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https://www.readbyqxmd.com/read/28428483/a-retrospective-study-of-anesthesia-for-subcutaneous-ureteral-bypass-placement-in-cats-27-cases
#1
Geneviève C Luca, Beatriz P Monteiro, Marilyn Dunn, Paulo Vm Steagall
The goals of this retrospective clinical case series study were to describe the management of anesthesia, and to report perioperative complications in cats undergoing subcutaneous ureteral bypass (SUB) placement due to ureteral obstruction. Medical records of client-owned cats with ureteral obstruction and anesthetized for SUB placement between 2012 and 2015 in a veterinary teaching hospital were reviewed. Twenty-seven cases were identified. Duration of anesthesia and surgery (mean ± standard deviation) were 215 ± 42 min and 148 ± 36 min, respectively...
April 20, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#2
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#3
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28426688/vancomycin-associated-acute-kidney-injury-a-cross-sectional-study-from-a-single-center-in-china
#4
Kunming Pan, Lingyun Ma, Qian Xiang, Xueying Li, Haixia Li, Ying Zhou, Li Yang, Yimin Cui
OBJECTIVE: The objective of this study was to investigate the current situation of vancomycin (VAN)-associated acute kidney injury (VA-AKI) in China and identify the risk factors for VA-AKI, as well as to comprehensively examine the risk related to concurrent drug use. Further, we assessed the outcomes of patients who developed VA-AKI and the risk factors for these outcomes. Finally, we aimed to provide suggestions for improving the prevention and treatment of VA-AKI in China. METHODS: We conducted a retrospective observational study of inpatients who had been treated with VAN between January 2013 and December 2013 at Peking University First Hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28426557/loop-ileostomy-vs-total-colectomy-as-surgical-treatment-for-clostridium-difficile-associated-disease-an-eastern-association-for-the-surgery-of-trauma-multicenter-trial
#5
Paula Ferrada, Rachael Callcut, Martin D Zielinski, Brandon Bruns, Daniel Dante Yeh, Tanya L Zakrison, Jonathan P Meizoso, Babak Sarani, Richard D Catalano, Peter Kim, Valerie Plant, Amelia Pasley, Linda A Dultz, Asad J Choudhry, Elliott R Haut
OBJECTIVES: The mortality of patients with Clostridum Dificile Associated Disease (CDAD) requiring surgery continues to be very high. Loop ileostomy (LI) was introduced as an alternative procedure to total colectomy (TC) for CDAD by a single center study. To date, no reproducible results have been published. The objective of this study is to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need. METHODS: This was a retrospective multicenter study conducted under the sponsorship of the Eastern Association for the Surgery of Trauma (EAST)...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#6
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28425335/the-incidence-of-and-risk-factors-for-postintubation-hypotension-in-the-immunocompromised-critically-ill-adult
#7
Nathan J Smischney, Mohamed O Seisa, John Cambest, Robert A Wiegand, Kyle D Busack, Theodore O Loftsgard, Darrell R Schroeder, Daniel A Diedrich
OBJECTIVES: Our primary aim was to ascertain the frequency of postintubation hypotension in immunocompromised critically ill adults with secondary aims of arriving at potential risk factors for the development of postintubation hypotension and its impact on patient-related outcomes. METHODS: Critically ill adult patients (≥18 years) were included from January 1, 2010, to December 31, 2014. We defined immunocompromised as patients with any solid organ or nonsolid organ malignancy or transplant, whether solid organ or not, requiring current chemotherapy...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28425079/outcome-of-patients-with-septic-shock-and-high-dose-vasopressor-therapy
#8
Thomas Auchet, Marie-Alix Regnier, Nicolas Girerd, Bruno Levy
BACKGROUND: Despite the dissemination of international guidelines, mortality from septic shock remains high. Norepinephrine is recommended as first-line vasopressor therapy with a target mean arterial pressure of 65 mmHg. High-dose vasopressor (HDV) may also be required. This study aimed to assess survival in patients with septic shock requiring HDV. We conducted a retrospective study of patients admitted between January 2008 and December 2013 to a 13-bed ICU for septic shock and receiving high-dose vasopressor therapy (defined by a dose >1 µg/kg/min)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28424322/kaposi-sarcoma-inflammatory-cytokine-syndrome-kics-a-rare-but-potentially-treatable-condition
#9
Michael Karass, Emily Grossniklaus, Talal Seoud, Sanjay Jain, Daniel A Goldstein
Kaposi sarcoma inflammatory cytokine syndrome (KICS) is a newly-described condition affecting individuals who are HIV-positive and are infected with human herpesvirus 8 (HHV-8). This is a syndrome that in some ways mimics severe sepsis with associated acute respiratory distress syndrome, possibly requiring a ventilator and vasopressor support. However, unlike severe sepsis, antibiotics provide no benefit. Management of KICS has not been fully elucidated because of its high mortality rate. However, the syndrome has been successfully treated in some cases with immunomodulatory therapy...
