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electrolytes in icu patients

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https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#1
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29727526/incidence-of-hypochloremic-metabolic-alkalosis-in-dogs-and-cats-with-and-without-nasogastric-tubes-over-a-period-of-up-to-36-hours-in-the-intensive-care-unit
#2
Annie Chih, Elke Rudloff, Cheryl Waldner, Andrew K J Linklater
OBJECTIVE: To evaluate the incidence of hypochloremic metabolic alkalosis (HCMA) in dogs and cats in the ICU that had intermittent nasogastric tube (NGT) aspiration for up to 36 hours. DESIGN: Prospective cohort study (December 2013 to October 2014). SETTING: Privately owned emergency and referral teaching hospital. ANIMALS: Forty-nine client-owned dogs and 16 client-owned cats. INTERVENTIONS: Patients wherein NGT placement was recommended and client consent was obtained were included in the interventional group...
May 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/29714433/peritoneal-dialysis-in-neonates-six-years-of-single-center-experience
#3
Ferda Özlü, Hacer Yapıcıoğlu Yıldızdaş, Gül Şeker, Hüseyin Şimşek, Aysun Karabay Bayazıt, Mehmet Satar
Background/aim: Peritoneal dialysis (PD) is generally considered the practical dialysis modality for neonates in the treatment of acute kidney injury (AKI) and metabolic disturbances. The aim of this study was to evaluate the indications, complications, and outcomes of PD between January 2011 and December 2016. Materials and methods: This study included all 56 neonates that underwent PD over six years in our neonatal intensive care unit (NICU). A retrospective chart review was performed for all patients in our institution...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29713622/nutritional-care-in-iranian-intensive-care-units
#4
Maryam Shabanpur, Seyed Mostafa Nachvak, Shima Moradi, Safora Hedayati, Mahboobe Hosseinikia, Yahya Pasdar, Shahrbanoo Gholizadeh, Mehnoosh Samadi
Intensive care units (ICUs) provides intensive treatment medicine to avoid complications such as malnutrition, infection and even death. As very little is currently known about the nutritional practices in Iranian ICUs, this study attempted to assess the various aspects of current nutrition support practices in Iranian ICUs. We conducted a cross-sectional study on 150 critically ill patients at 18 ICUs in 12 hospitals located in 2 provinces of Iran from February 2015 to March 2016. Data were collected through interview with supervisors of ICUs, medical record reviews and direct observation of patients during feeding...
April 2018: Clinical Nutrition Research
https://www.readbyqxmd.com/read/29700220/intensive-care-management-of-severe-hypernatraemia-in-the-context-of-group-a-streptococcal-septicaemia
#5
Bethan Davies, Robert Jesty, Shahana Uddin, Victoria Metaxa
This case describes a 54-year-old woman with exudative eczema, who was admitted to the intensive care unit with a serum sodium concentration of 191 mmol/L, secondary to profound dehydration in the context of group A streptococcal septicaemia. Successful rehydration and electrolyte normalisation was achieved with continuous venovenous haemodiafiltration (CVVHDF), the replacement fluid of which was infused with hypertonic saline to limit the rate of sodium reduction. This case report comments on three areas of interest...
April 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29686877/how-to-manage-various-arrhythmias-and-sudden-cardiac-death-in-the-cardiovascular-intensive-care
#6
REVIEW
Yoshinori Kobayashi
In the clinical practice of cardiovascular critical care, we often observe a variety of arrhythmias in the patients either with (secondary) or without (idiopathic) underlying heart diseases. In this manuscript, the clinical background and management of various arrhythmias treated in the CCU/ICU will be reviewed. The mechanism and background of lethal ventricular tachyarrhythmias vary as time elapses after the onset of MI that should be carefully considered to select a most suitable therapy. In the category of non-ischemic cardiomyopathy, several diseases are known to be complicated by the various ventricular tachyarrhythmias with some specific mechanisms...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29675629/-geriatric-trauma-center-dgu%C3%A2-evaluation-of-clinical-and-economic-parameters-a-pilot-study-in-a-german-university-hospital
#7
M Knobe, B Böttcher, M Coburn, T Friess, L C Bollheimer, H J Heppner, C J Werner, J-P Bach, M Wollgarten, S Poßelt, C Bliemel, B Bücking
BACKGROUND: Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE: The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU)...
