumar, Grace Kung, Nathan Noh, Novel Castillo, Brian Fagan, Winfield J Wells, Vaughn A Starnes
BACKGROUND: We have previously shown that neonates in profound cardiogenic shock caused by a severe Ebstein anomaly can be successfully salvaged with fenestrated right ventricular exclusion and systemic to pulmonary shunt (modified Starnes procedure). The long-term outcome of single-ventricle management in these patients is not known. METHODS: We retrospectively reviewed the records of patients who underwent neonatal Starnes procedure between 1989 and 2015. Patient demographics, clinical variables, and outcome data were collected...
October 25, 2016: Circulation
Jiangquan Yu, Ruiqiang Zheng, Hua Lin, Qihong Chen, Jun Shao, Daxin Wang
PURPOSE: This study aimed to investigate the clinical effects of early goal-directed therapy according to the global end-diastolic volume index (GEDI) on chronic obstructive pulmonary disease (COPD) patients with septic shock. METHODS: A total of 71 COPD patients with septic shock were randomly assigned to 2 groups. In the control group (n = 37), fluid resuscitation was performed based on the central venous pressure. In the study group (n = 34), fluid resuscitation was performed until GEDI reached 800 mL/m(2)...
October 8, 2016: American Journal of Emergency Medicine
Tomás Lejarraga, Jan K Woike, Ralph Hertwig
A few years ago, the world experienced the most severe economic crisis since the Great Depression. According to the depression baby hypothesis, people who live through such macroeconomic shocks take less financial risk in their future lives (e.g., lower stock market participation). This hypothesis has previously been tested against survey data. Here, we tested it in a simulated experimental stock market (based on the Spanish stock index, IBEX-35), varying both the length of historical data available to participants (including or excluding a macroeconomic shock) and the mode of learning about macroeconomic events (through sequential experience or symbolic descriptions)...
October 20, 2016: Cognition
Ricardo Ferrer, Rafael Zaragoza, Alejandro H Rodríguez, Emilio Maseda, Pedro Llinares, Santiago Grau, Francisco Álvarez-Lerma, Guillermo Quindós, Miguel Salavert, Rafael Huarte
BACKGROUND: Although the management of invasive fungal infection (IFI) has improved, a number of controversies persist regarding the approach to invasive fungal infection in non-neutropenic medical ward patients. AIMS: To identify the essential clinical knowledge to elaborate a set of recommendations with a high level of consensus necessary for the management of IFI in non-neutropenic medical ward patients. METHODS: A prospective, Spanish questionnaire, which measures consensus through the Delphi technique, was anonymously answered and e-mailed by 30 multidisciplinary national experts, all specialists (intensivists, anesthesiologists, microbiologists, pharmacologists and specialists in infectious diseases) in IFI and belonging to six scientific national societies...
October 18, 2016: Revista Iberoamericana de Micología
Chi-Fai Ng, Sylvia Luke, Chi-Hang Yee, Winnie Chu, Ka-Tak Wong, John Yuen
Objectives To perform a prospective study to evaluate the renal protective effects of ramping protocol and pause protocol for extracorporeal shockwave lithotripsy in human subjects. Patients and Methods 320 patients with solitary renal stone <15mm, were randomized to receive one of four protocols: (1) 80% power from beginning until the end of treatment; (2) the first 100 SWs at 40% power, and then 80% power until the end of treatment; (3) the first 100 shocks at 40% power, followed by a 3-minute pause and then further SWs at 80% power until the end of treatment; and (4) the first 100 shocks at 80% power, followed by a 3-minute pause and then further SWs at 80% power until the end of treatment...
October 20, 2016: Journal of Endourology
Jie Zhao, Guolin Wang
BACKGROUND This study aimed to investigate the relationship between the inferior vena cava respirophasic variation (IVC collapsibility index [IVCCI]) and the general heart end-diastolic volume index (GEDVI). By determining the above relationship, we could evaluate the utility of IVCCI as an indicator. MATERIAL AND METHODS Forty-two septic patients were finally enrolled in this study. The inferior vena cava's diameter was measured with the largest at the end of expiration (IVC3) and with the smallest at the end of inspiration (IVCi) on the ultrasound (IVCCI=[(IVCD e - IVCD i)/IVCD e] ×100%)...
