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https://www.readbyqxmd.com/read/28210935/the-effect-of-fluid-resuscitation-on-the-effective-circulating-volume-in-patients-undergoing-liver-surgery-a-post-hoc-analysis-of-a-randomized-controlled-trial
#1
Jaap Jan Vos, A F Kalmar, H G D Hendriks, J Bakker, T W L Scheeren
To assess the significance of an analogue of the mean systemic filling pressure (Pmsa) and its derived variables, in providing a physiology based discrimination between responders and non-responders to fluid resuscitation during liver surgery. A post-hoc analysis of data from 30 patients undergoing major hepatic surgery was performed. Patients received 15 ml kg(-1) fluid in 30 min. Fluid responsiveness (FR) was defined as an increase of 20% or greater in cardiac index, measured by FloTrac-Vigileo(®). Dynamic preload variables (pulse pressure variation and stroke volume variation: PPV, SVV) were recorded additionally...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#2
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28207539/role-of-coronary-angiography-for-out-of-hospital-cardiac-arrest-survivors-according-to-postreturn-of-spontaneous-circulation-on-an-electrocardiogram
#3
Tae Rim Lee, Sung Yeon Hwang, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors.We collected data from our OHCA registry from January 2010 to November 2014...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28203222/unexpected-death-of-a-child-with-complex-febrile-seizures-pathophysiology-similar-to-sudden-unexpected-death-in-epilepsy
#4
Brian J Dlouhy, Michael A Ciliberto, Christina L Cifra, Patricia A Kirby, Devin L Shrock, Marcus Nashelsky, George B Richerson
Febrile seizures are usually considered relatively benign. Although some cases of sudden unexplained death in childhood have a history of febrile seizures, no documented case of febrile seizure-induced death has been reported. Here, we describe a child with complex febrile seizures who died suddenly and unexpectedly after a suspected seizure while in bed at night during the beginning phases of sleep. She was resuscitated and pronounced brain dead 2 days later at our regional medical center. Autopsy revealed multiorgan effects of hypoperfusion and did not reveal an underlying (precipitating) disease, injury, or toxicological cause of death...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28202686/simvastatin-pre-treatment-improves-survival-and-mitochondrial-function-in-a-three-day-fluid-resuscitated-rat-model-of-sepsis
#5
Jerome Morel, Iain Hargreaves, David Brealey, Viruna Neergheen, Janne T Backman, Sandro Lindig, Marcus Bläss, Michael Bauer, Daniel F McAuley, Mervyn Singer
Statins may offer protective effects in sepsis through anti-inflammatory, mitochondrial protection and other actions. We thus evaluated the effects of simvastatin on survival, organ and mitochondrial function, tissue and plasma ubiquinone levels and liver transcriptomics in a 3-day rat model of sepsis. Comparisons of rat plasma simvastatin and ubiquinone levels were made against levels sampled in blood from patients with acute lung injury (ALI) enrolled into a trial of statin therapy. Animals received simvastatin by gavage either pre- or post-induction of faecal peritonitis...
February 15, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28178160/extracorporeal-membrane-oxygenation-support-in-post-traumatic-cardiopulmonary-failure-a-10-year-single-institutional-experience
#6
Chun-Yu Lin, Feng-Chun Tsai, Hsiu-An Lee, Yuan-His Tseng
Patients with multiple traumas associated with cardiopulmonary failure have a high mortality rate; however, such patients can be temporarily stabilized using extracorporeal membrane oxygenation (ECMO), providing a bridge to rescue therapy. Using a retrospective study design, we aimed to clarify the prognostic factors of post-traumatic ECMO support.From March 2006 to July 2016, 43 adult patients (mean age, 37.3 ± 15.2 years; 7 females [16.3%]) underwent ECMO because of post-traumatic cardiopulmonary failure...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28176924/high-stakes-and-high-emotions-providing-safe-care-in-canadian-emergency-departments
#7
Samina Ali, Denise Thomson, Timothy A D Graham, Sean E Rickard, Antonia S Stang
BACKGROUND: The high-paced, unpredictable environment of the emergency department (ED) contributes to errors in patient safety. The ED setting becomes even more challenging when dealing with critically ill patients, particularly with children, where variations in size, weight, and form present practical difficulties in many aspects of care. In this commentary, we will explore the impact of the health care providers' emotional reactions while caring for critically ill patients, and how this can be interpreted and addressed as a patient safety issue...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28176385/financial-and-clinical-outcomes-of-extracorporeal-mechanical-support
#8
Ryan Chiu, Eric Pillado, Sohail Sareh, Kim De La Cruz, Richard J Shemin, Peyman Benharash
BACKGROUND: Over the past decade, extracorporeal mechanical support (ECMO) has been increasingly utilized in respiratory failure and cardiogenic shock. There is a need for assessing clinical and financial outcomes of ECMO use. This study presents our institution's experience with veno-arterial ECMO (VA-ECMO) over a 9-year period. METHODS: A retrospective review of our institution's ECMO database identified patients undergoing VA-ECMO between 2005 and 2013 (N = 150)...