April 19, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29643888/spectrum-of-complications-of-severe-dka-in-children-in-pediatric-intensive-care-unit
#8
Qalab Abbas, Saba Arbab, Anwar Ul Haque, Khadija Nuzhat Humayun
Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis (DKA) observed in children admitted with severe DKA. Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit (PICU) of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied. Results: Total 37 children were admitted with complicated DKA (1...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29628184/the-two-bag-method-for-treatment-of-diabetic-ketoacidosis-in-adults
#9
Nathan L Haas, Roma Y Gianchandani, Kyle J Gunnerson, Benjamin S Bassin, Arun Ganti, Christopher Hapner, Caryn Boyd, James A Cranford, Sage P Whitmore
BACKGROUND: The "two-bag method" of management of diabetic ketoacidosis (DKA) allows for titration of dextrose delivery by adjusting the infusions of two i.v. fluid bags of varying dextrose concentrations while keeping fluid, electrolyte, and insulin infusion rates constant. OBJECTIVE: We aimed to evaluate the feasibility and potential benefits of this strategy in adult emergency department (ED) patients with DKA. METHODS: This is a before-and-after comparison of a protocol using the two-bag method operationalized in our adult ED in 2015...
April 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29605073/non-intensive-care-unit-management-of-acute-liver-failure
#10
REVIEW
Andres F Carrion, Paul Martin
Acute liver failure (ALF) is an uncommon syndrome with a highly variable and unpredictable clinical course. The initial diagnostic evaluation is typically performed in a non-intensive care unit (ICU) setting, like the emergency department or general hospital ward. Prompt restoration of intravascular volume with intravenous fluids and correction of electrolyte, metabolic, and acid-base disturbances are important initial interventions in the management of ALF and can be safely accomplished in non-ICU settings in many patients...
May 2018: Clinics in Liver Disease
https://www.readbyqxmd.com/read/29589205/hyperchloraemia-in-sepsis
#11
REVIEW
Christos Filis, Ioannis Vasileiadis, Antonia Koutsoukou
Chloride represents-quantitatively-the most prevalent, negatively charged, strong plasma electrolyte. Control of chloride concentration is a probable major mechanism for regulating the body's acid-base balance and for maintaining homeostasis of the entire internal environment. The difference between the concentrations of chloride and sodium constitutes the major contributor to the strong ion difference (SID); SID is the key pH regulator in the body, according to the physicochemical approach. Hyperchloraemia resulting from either underlying diseases or medical interventions is common in intensive care units...
March 27, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29589054/maintenance-fluid-therapy-and-fluid-creep-impose-more-significant-fluid-sodium-and-chloride-burdens-than-resuscitation-fluids-in-critically-ill-patients-a-retrospective-study-in-a-tertiary-mixed-icu-population
#12
Niels Van Regenmortel, Walter Verbrugghe, Ella Roelant, Tim Van den Wyngaert, Philippe G Jorens
PURPOSE: Research on intravenous fluid therapy and its side effects, volume, sodium, and chloride overload, has focused almost exclusively on the resuscitation setting. We aimed to quantify all fluid sources in the ICU and assess fluid creep, the hidden and unintentional volume administered as a vehicle for medication or electrolytes. METHODS: We precisely recorded the volume, sodium, and chloride burdens imposed by every fluid source administered to 14,654 patients during the cumulative 103,098 days they resided in our 45-bed tertiary ICU and simulated the impact of important strategic fluid choices on patients' chloride burdens...
March 27, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29555318/blood-gas-sample-spiking-with-total-parenteral-nutrition-lipid-emulsion-and-concentrated-dextrose-solutions-as-a-model-for-predicting-sample-contamination-based-on-glucose-result
#13
Jose C Jara-Aguirre, Steven W Smeets, Amy M Wockenfus, Brad S Karon
OBJECTIVE: Evaluate the effects of blood gas sample contamination with total parenteral nutrition (TPN)/lipid emulsion and dextrose 50% (D50) solutions on blood gas and electrolyte measurement; and determine whether glucose concentration can predict blood gas sample contamination with TPN/lipid emulsion or D50. DESIGN AND METHODS: Residual lithium heparin arterial blood gas samples were spiked with TPN/lipid emulsion (0 to 15%) and D50 solutions (0 to 2.5%). Blood gas (pH, pCO2, pO2), electrolytes (Na+, K+ ionized calcium) and hemoglobin were measured with a Radiometer ABL90...
