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electrolytes in icu patients

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https://www.readbyqxmd.com/read/28746899/hypertonic-saline-in-critical-illness-a-systematic-review
#1
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...
June 19, 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
#2
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...
July 12, 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
#3
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...
July 10, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28719134/development-and-implementation-of-a-clinical-pathway-for-cardiac-surgery-in-the-intensive-care-unit-effects-on-protocol-adherence
#4
Marion van der Kolk, Mark van den Boogaard, Corine Ter Brugge-Speelman, Jeroen Hol, Luc Noyez, Kees van Laarhoven, Hans van der Hoeven, Peter Pickkers
RATIONALE, AIMS AND OBJECTIVES: Cardiac surgery (CS) is facilitated by multiple perioperative guidelines and protocols. Use of a clinical pathway (CP) may facilitate the care of these patients. METHODS: This is a pre-post design study in the ICU of a tertiary referral centre. A CP for CS patients in the ICU was developed by ICU-nurses and enabled them to execute proactively predefined actions in accordance with and within the preset boundaries which were part of a variance report...
July 18, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28711893/-incidence-of-adverse-medical-events-in-the-neonatal-intensive-care-unit-with-the-help-of-a-global-trigger-tool
#5
Марина Н Фастовец, Андрей И Белорус, Виктор П Лысак, Лариса С Зюзина, Елена М Ковалева
INTRODUCTION: Identification and monitoring of the frequency of adverse medical events are important in the organization of the patient's safety system in the intensive care units (ICU). The consistent and accurate identification of adverse events remains a problem for most medical institutions, even in developed countries of the world. AIM: To determine the frequency of adverse medical events in the NICU by using Global and Pediatric Trigger Instruments. MATERIALS AND METHODS: To achieve the goal, the cross-sectional study was conducted in which in retrospect analyzed 160 newborn development records which were treated in the ICU of the newborn in the perinatal center of the M...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28703019/effectiveness-and-safety-of-magnesium-replacement-in-critically-ill-patients-admitted-to-the-medical-intensive-care-unit-in-an-academic-medical-center-a-retrospective-cohort-study
#6
Drayton A Hammond, Jelena Stojakovic, Niranjan Kathe, Julie Tran, Oktawia A Clem, Kristina Erbach, Jarrod King
BACKGROUND: "Rules of thumb" for the replacement of electrolytes, including magnesium, in critical care settings are used, despite minimal empirical validation of their ability to achieve a target serum concentration. This study's purpose was to evaluate the effectiveness and safety surrounding magnesium replacement in medically, critically ill patients with mild-to-moderate hypomagnesemia. METHODS: This was a single-center, retrospective, observational evaluation of episodes of intravenous magnesium replacement ordered for patients with mild-to-moderate hypomagnesemia (1...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28673222/rational-clinical-pathology-assessment-in-the-intensive-care-unit
#7
K S Rachakonda, M Parr, A Aneman, S Bhonagiri, S Micallef
Blood tests are ordered on a daily basis in intensive care units (ICU). There are no widely accepted guidelines for testing requirements. This study investigated the impact on ICU laboratory test costs of a multi-strategy change in practice involving routine blood testing. A single centre, prospective, interventional study using historical controls was undertaken to investigate the impact of ICU specialist authorisation of high-volume routine tests on ICU laboratory test costs. Prior to commencement of the study, ICU nursing and junior ICU doctors were able to order tests...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28651510/pharmacodynamics-of-intravenous-frusemide-bolus-in-critically-ill-patients
#8
Agnes Huang, Nora Luethi, Johan Mårtensson, Rinaldo Bellomo, Luca Cioccari
OBJECTIVE: To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients. DESIGN, SETTING AND PATIENTS: A prospective observational study of 21 critically ill patients in a tertiary intensive care unit in Australia. INTERVENTIONS: We collected information on urine output (UO), fluid balance, serum and urinary electrolyte levels, serum biochemical levels and haemodynamics...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28630246/ominous-triad-triggered-by-high-dose-glucocorticosteroid-therapy
#9
Sarah Bär, Fritz Daudel, Thomas Zueger