October 20, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Daniel Silva de Azevedo, Angela Salomao Macedo Salinet, Marcelo de Lima Oliveira, Manoel Jacobsen Teixeira, Edson Bor-Seng-Shu, Ricardo de Carvalho Nogueira
Cerebral microcirculation is gradually compromised during sepsis, with significant reductions in the function of capillaries and blood perfusion in small vessels. Transcranial Doppler ultrasound (TCD) has been used to assess cerebral circulation in a typical clinical setting. This study was to systematically review TCD studies, assess their methodological quality, and identify trends that can be associated with the temporal evolution of sepsis and its clinical outcome. A meta-analysis of systematic reviews was conducted according to the PRISMA statement...
October 18, 2016: Journal of Clinical Monitoring and Computing
Kohji Shirai
BACKGROUND: The cardio-ankle vascular index (CAVI) is a new arterial stiffness index of the arterial tree from the origin of the aorta to the ankle, and was essentially derived from the stiffness parameterβtheory proposed by Hayashi. The conspicuous feature of CAVI is independency from blood pressure at the time of measurement. AIM: The purpose is to clarify the meaning of CAVI as a surrogate marker of arteriosclerosis, and also the role of CAVI in the blood pressure control system...
September 2016: Journal of Hypertension
Gyuho Song, Yeonho You, Wonjoon Jeong, Junwan Lee, Yongchul Cho, Seungwhan Lee, Seung Ryu, Jinwoong Lee, Seungwhan Kim, Insool Yoo
OBJECTIVE: We investigated whether patients with out-of-hospital cardiac arrest (OHCA) due to an acute myocardial infarction without cardiogenic shock required higher doses of vasopressors with low targeted temperature management (TTM) after return of spontaneous circulation. METHODS: We included consecutive comatose patients resuscitated from OHCA between January 2011 and December 2013. Patients with return of spontaneous circulation, regional wall motion abnormality on echocardiography, and coronary artery stenosis of ≥70% on percutaneous coronary artery angiography were enrolled...
March 2016: Clin Exp Emerg Med
Gan Chen, Xiang Song, Bo Wang, Guoxing You, Jingxiang Zhao, Sha Xia, Yuhua Zhang, Lian Zhao, Hong Zhou
Hemorrhagic shock/resuscitation involves overwhelming reactive oxygen species (ROS) that cause oxidative stress, inflammation, and subsequent tissue injury. We investigated the effects of the potent antioxidant carboxyfullerene (C3) on acute liver injury during hemorrhage shock/resuscitation. C3 infusion reduced the alanine aminotransferase (ALT) activity, methemoglobin content, malondialdehyde content, myeloperoxidase activity and expression levels of tumor necrosis factor -α and interleukin-6; it increased superoxide dismutase activity in the liver...
October 12, 2016: Biomaterials
Annika Strauch, Martin Haslbeck
All organisms rely on a conserved cellular machinery supporting and controlling the life cycle of proteins: the proteostasis network. Within this network, the main players that determine the fate of proteins are molecular chaperones, the ubiquitin-proteasome and the lysosome-autophagy systems. sHsps (small heat-shock proteins) represent one family of molecular chaperones found in all domains of life. They prevent irreversible aggregation of unfolded proteins and maintain proteostasis by stabilizing promiscuously a variety of non-native proteins in an ATP-independent manner...
October 15, 2016: Essays in Biochemistry
Guillaume Geri, Guillaume Savary, Stéphane Legriel, Florence Dumas, Sybille Merceron, Olivier Varenne, Bernard Livarek, Olivier Richard, Jean-Paul Mira, Jean-Pierre Bedos, Jean-Philippe Empana, Alain Cariou, David Grimaldi
BACKGROUND: Obesity prevalence has dramatically increased over recent years and is associated with cardiovascular diseases, but data are lacking on its prognostic impact in out-of-hospital cardiac arrest (OHCA) patients. METHODS: Data of all consecutive OHCA patients admitted in two cardiac arrest centers from Paris and suburbs between 2005 and 2012 were prospectively collected. Patients treated by therapeutic hypothermia (TH) were included in the analysis. Logistic and Cox regression analyses were used to quantify the association between Body Mass Index (BMI) at hospital admission and day-30 and 1-year mortality respectively...