March 16, 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29541684/safety-and-efficacy-of-plasma-exchange-therapy-for-kawasaki-disease-in-children-in-intensive-care-unit-case-series
#14
Satoko Noguchi, Junichi Saito, Tomoyuki Kudo, Eiji Hashiba, Kazuyoshi Hirota
Background: We have reviewed four cases of Kawasaki disease treated with plasma exchange with 5% albumin in electrolyte-balanced solution, according to the recommended guidelines for Kawasaki disease in the intensive care unit, as their responses to intravenous immunoglobulin therapy were poor. Case presentation: The four cases were aged between 5 months and 3 years and weighted between 6.4 and 15.6 kg. The plasma levels of C-reactive protein were significantly decreased after plasma exchange ( p  < 0...
2018: JA Clinical Reports
https://www.readbyqxmd.com/read/29445220/association-of-admission-serum-levels-of-vitamin-d-calcium-phosphate-magnesium-and-parathormone-with-clinical-outcomes-in-neurosurgical-icu-patients
#15
Seyed Hossein Ardehali, Salman Dehghan, Ahmad Reza Baghestani, Aynaz Velayati, Zahra Vahdat Shariatpanahi
To evaluate the association of admission serum levels of 25(OH)D, parathormone and the related electrolytes with severity of illness and clinical outcomes in neurosurgical critically ill patients, serum levels of 25(OH)D, parathormone, calcium, magnesium, and phosphate, along with APACHE II score were measured for 210 patients upon admission. Mean serum 25(OH)D was 21.1 ± 7.4 ng/mL. 25(OH)D deficiency (less than 20 ng/dL) and elevated serum parathormone level were found in 47.6% and 38% of patients respectively...
February 14, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29396136/renal-replacement-therapy-in-the-neonatal-intensive-care-unit
#16
Tze Yee Diane Mok, Min-Hua Tseng, Ming-Chou Chiang, Ju-Li Lin, Shih Ming Chu, Jen-Fu Hsu, Reyin Lien
BACKGROUND: Renal replacement therapy (RRT) is becoming increasingly necessary for supporting critically ill neonates. Few studies have reported the use of RRT in the neonatal intensive care unit (NICU). Therefore, we performed a retrospective study to describe the use of RRT in our NICU and its associated efficacy, complications, and outcomes. METHODS: We identified patients requiring RRT between January 2009 and January 2017. Demographic data, mode of RRT, and associated factors were recorded...
December 21, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29386975/balanced-fluid-versus-saline-based-fluid-in-post-operative-severe-traumatic-brain-injury-patients-acid-base-and-electrolytes-assessment
#17
Mohamad Hasyizan Hassan, Wan Mohd Nazaruddin Wan Hassan, Rhendra Hardy Mohd Zaini, Wan Fadzlina Wan Muhd Shukeri, Huda Zainal Abidin, Chong Soon Eu
Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU...
October 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29384319/refeeding-hypophosphataemia-after-enteral-nutrition-in-a-malaysian-intensive-care-unit-risk-factors-and-outcome
#18
Azrina Md Ralib, Mohd Basri Mat Nor
BACKGROUND AND OBJECTIVES: Refeeding hypophosphataemia (RH) is characterized by an acute electrolyte derangement following nutrition therapy. Complications associated include heart failure, respiratory failure, paraesthesia, seizure and death. We aim to assess its incidence, risk factors, and outcome in our local intensive care unit (ICU). METHODS AND STUDY DESIGN: A prospective observational cohort study was conducted at the mixed medical- surgical of a tertiary ICU in Kuantan, Malaysia...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29362623/the-prevalence-and-risk-factors-of-early-arrhythmias-following-pediatric-open-heart-surgery-in-egyptian-children
#19
Tarek Ahmed Abdel Gawad, Waleed Mohamed Elguindy, Omneya Ibrahim Youssef, Tamer Ashraf Abosalem
AIM: This study aimed to assess the prevalence of early postoperative arrhythmias after cardiac operation in the pediatric population, and to analyse possible risk factors. MATERIAL AND METHODS: Cross-sectional study included 30 postoperative patients, with age range four up to 144 months. They were selected from those admitted to the Cardiology Unit in the Pediatric department of Ain Shams University hospitals, after undergoing cardiopulmonary bypass (CPB) surgery for correction of congenital cardiac defects...
December 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29310415/cisplatin-induced-sudden-cardiac-death-with-hemodynamic-collapse-a-severe-adverse-drug-reaction-case-report
#20
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)
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