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https://www.readbyqxmd.com/read/29026888/korean-shock-society-septic-shock-registry-a-preliminary-report
#1
Tae Gun Shin, Sung Yeon Hwang, Gu Hyun Kang, Won Young Kim, Seung Mok Ryoo, Kyuseok Kim, You Hwan Jo, Sung Phil Chung, Young Seon Joo, Jin Ho Beom, Sung-Hyuk Choi, Young Hoon Yoon, Woon Yong Kwon, Tae Ho Lim, Kap Su Han, Han Sung Choi, Gil Joon Suh
OBJECTIVE: To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED). METHODS: This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29024080/randomized-comparison-of-balloon-aortic-valvuloplasty-performed-with-or-without-rapid-cardiac-pacing-the-pacing-versus-no-pacing-pnp-study
#2
Gianni Dall'Ara, Antonio Marzocchi, Nevio Taglieri, Carolina Moretti, Giulio Rodinò, Matteo Chiarabelli, Paolo Bottoni, Cinzia Marrozzini, Maria Rita Sabattini, Maria-Letizia Bacchi-Reggiani, Claudio Rapezzi, Francesco Saia
OBJECTIVES: To compare the effectiveness and safety of balloon aortic valvuloplasty (BAV) performed with or without rapid ventricular pacing (RP). BACKGROUND: BAV technique is poorly standardized. METHODS: One hundred consecutive patients were randomly assigned 1:1 between BAV performed with or without RP. Exclusion criteria were an immediate indication for surgical or transcatheter aortic valve replacement, presentation in cardiogenic shock or pulmonary edema refractory to medical stabilization...
October 11, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28992392/norepinephrine-infusion-improves-hemodynamics-in-the-preterm-infants-during-septic-shock
#3
M Y Rizk, A Lapointe, F Lefebvre, K J Barrington
AIM: This study evaluated the clinical and hemodynamic effects of norepinephrine infusion in preterm infants. METHODS: The effects of norepinephrine therapy for refractory hypotension were evaluated in preterm infants between April 2009 and April 2011 at the neonatal intensive care unit of Sainte-Justine Hospital, Montreal, Quebec. Changes in hemodynamics and clinical parameters were analyzed eight hours before and eight hours after the start of norepinephrine infusion, and eight hours after its cessation...
October 9, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28989041/deciphering-molecular-mechanisms-of-arginine-deiminase-based-therapy-comparative-response-analysis-in-paired-human-primary-and-recurrent-glioblastomas
#4
Claudia Maletzki, Yvonne Rosche, Christin Matzack, Aline Scholz, Doreen William, Carl Friedrich Classen, Bernd Kreikemeyer, Michael Linnebacher, Tomas Fiedler
Arginine auxotrophy constitutes the Achilles' heel for several tumors, among them glioblastoma multiforme (GBM). Hence, arginine-depleting enzymes such as arginine deiminase (ADI) from Streptococcus pyogenes are promising for treatment of primary and maybe even refractory GBM. Based on our previous study in which ADI-susceptibility was shown on a panel of patient-derived GBM cell lines, we here aimed at deciphering underlying molecular mechanisms of ADI-mediated growth inhibition. We found that ADI (35 mU/mL) initially induces a cellular stress-response that is characterized by upregulation of genes primarily belonging to the heat-shock protein family...
October 5, 2017: Chemico-biological Interactions
https://www.readbyqxmd.com/read/28978402/double-sequential-defibrillation-for-refractory-ventricular-fibrillation
#5
Chady El Tawil, Sandra Mrad, Basem F Khishfe
A 54-year-old suffered from an out-of-hospital cardiac arrest. Compressions were started within minutes and the patient was in refractory ventricular fibrillation despite multiple asynchronized shocks and maximal doses of antiarrhythmic agents. Double sequential defibrillation was attempted with successful Return Of Spontaneous Circulation (ROSC) after a total of 61min of cardiac arrest. The patient was discharged home neurologically intact. Double sequential defibrillation could be a simple effective approach to patients with refractory ventricular fibrillation...
September 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28964115/highly-trabeculated-structure-of-the-human-endocardium-underlies-asymmetrical-response-to-low-energy-monophasic-shocks
#6
Adam Connolly, Matthew D Robson, Jürgen Schneider, Rebecca Burton, Gernot Plank, Martin J Bishop
Novel low-energy defibrillation therapies are thought to be driven by virtual-electrodes (VEs), due to the interaction of applied monophasic electric shocks with fine-scale anatomical structures within the heart. Significant inter-species differences in the cardiac (micro)-anatomy exist, however, particularly with respect to the degree of endocardial trabeculations, which may underlie important differences in response to low-energy defibrillation protocols. Understanding the interaction of monophasic electric fields with the specific human micro-anatomy is therefore imperative in facilitating the translation and optimisation of these promising experimental therapies to the clinic...
