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electrolytes in icu patients

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https://www.readbyqxmd.com/read/29310415/cisplatin-induced-sudden-cardiac-death-with-hemodynamic-collapse-a-severe-adverse-drug-reaction-case-report
#1
Silvijus Abramavicius, Marius Zemaitis, Vidas Pilvinis, Edmundas Kadusevicius
RATIONALE: Cisplatin is responsible for a significant percentage of adverse drug reactions (ADRs) in oncology setting. A great proportion of cisplatin-induced severe adverse events are difficult to foresee, and giving premedication does not always prevent the occurrence of such events. PATIENT CONCERNS: A 53-year-old woman with progressive T4 N0 M0 stage IV pleural mesothelioma experienced cardiac arrest with hemodynamic collapse after cisplatin and pemetrexed chemotherapy administration...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29310404/extracorporeal-membrane-oxygenation-combined-with-continuous-renal-replacement-therapy-in-cutaneous-burn-and-inhalation-injury-caused-by-hydrofluoric-acid-and-nitric-acid
#2
Qinhua Pu, Jinxian Qian, Weiyi Tao, Aixiang Yang, Jian Wu, Yaodong Wang
RATIONALE: Hydrofluoric acid (HF) is a highly corrosive agent and can cause corrosive burns. HF can penetrate deeply into tissues through intact skin and the lipid barrier, leading to painful liquefactive necrosis, and inducing hypocalcemia and hypomagnesemia. In this study, we hypothesize that continuous renal replacement therapy (CRRT) may be beneficial in addressing hemodynamic instability in cases of HF poisoning. PATIENT CONCERNS: A 25-year-old man fell into an electroplating pool containing 10% HF and 50% nitric acid...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29251692/is-refeeding-syndrome-relevant-for-critically-ill-patients
#3
Wilhelmina A C Koekkoek, Arthur R H Van Zanten
PURPOSE OF REVIEW: To summarize recent relevant studies regarding refeeding syndrome (RFS) in critically ill patients and provide recommendations for clinical practice. RECENT FINDINGS: Recent knowledge regarding epidemiology of refeeding syndrome among critically ill patients, how to identify ICU patients at risk, and strategies to reduce the potential negative impact on outcome are discussed. SUMMARY: RFS is a potentially fatal acute metabolic derangement that ultimately can result in marked morbidity and even mortality...
December 14, 2017: Current Opinion in Clinical Nutrition and Metabolic Care
https://www.readbyqxmd.com/read/29232194/persistent-ventricular-bigeminy-during-anesthesia-in-pediatric-patients-a-case-report-of-an-11-year-old-child
#4
Sheetal Dalal, Vikas Chaudhari
An 11-year-old male child with fractures in both bones in his left forearm presented for open reduction and internal fixation. The pre-anesthetic check-up and investigations did not reveal any pre-existing underlying cardio-respiratory disease. The patient had an uneventful peri-operative period during the operation and was comfortable without any anxiety or restlessness. After an uneventful induction and intubation as per routine protocol, the patient received 600 mg of amoxicillin+clavunate intravenously as an antibiotic...
December 12, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/29227201/early-rescue-from-acute-severe-clostridium-difficile-a-novel-treatment-strategy
#5
Biniam Kidane, Kalvin Lung, Greig McCreery, Chadia El-Khatib, Michael C Ott, Roberto Hernandez-Alejandro, Chris Vinden, Daryl Gray, Neil G Parry, Kenneth A Leslie, Tina S Mele
BACKGROUND: Severe Clostridium difficile infections (CDI) can lead to significant impediments to effective treatment. We developed a novel treatment protocol utilizing bedside gastrointestinal lavage (GIL) for the management of patients with severe, complicated CDI. We describe the development and early outcomes of non-operative bedside GIL in hospitalized patients with severe, complicated CDI following the Idea, Development, Exploration, Assessment, Long Term Study (IDEAL) framework at the Idea stage...