February 8, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28174032/emergency-medicine-myths-epinephrine-in-cardiac-arrest
#9
Brit Long, Alex Koyfman
BACKGROUND: Sudden cardiac arrest accounts for approximately 15% of deaths in developed nations, with poor survival rate. The American Heart Association states that epinephrine is reasonable for patients with cardiac arrest, though the literature behind its use is not strong. OBJECTIVE: To review the evidence behind epinephrine for cardiac arrest. DISCUSSION: Sudden cardiac arrest causes over 450,000 deaths annually in the United States. The American Heart Association recommends epinephrine may be reasonable in patients with cardiac arrest, as part of Advanced Cardiac Life Support...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28168185/optimal-chest-compression-rate-and-compression-to-ventilation-ratio-in-delivery-room-resuscitation-evidence-from-newborn-piglets-and-neonatal-manikins
#10
REVIEW
Anne Lee Solevåg, Georg M Schmölzer
Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28157808/improved-clinical-performance-and-teamwork-of-pediatric-interprofessional-resuscitation-teams-with-a-simulation-based-educational-intervention
#11
Elaine Gilfoyle, Deanna A Koot, John C Annear, Farhan Bhanji, Adam Cheng, Jonathan P Duff, Vincent J Grant, Cecilia E St George-Hyslop, Nicole J Delaloye, Afrothite Kotsakis, Carolyn D McCoy, Christa E Ramsay, Matthew J Weiss, Ronald D Gottesman
OBJECTIVES: To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. DESIGN: Multicenter prospective interventional study. SETTING: Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. SUBJECTS: Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams)...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28150304/effects-of-fluid-restriction-on-measures-of-circulatory-efficacy-in-adults-with-septic-shock
#12
P B Hjortrup, N Haase, J Wetterslev, T Lange, H Bundgaard, B S Rasmussen, N Dey, E Wilkman, L Christensen, D Lodahl, M Bestle, A Perner
BACKGROUND: The haemodynamic consequences of fluid resuscitation in septic shock have not been fully elucidated. Therefore, we assessed circulatory effects in the first 24 h of restriction of resuscitation fluid as compared to standard care in intensive care unit (ICU) patients with septic shock. METHODS: This was a post-hoc analysis of the multicentre CLASSIC randomised trial in which patients with septic shock, who had received the initial fluid resuscitation, were randomised to a protocol restricting resuscitation fluid or a standard care protocol in nine ICUs...
February 1, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28146450/patient-simulation-for-assessment-of-layperson-management-of-opioid-overdose-with-intranasal-naloxone-in-a-recently-released-prisoner-cohort
#13
Leo Kobayashi, Traci C Green, Sarah E Bowman, Madeline C Ray, Michelle S McKenzie, Josiah D Rich
INTRODUCTION: Investigators applied simulation to an experimental program that educated, trained, and assessed at-risk, volunteering prisoners on opioid overdose (OD) prevention, recognition, and layperson management with intranasal (IN) naloxone. METHODS: Consenting inmates were assessed for OD-related experience and knowledge then exposed on-site to standardized didactics and educational DVD (without simulation). Subjects were provided with IN naloxone kits at time of release and scheduled for postrelease assessment...
February 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28138363/perforated-peptic-ulcer-an-update
#14
REVIEW
Kin Tong Chung, Vishalkumar G Shelat
Peptic ulcer disease (PUD) affects 4 million people worldwide annually. The incidence of PUD has been estimated at around 1.5% to 3%. Perforated peptic ulcer (PPU) is a serious complication of PUD and patients with PPU often present with acute abdomen that carries high risk for morbidity and mortality. The lifetime prevalence of perforation in patients with PUD is about 5%. PPU carries a mortality ranging from 1.3% to 20%. Thirty-day mortality rate reaching 20% and 90-d mortality rate of up to 30% have been reported...
January 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28131602/correlation-of-impedance-threshold-device-use-during-cardiopulmonary-resuscitation-with-post-cardiac-arrest-acute-kidney-injury
#15
Panagiota Niforopoulou, Nicoletta Iacovidou, Pavlos Lelovas, George Karlis, Αpostolos Papalois, Spyros Siakavellas, Vasileios Spapis, George Kaparos, Ioanna Siafaka, Theodoros Xanthos
PURPOSE: To assess whether use of Impedance Threshold Device (ITD) during cardiopulmonary resuscitation (CPR) reduces the degree of post-cardiac arrest Acute Kidney Injury (AKI), as a result of improved hemodynamics, in a porcine model of ventricular fibrillation (VF) cardiac arrest. METHODS: After 8 min of untreated cardiac arrest, the animals were resuscitated either with active compression-decompression (ACD) CPR plus a sham ITD (control group, n=8) or with ACD-CPR plus an active ITD (ITD group, n=8)...