April 19, 2017: Oncologist
https://www.readbyqxmd.com/read/28424126/the-novel-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-to-explore-a-retroperitoneal-hematoma-in-a-hemodynamically-unstable-patient
#10
Martin D Rosenthal, Ahsan Raza, Stephanie Markle, Chasen A Croft, Alicia M Mohr, R Stephen Smith
Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that "it is a feasible method for proximal aortic control...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422915/enteral-tranexamic-acid-attenuates-vasopressor-resistance-and-changes-in-%C3%AE-1-adrenergic-receptor-expression-in-hemorrhagic-shock
#11
Marco Santamaria, Federico Aletti, Joyce B Li, Aaron Tan, Monica Chang, Jessica Leon, Geert W Schmid-Schönbein, Erik B Kistler
BACKGROUND: Irreversible hemorrhagic shock is characterized by hyporesponsiveness to vasopressor and fluid therapy. Little is known, however, about the mechanisms that contribute to this phenomenon. Previous studies have shown that decreased intestinal perfusion in hemorrhagic shock leads to proteolytically-mediated increases in gut permeability, with subsequent egress of vasoactive substances systemically. Maintenance of blood pressure is achieved in part by α1 receptor modulation, which may be affected by vasoactive factors; we thus hypothesized that decreases in hemodynamic stability and vasopressor response in shock can be prevented by enteral protease inhibition...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28420900/intracranial-pressure-monitoring-for-pediatric-acute-encephalopathy
#12
Nobuyuki Nosaka, Kohei Tsukahara, Emily Knaup, Toshihiko Yabuuchi, Tomonobu Kikkawa, Yosuke Fujii, Masato Yashiro, Takao Yasuhara, Ayumi Okada, Toyomu Ugawa, Atsunori Nakao, Hirokazu Tsukahara, Isao Date
Newly published clinical practice guidelines recommend intracranial pressure (ICP) monitoring in critical care for the management of pediatric acute encephalopathy (pAE), but the utility of ICP monitoring for pAE has been poorly studied. We recently performed direct ICP monitoring for two patients. We observed that although the direct ICP monitoring had clinical benefits with less body weight gain and no vasopressor use in both cases, this monitoring technique is still invasive. Future studies should determine the utility of non-invasive ICP monitoring systems in pAE to further improve the quality of intensive-care management...
April 2017: Acta Medica Okayama
https://www.readbyqxmd.com/read/28418697/a-two-biomarker-model-predicts-mortality-in-the-critically-ill-with-sepsis
#13
Carmen Mikacenic, Brenda L Price, Susanna Harju-Baker, D Shane O'Mahony, Cassianne Robinson-Cohen, Frank Radella, William O Hahn, Ronit Katz, David C Christiani, Jonathan Himmelfarb, W Conrad Liles, Mark M Wurfel
RATIONALE: Improving the prospective identification of patients with the systemic inflammatory response syndrome (SIRS) and sepsis at low for organ dysfunction and death is a major clinical challenge. OBJECTIVE: To develop and validate a multi-biomarker based prediction model for 28-day mortality in critically ill patients with SIRS and sepsis. METHODS: The derivation cohort (n=888) and internal test cohort (n=278) were from a prospective study of critically ill intensive care unit (ICU) patients meeting 2 of 4 SIRS criteria at an academic medical center for whom plasma was obtained within 24 hours...