December 11, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29203991/postoperative-delirium-in-indian-patients-following-major-abdominal-surgery-for-cancer-risk-factors-and-associations
#6
Vibhawari Dhakharia, Subir Sinha, Jaydip Bhaumik
Postoperative delirium (POD) is not uncommon following major abdominal surgery with its incidence ranging between five and 51%. As cancer affects disproportionately, the population older than 65 years and as delirium is more common in the elderly, surgical oncology patients are at a higher risk of developing POD. The present study was undertaken to explore the impact and associations of POD in Indian patients undergoing oncological major abdominal surgery. A retrospective review of the electronic medical records in a tertiary cancer care institution of all postoperative patients who had undergone major gastrointestinal gynaecological and urological abdominal surgery for cancer and required psycho-oncology referral was performed...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29200827/severe-hypertriglyceridemia-and-colchicine-intoxication-following-suicide-attempt
#7
Shaul Lev, David Snyder, Carmil Azran, Victor Zolotarsky, Arik Dahan
Colchicine overdose is uncommon but potentially life threatening. Due to its serious adverse systemic effects, overdose must be recognized and treated. We report a case of an 18-year-old female who ingested 18 mg (~0.4 mg/kg) of colchicine in a suicide attempt. The patient's clinical manifestations included abdominal cramps, vomiting, pancytopenia, hypocholesterolemia, and rhabdomyolysis. Two unique manifestations of toxicity in this patient were profound and persistent, severe hypertriglyceridemia and electrolyte imbalance, mainly hypophosphatemia, with no other evident cause except the colchicine intoxication...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#8
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29132411/an-isolated-elevation-in-blood-urea-level-is-not-uraemia-and-not-an-indication-for-renal-replacement-therapy-in-the-icu
#9
EDITORIAL
Jack Mackenzie, Bobby Chacko
The decision to initiate renal replacement therapy (RRT) and the optimal timing for commencement is a difficult decision faced by clinicians when treating acute kidney injury (AKI) in the intensive care setting. Without clinically significant ureamic symptoms or emergent indications (electrolyte abnormalities, volume overload) the timing of RRT initiation remains contentious and inconsistent across health providers. Current trends of initiating RRT in the ICU are often based on isolated blood urea levels without clear guidelines demonstrating an upper limit for treatment...
November 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29123653/chloride-in-intensive-care-units-a-key-electrolyte
#10
REVIEW
Ghassan Bandak, Kianoush B Kashani
Over the past few years, chloride has joined the league of essential electrolytes for critically ill patients. Dyschloremia can occur secondary to various etiologic factors before and during patient admission in the intensive care unit. Some cases are disease-related; others, treatment-related. Chloride abnormalities were shown in animal models to have adverse effects on arterial blood pressure, renal blood flow, and inflammatory markers, which have led to several clinical investigations. Hyperchloremia was studied in several settings and correlated to different outcomes, including death and acute kidney injury...
2017: F1000Research
https://www.readbyqxmd.com/read/29121712/epidemiologic-incidence-of-rhabdomyolysis-in-opioid-overdose-in-icu-of-poisoning-center-in-iran-2014
#11
Babak Khoshideh, Mohammad Arefi, Mazaher Ghorbani, Samaneh Akbarpour, Fatemeh Taghizadeh
Objectives: The aim of this study is to investigate the clinical, demographical characteristics and some laboratory findings of hospitalized patients with acute opioid toxicity and rhabdomyolysis. Methods: In this cross-sectional study, 354 hospitalized patients were investigated at Baharloo Educational Hospital in Tehran, with acute illicit drug toxicity in 2014. Data was collected by an investigator-made check lists. The collected data and variations (such as mortality rate, demographic data, and renal function tests as well as serum biochemical elements) were analyzed by descriptive statistics and x-square test...
November 8, 2017: Epidemiology and Health
https://www.readbyqxmd.com/read/29044308/heart-conduction-system-defects-and-sustained-ventricular-tachycardia-complications-in-a-patient-with-granulomatosis-with-polyangiitis-a-case-report-and-literature-review
#12
Laryssa Passos Sarmento Santos, Victor Guerreiro Bomfim, Camila Fagundes Bezerra, Natália Vieira Costa, Rafael Barreto Paes de Carvalho, Ricardo Sobral de Carvalho, Rogério da Hora Passos, Olivia Carla Bomfim Boaventura, André Luiz Nunes Gobatto
Granulomatosis with polyangiitis is a rare systemic inflammatory disorder characterized by vasculitis of the small arteries, the arterioles and the capillaries together with necrotizing granulomatous lesions. This case reports on a young female patient, previously diagnosed with granulomatosis with polyangiitis, who was admitted to the intensive care unit with seizures and hemodynamic instability due to a complete atrioventricular heart block. The event was associated with multiple episodes of sustained ventricular tachycardia without any structural heart changes or electrolyte disturbances...
July 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28953555/acute-kidney-injury-and-electrolyte-disorders-in-the-critically-ill-patient-with-cancer
#13
Mitchell H Rosner, Giovambattista Capasso, Mark A Perazella
PURPOSE OF REVIEW: Patients with cancer increasingly make up a significant proportion of patients receiving care in the intensive care unit (ICU). Acute kidney injury and cancer-associated electrolyte disorders are encountered in many of these patients and can significantly impact both short-term and long-term outcomes. RECENT FINDINGS: Advances in chemotherapeutic regimens as well as in our understanding of cancer-associated kidney disease highlight the need for specialized knowledge of the unique causes and therapies required in this subset of critically ill patients...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28913489/cerebral-salt-wasting-syndrome-in-patients-with-minor-head-trauma-two-case-reports
#14
Gabriela Csipak, Natalia Hagau
We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems...