September 2017: Chaos
https://www.readbyqxmd.com/read/28961605/radial-extracorporeal-shock-wave-therapy-in-an-individual-with-primary-trigeminal-neuralgia-a-case-report-and-literature-review
#7
Dai Zhang, Ying Meng, Hong Hai, Xiao Tong Yu, Yue Wen Ma
A patient with primary trigeminal neuralgia exhibited pain relief without medication after radial extracorporeal shock wave therapy. The 52-yr-old woman had a 3-yr history of primary trigeminal neuralgia, involving the right maxillary division (V2) and the mandibular division (V3). She became refractory to carbamazepine and exhibited hepatic dysfunction. She hence received 3000 to 6000 impulses of craniofacial radial extracorporeal shock wave therapy to the region centered on the surface projection of the trigeminal ganglion and pain areas at 10 Hz; the intensity ranged from 1...
September 28, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28958592/amiodarone-lidocaine-magnesium-or-placebo-in-shock-refractory-ventricular-arrhythmia-a-bayesian-network-meta-analysis
#8
REVIEW
Safi U Khan, Lydia Winnicka, Muhammad A Saleem, Hammad Rahman, Najeeb Rehman
Recent evidence challenges, the superiority of amiodarone, compared to other anti-arrhythmic medications, as the agent of choice in pulseless ventricular tachycardia (VT) or ventricular fibrillation (VF). We conducted Bayesian network and traditional meta-analyses to investigate the relative efficacies of amiodarone, lidocaine, magnesium (MgSO4) and placebo as treatments for pulseless VT or VF. Eleven studies [5200 patients, 7 randomized trials (4, 611 patients) and 4 non-randomized studies (589 patients)], were included in this meta-analysis...
September 25, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28941883/a-national-survey-of-premedication-for-transfusion-reactions-in-japan
#9
Shin-Ichiro Fujiwara, Shuichi Kino, Asashi Tanaka, Yuichi Hasegawa, Akihiko Yokohama, Keizo Fujino, Makino Shigeyoshi, Mayumi Matsumoto, Akihiro Takeshita, Kazuo Muroi
BACKGROUND: Premedication before transfusion is commonly administered in clinical practice despite a lack of evidence for its efficacy. The aim of this study was to clarify the status of premedication and evaluate expert opinions regarding its use in Japanese medical institutions. METHOD: Between May and July 2016, we conducted a questionnaire survey on premedication before transfusion in 252 medical institutes that were certified by an academic society or employed transfusion experts...
September 11, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28941568/resuscitation-thoracotomy
#10
G Boddaert, E Hornez, H De Lesquen, A Avramenko, B Grand, T MacBride, J-P Avaro
Resuscitation thoracotomy is a rarely performed procedure whose use, in France, remains marginal. It has five specific goals that correspond point-by-point to the causes of traumatic cardiac arrest: decompression of pericardial tamponade, control of cardiac hemorrhage, performance of internal cardiac massage, cross-clamping of the descending thoracic aorta, and control of lung injuries and other intra-thoracic hemorrhage. This approach is part of an overall Damage Control strategy, with a targeted operating time of less than 60minutes...
September 20, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28937421/methylene-blue-to-treat-refractory-latex-induced-anaphylactic-shock-a-case-report
#11
Paulo Sergio Da Silva, Paula Furtado
Anaphylaxis occurs in 1/5000-1/20,000 of anesthesia cases and may evolve with shock and cardiovascular collapse in up to 54% of cases. Mortality varies from 3% to 10%. Latex is the second leading cause of anaphylaxis during the perioperative period. We report a case of latex-induced anaphylactic shock refractory to the usual catecholamine treatment that was reversed with the aid of methylene blue. Exaggerated activation of the nitric oxide-cyclic guanosine monophosphate pathway is observed in refractory shock...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28932731/extracorporeal-membrane-oxygenation-support-for-refractory-septic-shock-in-liver-transplantation-recipients
#12
Kyo Won Lee, Chan Woo Cho, Nuri Lee, Gyu-Seong Choi, Yang Hyun Cho, Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh
PURPOSE: This study was designed to assess the outcome of the extracorporeal membrane oxygenation (ECMO) in liver transplantation (LT) recipients with refractory septic shock and predict the prognosis of those cases. METHODS: From February 2005 to October 2012, ECMO was used in 8 cases of refractory septic shock. Laboratory values including lactate and total bilirubin level just before starting ECMO were obtained and sepsis-related organ failure assessment (SOFA) score, acute physiology and chronic health evaluation (APACH) II score and simplified acute physiology score (SAPS) 3 were calculated...
September 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28930049/experience-with-the-syncardia-total-artificial-heart-in-a-canadian-centre
#13
Anthony Nguyen, Michel Pellerin, Louis P Perrault, Michel White, Anique Ducharme, Normand Racine, Michel Carrier
BACKGROUND: The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. METHODS: We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. RESULTS: From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%)...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28925084/extracorporeal-membrane-oxygenation-in-the-therapy-of-cardiogenic-shock-ecmo-cs-the%C3%A2-need-for-a-better-definition-of-refractory-cardiogenic-shock
#14
EDITORIAL
Sébastien Champion
No abstract text is available yet for this article.