April 18, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28416053/-treatment-of-anaphylactic-schock-in-pregnant-women
#14
Therese Simonsen Straarup, Ulla Bang
This is an update on the treatment of anaphylactic shock in pregnant women. Most guidelines recommend adrenaline as first-line treatment in all patients, but in pregnant patients some recommend ephedrine due to a potential risk of utero-placental hypoperfusion with adrenaline. However, ephedrine is a less potent vasopressor than adrenaline and does not possess the same anti-inflammatory or broncho-dilating effects. As immediate and correct treatment is essential for both the maternal and the fetal outcome, adrenaline should be first-line treatment also in pregnant women...
April 10, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28413267/vasopressors-do-they-have-any-role-in-hemorrhagic-shock
#15
REVIEW
Babita Gupta, Neha Garg, Rashmi Ramachandran
The priority in the management of patients with traumatic hemorrhagic shock is to control the bleeding with simultaneous volume resuscitation to maintain adequate tissue perfusion. Fluid replacement remains the mainstay of initial resuscitation in hemorrhagic shock. Traditionally, vasopressors are contraindicated in the early management of hemorrhagic shock due to their deleterious consequences, although vasopressors may have a role in resuscitation when vasoplegic shock ensues and blood pressure cannot be maintained by fluids alone...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412015/managing-sepsis-electronic-recognition-rapid-response-teams-and-standardized-care-save-lives
#16
Faheem W Guirgis, Lisa Jones, Rhemar Esma, Alice Weiss, Kaitlin McCurdy, Jason Ferreira, Christina Cannon, Laura McLauchlin, Carmen Smotherman, Dale F Kraemer, Cynthia Gerdik, Kendall Webb, Jin Ra, Frederick A Moore, Kelly Gray-Eurom
PURPOSE: Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. MATERIALS AND METHODS: Retrospective review of patients ≥18years treated for sepsis. RESULTS: There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p=0.94) and Charlson Comorbidity Scores (2...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28411114/circulating-biologically-active-adrenomedullin-bio-adm-predicts-hemodynamic-support-requirement-and-mortality-during-sepsis
#17
Pietro Caironi, Roberto Latini, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Giuseppe Maggio, Marco Cavana, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Serge Masson
BACKGROUND: The biological role of adrenomedullin, a hormone involved in hemodynamic homeostasis, is controversial in sepsis, since administration of either the peptide or an antibody against it may be beneficial. METHODS: Plasma bio-ADM was assessed on days 1, 2 and 7 after randomization of 956 patients with sepsis or septic shock to albumin or crystalloids for fluid resuscitation in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial. We tested the association of bio-ADM and its time-dependent variation with fluid therapy, vasopressor administration, organ failures and mortality...
April 11, 2017: Chest
https://www.readbyqxmd.com/read/28410259/central-venous-catheter-placement-in-the-left-internal-jugular-vein-complicated-by-perforation-of-the-left-brachiocephalic-vein-and-massive-hemothorax-a-case-report
#18
Lindsay R Wetzel, Priyesh R Patel, Nicholas L Pesa
An elderly male presented for emergent repair of a ruptured abdominal aortic aneurysm. For anticipated volume resuscitation, vasopressor administration, and hemodynamic monitoring, a large-bore central venous catheter was placed in the left internal jugular vein under ultrasound guidance before surgical incision. Initially, there were no readily apparent signs of venous perforation. However, a massive left hemothorax developed because of perforation of the brachiocephalic vein and violation of the pleural space...
April 13, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28406862/a-randomized-controlled-trial-of-corticosteroids-in-pediatric-septic-shock-a-pilot-feasibility-study
#19
Kusum Menon, Dayre McNally, Katharine O'Hearn, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVE: To determine the feasibility of conducting a randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: Randomized, double-blind, placebo controlled trial. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years old inclusive with suspected septic shock. INTERVENTION: Administration of IV hydrocortisone versus placebo until hemodynamic stability is achieved or for a maximum of 7 days...
April 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28403066/non-hemodynamic-effects-of-catecholamines
#20
Clair Hartmann, Peter Radermacher, Martin Wepler, Benedikt Nubaum
Circulatory shock is defined as an imbalance between tissue oxygen supply and demand, and mostly results from a loss of blood volume, cardiac pump failure and/or reduction of vasomotor tone. The clinical hallmarks of circulatory shock are arterial hypotension and lactate acidosis. Since the degree and duration of hypotension are major determinants of outcome, vasopressor administration represents a cornerstone therapy to treat these patients. Current guidelines recommend the use of catecholamines as the drug of first choice...
April 11, 2017: Shock
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