Glucocorticosteroids (CS) play a key role in the treatment of numerous diseases. Nonetheless, they can be accompanied by several adverse effects. We present the case of a 51-year-old woman who was treated with high-dose CS for a relapse of her multiple sclerosis. After 5 days of treatment, the patient developed severe diabetic ketoacidosis, hypertriglyceridemia and acute pancreatitis-a potentially life-threatening triad which has previously been described, in our case, however, for the first time as a complication of CS therapy...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28625255/-effect-of-vitamin-d3-on-the-severity-and-prognosis-of-patients-with-sepsis-a-prospective-randomized-double-blind-placebo-study
#10
Fulai Ding, Bin Zang, Jiahong Fu, Kaiqiang Ji
OBJECTIVE: To observe the relationship between vitamin D3 and the severity as well as prognosis in patients with sepsis, and to explore whether exogenous vitamin D3 can improve the prognosis in patients with sepsis. METHODS: A prospective randomized double-blind placebo study was conducted. Fifty-seven patients with sepsis admitted to intensive care unit (ICU) of Shengjing Hospital Affiliated to China Medical University from March to November in 2015 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28591973/-the-application-of-internal-iliac-artery-balloon-occlusion-in-pernicious-placenta-previa
#11
Xiao-Rong Qi, Xing-Hui Liu, Yong You, Xiao-Dong Wang, Rong Zhou, Ai-Yun Xing, Li Zhang, Gang Ning, Fu-Min Zhao, Kai-Ming Li
OBJECTIVES: To evaluate the clinical application value of internal iliac artery balloon occlusion in pernicious placenta previa. METHODS: We retrospectively reviewed the medical records of the patients of pernicious placenta previa in a single center from Jan, 2010 to Jan, 2015. The patients were divided into two groups, internal iliac artery balloon occlusion group and the control group without endovascular intervention. Blood loss in operation, volume of transfused blood products, caesarean hysterectomy, operating time, hospital days after operation and postoperative morbidity were compared between the two groups...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28553133/inter-instrumental-comparison-for-the-measurement-of-electrolytes-in-patients-admitted-to-the-intensive-care-unit
#12
Vivek Pant, Arjun Tumbapo, Bipin Karki
OBJECTIVE: To investigate whether benchtop auto-analyzers (AAs) and arterial blood gas (ABG) analyzers, for measuring electrolyte levels of patients admitted to intensive care units (ICU), are equal and whether they can be used interchangeably. MATERIALS AND METHOD: This study was conducted on 98 patients admitted to the ICU of the Institute of Medicine, Kathmandu, Nepal between 15 October and 15 December 2016. The sample for AA was collected from the peripheral vein through venipuncture, and that for ABG analyzer was collected from radial artery simultaneously...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/28535742/electrolyte-disturbances-in-critically-ill-cancer-patients-an-endocrine-perspective
#13
Maryam I Khan, R Phillip Dellinger, Steven G Waguespack
Electrolyte disturbances are frequently encountered in critically ill oncology patients. Hyponatremia and hypernatremia as well as hypocalcemia and hypercalcemia are among the most commonly encountered electrolyte abnormalities. In the intensive care unit, management of critical electrolyte disturbances is focused on initial evaluation and immediate treatment plan to prevent severe complications. A PubMed search was performed to identify best available evidence for evaluation and management of dysnatremias, hypocalcemia, and hypercalcemia...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28482382/-application-of-improved-regional-citrate-anticoagulation-in-continuous-hemofiltration-in-children
#14
K Bai, C J Liu, Y Q Fu, F Xu
Objective: To investigate the application of regional citrate anticoagulation with calcium hemofiltration basic solution in continuous hemofiltration in children. Method: The clinical data of 18 patients with citrate anticoagulation in continuous hemofiltration in children, excluding the hepatic failure and septic shock cases, were analyzed retrospectively, from September 2015 to August 2016 in Intensive Care Unit of the Children's Hospital of Chongqing Medical University.The commercial calcium hemofiltration basic solution was used as displacement liquid ...
May 4, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28478880/neurologic-intensive-care-unit-electrolyte-management
#15
REVIEW
Craig Hutto, Mindy French
Dysnatremia is a common finding in the intensive care unit (ICU) and may be a predictor for mortality and poor clinical outcomes. Depending on the time of onset (ie, on admission vs later in the ICU stay), the incidence of dysnatremias in critically ill patients ranges from 6.9% to 15%, respectively. The symptoms of sodium derangement and their effect on brain physiology make early recognition and correction paramount in the neurologic ICU. Hyponatremia in brain injured patients can lead to life-threatening conditions such as seizures and may worsen cerebral edema and contribute to alterations in intracranial pressure...