January 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28126364/the-association-between-diabetes-status-and-survival-following-an-out-of-hospital-cardiac-arrest-a-retrospective-cohort-study
#16
Monica Parry, Kyle Danielson, Sarah Brennenstuhl, Ian R Drennan, Laurie J Morrison
BACKGROUND: Sudden cardiac arrest (SCA), confirmed absence of cardiac mechanical activity, is the leading cause of heart-related death in the US. Almost 85% of SCA occur out-of-hospital (OHCA), with very poor rates of return of spontaneous circulation (ROSC) and survival to hospital discharge. We sought to determine if diabetes status was associated with survival or ROSC following an OHCA. METHODS: We completed a retrospective cohort study using data from the Toronto Regional RescuNet Epistry dataset, based upon data definitions defined by the Resuscitation Outcomes Consortium (ROC) Epistry-Cardiac Arrest and the Strategies for Post Arrest Resuscitation Care (SPARC) network datasets...
January 23, 2017: Resuscitation
https://www.readbyqxmd.com/read/28122604/investigation-of-complications-secondary-to-chest-compressions-before-and-after-the-2010-cardiopulmonary-resuscitation-guideline-changes-by-using-multi-detector-computed-tomography-a-retrospective-study
#17
Jin Ho Beom, Je Sung You, Min Joung Kim, Min Kyung Seung, Yoo Seok Park, Hyun Soo Chung, Sung Phil Chung, Incheol Park
BACKGROUND: The purpose of this study was to identify the relationship between the deeper and faster chest compressions suggested by the 2010 cardiopulmonary resuscitation guidelines and complications arising from chest compressions, using multi-detector computed tomography. METHODS: We performed a retrospective analysis of prospective registry data. This study was conducted with in- and out-of-hospital cardiac arrest patients who underwent successful resuscitation in the emergency departments of two academic tertiary care centres from October 2006 to September 2010 (pre-2010 group) and from October 2011 to September 2015 (post-2010 group)...
January 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28114415/managing-neonatal-and-early-childhood-syndromic-sepsis-in-sub-district-hospitals-in-resource-poor-settings-improvement-in-quality-of-care-through-introduction-of-a-package-of-interventions-in-rural-bangladesh
#18
Ahmed Ehsanur Rahman, Afrin Iqbal, D M Emdadul Hoque, Md Moinuddin, Sojib Bin Zaman, Qazi Sadeq-Ur Rahman, Tahmina Begum, Atique Iqbal Chowdhury, Rafiqul Haider, Shams El Arifeen, Niranjan Kissoon, Charles P Larson
INTRODUCTION: Sepsis is dysregulated systemic inflammatory response which can lead to tissue damage, organ failure, and death. With an estimated 30 million cases per year, it is a global public health concern. Severe infections leading to sepsis account for more than half of all under five deaths and around one quarter of all neonatal deaths annually. Most of these deaths occur in low and middle income countries and could be averted by rapid assessment and appropriate treatment. Evidence suggests that service provision and quality of care pertaining to sepsis management in resource poor settings can be improved significantly with minimum resource allocation and investments...
2017: PloS One
https://www.readbyqxmd.com/read/28109621/-the-latest-in-paediatric-resuscitation-recommendations
#19
Jesús López-Herce, Antonio Rodríguez, Angel Carrillo, Nieves de Lucas, Custodio Calvo, Eva Civantos, Eva Suárez, Sara Pons, Ignacio Manrique
Cardiac arrest has a high mortality in children. To improve the performance of cardiopulmonary resuscitation, it is essential to disseminate the international recommendations and the training of health professionals and the general population in resuscitation. This article summarises the 2015 European Paediatric Cardiopulmonary Resuscitation recommendations, which are based on a review of the advances in cardiopulmonary resuscitation and consensus in the science and treatment by the International Council on Resuscitation...
January 18, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28105603/resuscitation-fluid-composition-affects-hepatic-inflammation-in-a-murine-model-of-early-sepsis
#20
Amanda L Patrick, Peter M Grin, Nicole Kraus, Michelle Gold, Matthew Berardocco, Patricia C Liaw, Alison E Fox-Robichaud
BACKGROUND: Fluid resuscitation is a crucial therapy for sepsis, and the use of balanced fluids and/or isotonic albumin may improve patient survival. We have previously demonstrated that resuscitation with normal saline results in increased hepatic leukocyte recruitment in a murine model of sepsis. Given that clinical formulations of albumin are in saline, our objectives were to develop a novel balanced electrolyte solution specifically for sepsis and to determine if supplementing this solution with albumin would improve the inflammatory response in sepsis...
December 2017: Intensive Care Medicine Experimental
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