September 18, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28917560/outcomes-of-rescue-cardiopulmonary-support-for-periprocedural-acute-hemodynamic-decompensation-in-patients-undergoing-catheter-ablation-of-electrical-storm
#15
Andres Enriquez, Jackson Liang, Javier Gentile, Robert Schaller, Gregory Supple, David S Frankel, Fermin Garcia, Joyce Wald, Edo Y Birati, J Eduardo Rame, Christian Bermudez, David Callans, Francis Marchlinski, Pasquale Santangeli
BACKGROUND: In patients with ventricular tachycardia or ventricular fibrillation (VT/VF) electrical storm (ES) undergoing catheter ablation (CA), hypotension due to refractory VT/VF, use of anesthesia, and cardiac stunning due to repeated implantable cardioverter-defibrillator shocks might precipitate acute hemodynamic decompensation (AHD). OBJECTIVE: We evaluated the outcomes of emergent cardiopulmonary support with extracorporeal membrane oxygenation (ECMO) to rescue AHD in patients undergoing CA of ES...
September 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28916516/an-uncommon-manifestation-of-shock-takotsubo-syndrome
#16
Ying X Gue, Sanjay S Bhandari, Mubarak Ahamed
76 year old female presented following an episode of collapse. She was hypotensive with the paramedics and remained refractory despite fluid resuscitation. Her initial baseline tests revealed an elevated troponin; she subsequently underwent a coronary angiogram which showed mild coronary artery disease. Left ventriculogram was performed which showed abnormal mid-wall ballooning and severely impaired systolic function, characteristic of takotsubo syndrome. Echocardiogram confirmed presence of diagnosis and presence of left ventricular outflow tract obstruction with high gradient...
September 15, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28916121/controversies-in-corticosteroid-use-for-sepsis
#17
Brit Long, Alex Koyfman
BACKGROUND: Severe sepsis and septic shock are potentially deadly conditions managed in the emergency department (ED). Management centers on source control, fluid resuscitation, broad-spectrum antimicrobials, and vasopressors as needed. The use of corticosteroids is controversial. OBJECTIVE: To evaluate the evidence behind corticosteroid therapy in patients with septic shock. DISCUSSION: Septic shock is associated with severe mortality and morbidity...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28904070/antiarrhythmic-drugs-for-non-shockable-turned-shockable-out-of-hospital-cardiac-arrest-the-amiodarone-lidocaine-or-placebo-study-alps
#18
Peter J Kudenchuk, Brian G Leroux, Mohamud Daya, Thomas Rea, Christian Vaillancourt, Laurie J Morrison, Clifton W Callaway, James Christenson, Joseph P Ornato, James V Dunford, Lynn Wittwer, Myron L Weisfeldt, Tom P Aufderheide, Gary M Vilke, Ahamed H Idris, Ian G Stiell, M Riccardo Colella, Tami Kayea, Debra A Egan, Patrice Desvigne-Nickens, Pamela Gray, Randal Gray, Ron Straight, Paul Dorian
Background -Out-of-hospital cardiac arrest (OHCA) commonly presents with non-shockable rhythms (asystole and pulseless electrical activity (PEA)). Whether antiarrhythmic drugs are safe and effective when these evolve to shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia (VF/VT)) during resuscitation is not known. Methods -Adults with non-traumatic OHCA, vascular access and VF/VT anytime after ≥1 shock(s) were prospectively randomized, double-blind, to receive amiodarone, lidocaine or placebo by paramedics...
September 13, 2017: Circulation
https://www.readbyqxmd.com/read/28901029/successful-venoarterial-extracorporeal-membrane-oxygenation-for-postoperative-septic-shock-in-a-child-with-liver-transplantation-a-case-report
#19
Michiko Abe, Kentaro Ide, Nao Nishimura, Satoshi Nakagawa, Akinari Fukuda, Seisuke Sakamoto, Mureo Kasahara
Refractory septic shock after LT is a life-threatening complication. VA ECMO is used to treat refractory cardiorespiratory failure. We present herein the case of a 5-year-old girl with post-Kasai biliary atresia, who underwent a living donor LT and suffered refractory septic shock. VA ECMO was indicated due to progressive cardiac deterioration. After full recovery of her EF, she has been steadily improving and has shown good liver function and no neurological sequelae. This is the first report of successful VA ECMO in a post- LT patient with refractory septic shock...
September 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28895166/diabetes-insipidus-after-discontinuation-of-vasopressin-infusion-for-septic-shock
#20
H Rana, N Ferguson, P V Dicpinigaitis
WHAT IS KNOWN AND OBJECTIVE: Despite widespread use of vasopressin for the treatment of septic shock, few cases of diabetes insipidus (DI) following its discontinuation have been reported. CASE SUMMARY: A 54-year-old man presented with pneumonia progressing to septic shock, requiring norepinephrine and vasopressin for refractory hypotension. After clinical improvement, the patient on 3 separate occasions developed polyuria and severe hypernatremia upon discontinuation of vasopressin, with prompt recovery upon its resumption...
September 11, 2017: Journal of Clinical Pharmacy and Therapeutics
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