June 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28446775/delivering-prolonged-intensive-care-to-a-non-human-primate-a-high-fidelity-animal-model-of-critical-illness
#16
P Guillaume Poliquin, Mia Biondi, Charlene Ranadheera, Mable Hagan, Alexander Bello, Trina Racine, Mark Allan, Duane Funk, Gregory Hansen, B J Hancock, Murray Kesselman, Todd Mortimer, Anand Kumar, Shane Jones, Anders Leung, Allen Grolla, Kaylie N Tran, Kevin Tierney, Xiangguo Qiu, Darwyn Kobasa, James E Strong
Critical care needs have been rising in recent decades as populations age and comorbidities increase. Sepsis-related admissions to critical care contribute up to 50% of volume and septic shock carries a 35-54% fatality rate. Improvements in sepsis-related care and mortality would have a significant impact of a resource-intensive area of health care delivery. Unfortunately, research has been hampered by the lack of an animal model that replicates the complex care provided to humans in an intensive care unit (ICU)...
April 26, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28406814/pilot-feasibility-study-of-therapeutic-hypothermia-for-moderate-to-severe-acute-respiratory-distress-syndrome
#17
Donald F Slack, Douglas S Corwin, Nirav G Shah, Carl B Shanholtz, Avelino C Verceles, Giora Netzer, Kevin M Jones, Clayton H Brown, Michael L Terrin, Jeffrey D Hasday
OBJECTIVES: Prior studies suggest hypothermia may be beneficial in acute respiratory distress syndrome, but cooling causes shivering and increases metabolism. The objective of this study was to assess the feasibility of performing a randomized clinical trial of hypothermia in patients with acute respiratory distress syndrome receiving treatment with neuromuscular blockade because they cannot shiver. DESIGN: Retrospective study and pilot, prospective, open-label, feasibility study...
July 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28377295/frequency-of-medical-emergency-team-activation-prior-to-pediatric-cardiopulmonary-resuscitation
#18
Natalie Jayaram, Maya L Chan, Fengming Tang, Christopher S Parshuram, Paul S Chan
BACKGROUND: Medical Emergency Teams (METs) are designed to respond to signs of clinical decline in order to prevent cardiopulmonary arrest and reduce mortality. The frequency of MET activation prior to pediatric cardiopulmonary resuscitation (CPR) is unknown. METHODS: Within the Get With The Guidelines-Resuscitation Registry (GWTG-R), we identified children with bradycardia or cardiac arrest requiring CPR on the general inpatient or telemetry floors from 2007 to 2013...
June 2017: Resuscitation
https://www.readbyqxmd.com/read/28347943/the-association-between-sodium-fluctuations-and-mortality-in-surgical-patients-requiring-intensive-care
#19
Dominic C Marshall, Justin D Salciccioli, Ross J Goodson, Marco A Pimentel, Kristi Y Sun, Leo Anthony Celi, Joseph Shalhoub
PURPOSE: Serum sodium derangement is the most common electrolyte disturbance among patients admitted to intensive care. This study aims to validate the association between dysnatremia and serum sodium fluctuation with mortality in surgical intensive care patients. METHOD: We performed a retrospective analysis of the Medical Information Mart for Intensive Care II database. Dysnatremia was defined as a sodium concentration outside physiologic range (135-145mmol/L) and subjects were categorized by severity of dysnatremia and sodium fluctuation...
February 13, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28322757/impaired-clinical-utility-of-sequential-patient-gem-blood-gas-measurements-associated-with-calibration-schedule
#20
George S Cembrowski, Qian Xu, Adam R Cembrowski, Junyi Mei, Hossein Sadrzadeh
BACKGROUND: Within- and/or between-instrument variation may falsely indicate patient trends or obscure real trends. We employ a methodology that transforms sequential intra-patient results into estimates of biologic and analytic variation. We previously derived realistic biologic variation (sb) of blood gas (BG) and hematology analytes. We extend this methodology to derive the imprecision of two GEM 4000 BG analyzers. METHODS: A laboratory data repository provided arterial BG, electrolyte and metabolite results generated by two GEM 4000s on ICU patients in 2012-2013...
March 18, 2017: Clinical Biochemistry
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