October 2016: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28903842/effect-of-early-%C3%A2-3-mets-metabolic-equivalent-of-tasks-of-physical-activity-on-patient-s-outcome-after-cardiac-surgery
#15
Muhammad Iqbal Tariq, Asif Ali Khan, Zara Khalid, Hania Farheen, Furqan Ahmed Siddiqi, Imran Amjad
OBJECTIVE: To determine the effect of <3 Mets (Metabolic Equivalent of Tasks) of physical activity on zero postoperative days for improving hemodynamic and respiratory parameters of patients after cardiac surgeries. STUDY DESIGN: Randomized control trial. PLACE AND DURATION OF STUDY: BARMWTHospital, Rawalpindi, from March to August 2015. METHODOLOGY: Arandomized controlled trial was conducted on 174 CABG and valvular heart disease patients undergoing cardiac surgical procedures...
August 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28866139/impact-of-caloric-intake-in-critically-ill-patients-with-and-without-refeeding-syndrome-a-retrospective-study
#16
Laura E Olthof, W A C Kristine Koekkoek, Coralien van Setten, Johannes C N Kars, Dick van Blokland, Arthur R H van Zanten
BACKGROUND & AIMS: Refeeding syndrome comprises metabolic disturbances that occur after the reintroduction of feeding after prolonged fasting. Standard care consists of correcting fluid and electrolytes imbalances. Energy intake during refeeding syndrome is heavily debated. This study addresses the effect of caloric intake on outcome during the management of refeeding syndrome. METHODS: A retrospective study among critically ill invasive mechanically ventilated patients admitted for >7 days to a medical-surgical ICU...
August 10, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28821524/the-association-between-intensive-care-unit-acquired-hypernatraemia-and-mortality-in-critically-ill-patients-with-cerebrovascular-diseases-a-single-centre-cohort-study-in-japan
#17
Takahiro Imaizumi, Masahiro Nakatochi, Yoshiro Fujita, Rie Nomura, Kenshi Watanabe, Michitaka Maekawa, Taishi Yamakawa, Takayuki Katsuno, Shoichi Maruyama
OBJECTIVES: Hypernatraemia is one of the major electrolyte disorders associated with mortality among critically ill patients in intensive care units (ICUs). It is unclear whether this applies to patients with cerebrovascular diseases in whom high sodium concentrations may be allowed in order to prevent cerebral oedema. This study aimed to examine the association between ICU-acquired hypernatraemia and the prognosis of patients with cerebrovascular diseases. DESIGN: A retrospective cohort study...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28746899/hypertonic-saline-in-critical-illness-a-systematic-review
#18
REVIEW
Carmen Andrea Pfortmueller, Joerg C Schefold
INTRODUCTION: The optimal approach to fluid management in critically ill patients is highly debated. Fluid resuscitation using hypertonic saline was used in the past for more than thirty years, but has recently disappeared from clinical practice. Here we provide an overview on the currently available literature on effects of hypertonic saline infusion for fluid resuscitation in the critically ill. METHODS: Systematic analysis of reports of clinical trials comparing effects of hypertonic saline as resuscitation fluid to other available crystalloid solutions...
December 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28732314/the-effect-of-low-dose-furosemide-in-critically-ill-patients-with-early-acute-kidney-injury-a-pilot-randomized-blinded-controlled-trial-the-spark-study
#19
Sean M Bagshaw, R T Noel Gibney, Peter Kruger, Imran Hassan, Finlay A McAlister, Rinaldo Bellomo
PURPOSE: Furosemide is commonly prescribed in acute kidney injury (AKI). Prior studies have found conflicting findings on whether furosemide modifies the course and outcome of AKI. METHODS: Pilot multi-center randomized blinded placebo-controlled trial in adult patients with AKI admitted to three intensive care units. Participants were randomly allocated to furosemide bolus and infusion or 0.9% saline placebo. Primary endpoint was worsening AKI, defined by the RIFLE criteria...
December 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28719887/anesthetic-management-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-crs-hipec-the-importance-of-hydro-electrolytic-and-acid-basic-control
#20
Fabrício Tavares Mendonça, Marília Moreira Guimarães, Sérgio Honorato de Matos, Rúbia Garcia Dusi
JUSTIFICATION AND OBJECTIVES: Patients affected by gynecological or gastrointestinal tract neoplasms that evolve to peritoneal carcinomatosis experience a significant drop in their quality of life, high morbidity and short survival times with currently available chemotherapeutic schemes. The surgical treatment based on cytoreduction and the employment of hyperthermic intraperitoneal chemotherapy in the intra-operative period is a true challenge to anesthesiologist. CASE REPORT: A 67 years old patient diagnosed with mucinous adenocarcinoma of the Appendix associated with mucinous carcinomatosis, was submitted to cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), under general anesthesia and epidural block...
2017: International Journal of Surgery Case Reports
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