October 12, 2016: Resuscitation
Larissa Becirovic, Ian R Brown
Heat shock proteins (Hsps) are a set of highly conserved proteins involved in cellular repair and protective mechanisms. The intracellular localization of inducible members of the HSPA (HSP70) family can be used as an index to identify stress-sensitive sites in differentiated human neuronal cells. Following thermal stress, the little studied HSPA6 (HSP70B') was targeted to the periphery of nuclear speckles (perispeckles) that are sites of transcription factories. Triptolide, a fast-acting transcription inhibitor, knocked down levels of the large subunit of RNA polymerase II, RPB1, during the time-frame when HSPA6 associated with perispeckles...
October 14, 2016: Neurochemical Research
Praveen Hariharan, David M Dudzinski, Rachel Rosovsky, Farris Haddad, Peter MacMahon, Blair Parry, Yuchiao Chang, Christopher Kabrhel
Computed tomography pulmonary angiogram (CTPA) provides a volumetric assessment of clot burden in acute pulmonary embolism (PE). However, it is unclear if clot burden is associated with right-sided heart strain (RHS) or adverse clinical events (ACE). We prospectively enrolled Emergency Department patients with PE (in CTPA) from 2008 to 2011. We assigned 1 to 9 points as clot burden score, based on whether emboli were saddle, central, lobar, segmental, and subsegmental. We evaluated a novel score (the "CT-PASS") based on the sum (in millimeters) of the largest filling defects in the right and left pulmonary vasculature...
August 24, 2016: American Journal of Cardiology
Marloes Visser, Jeroen F van der Heijden, Jasper J van der Smagt, Pieter A Doevendans, Arthur A Wilde, Peter Loh, Rutger J Hassink
BACKGROUND: Idiopathic ventricular fibrillation (IVF) is a rare cause of sudden cardiac arrest. Limited data are available on the long-term outcome of IVF patients. METHODS AND RESULTS: In this retrospective cohort study, 107 consecutive patients with an initial diagnosis of IVF were analyzed (age at index event 40.4 years, 60% male). Missing diagnostic data were acquired during follow-up, including genetic testing, to exclude underlying disease. A specific diagnosis was revealed in 22 of 107 patients (21%) during a median follow-up of 10...
October 2016: Circulation. Arrhythmia and Electrophysiology
Sameer Mehta
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
L W Hall, F R Dunshea, J D Allen, S Rungruang, J L Collier, N M Long, R J Collier
Betaine (BET), a natural, organic osmolyte, improves cellular efficiency by acting as a chaperone, refolding denatured proteins. To test if dietary BET reduced the effect of heat stress (HS) in lactating dairy cows, multiparous, lactating Holstein cows (n = 24) were blocked by days in milk (101.4 ± 8.6 d) and randomly assigned to 1 of 3 daily intakes of dietary BET: the control (CON) group received no BET, mid intake (MID) received 57 mg of BET/kg of body weight, and high dose (HI) received 114 mg of BET/kg of body weight...
October 5, 2016: Journal of Dairy Science
Maria E Linnaus, David M Notrica, Crystal S Langlais, Shawn D St Peter, Charles M Leys, Daniel J Ostlie, R Todd Maxson, Todd Ponsky, David W Tuggle, James W Eubanks, Amina Bhatia, Adam C Alder, Cynthia Greenwell, Nilda M Garcia, Karla A Lawson, Prasenjeet Motghare, Robert W Letton
BACKGROUND: Age-adjusted pediatric shock index (SIPA) does not require knowledge of age-adjusted blood pressure norms, yet correlates with mortality, serious injury, and need for transfusion in trauma. No prospective studies support its validity. METHODS: A multicenter prospective observational study of patients 4-16years presenting April 2013-January 2016 with blunt liver and/or spleen injury (BLSI). SIPA (maximum heart rate/minimum systolic blood pressure) thresholds of >1...
September 23, 2016: Journal of Pediatric Surgery
David N Naumann, Clare Mellis, Shamus L G Husheer, Philip Hopkins, Jon Bishop, Mark J Midwinter, Sam D Hutchings
BACKGROUND: Despite over a decade of research and technological advances, sublingual microcirculatory monitoring has not yet reached clinical utility. Offline analysis is time consuming and occurs away from the patient. A system to assess the microcirculation at the point of care is desirable. We present a novel 5-point grading system (the point of care microcirculation (POEM) scoring system) that can be used at the point of care during non-invasive sublingual microcirculatory monitoring...
September 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
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