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hyperchloremia

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https://www.readbyqxmd.com/read/29756707/impact-of-the-hyperchloremic-component-of-metabolic-acidosis-on-the-patient-s-hydration-status-and-the-treatment-of-diabetic-ketoacidosis
#1
Ismael Toledo, Raquel Wainsztein, Carla Mannucci, Mabel Ferraro, Juan Ferreira, Alejandro Balestracci
INTRODUCTION: Diabetic ketoacidosis (DKA) is characterized by metabolic acidosis (MA) with a high anion gap (AG), although, occasionally, it can present with hyperchloremia. It has been postulated that the early presence of hyperchloremia could reflect a better hydration status; however, its prevalence and impact on DKA treatment remain unknown. determine the prevalence of the hyperchloremic component in MA prior to treatment and to assess whether it is associated with a better hydration status and a shorter recovery time from DKA compared to patients with high AG only...
June 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29727367/insidious-harm-of-medication-diluents-as-a-contributor-to-cumulative-volume-and-hyperchloremia-a-prospective-open-label-sequential-period-pilot-study
#2
Carolyn A Magee, Melissa L Thompson Bastin, Melanie E Laine, Brittany D Bissell, Gavin T Howington, Peter R Moran, Emily J McCleary, Gary D Owen, Lauren E Kane, Emily A Higdon, Cathy A Pierce, Peter E Morris, Alexander H Flannery
OBJECTIVES: Although the potential dangers of hyperchloremia from resuscitation fluids continue to emerge, no study to date has considered the contribution of medication diluents to cumulative volume and hyperchloremia. This study compares saline versus dextrose 5% in water as the primary medication diluent and the occurrence of hyperchloremia in critically ill patients. DESIGN: Prospective, open-label, sequential period pilot study. SETTING: Medical ICU of a large academic medical center...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29643888/spectrum-of-complications-of-severe-dka-in-children-in-pediatric-intensive-care-unit
#3
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/29573523/presenting-predictors-and-temporal-trends-of-treatment-related-outcomes-in-diabetic-ketoacidosis
#4
Christopher M Horvat, Heba M Ismail, Alicia K Au, Luigi Garibaldi, Nalyn Siripong, Sajel Kantawala, Rajesh K Aneja, Diane S Hupp, Patrick M Kochanek, Robert S B Clark
OBJECTIVE: This study examines temporal trends in treatment-related outcomes surrounding a diabetic ketoacidosis (DKA) performance improvement intervention consisting of mandated intensive care unit admission and implementation of a standardized management pathway, and identifies physical and biochemical characteristics associated with outcomes in this population. METHODS: A retrospective cohort of 1,225 children with DKA were identified in the electronic health record by International Classification of Diseases codes and a minimum pH less than 7...
March 24, 2018: Pediatric Diabetes
https://www.readbyqxmd.com/read/29541861/internalization-of-nkcc2-is-impaired-in-thick-ascending-limb-of-henle-in-moesin-knockout-mice
#5
Kotoku Kawaguchi, Ryo Hatano, Mitsunobu Matsubara, Shinji Asano
Moesin is expressed in several types of cells including epithelial and endothelial cells. Several groups reported that moesin plays important roles in the regulation of the cellular motility, and the process of internalization of membrane proteins. However, the physiological roles of moesin in the kidney still remain unclear. Herein, we examined the physiological function of moesin in the kidney using moesin knockout (Msn -/y ) mice. There was no obvious abnormality in the renal morphology of Msn -/y mice. However, we found that Msn -/y mice exhibited mild hyperchloremia, and reduced glomerular filtration rate compared to wild type (WT) mice...
March 15, 2018: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/29428918/predictors-and-outcome-of-acute-kidney-injury-in-children-with-diabetic-ketoacidosis
#6
Mullai Baalaaji, Muralidharan Jayashree, Karthi Nallasamy, Sunit Singhi, Arun Bansal
OBJECTIVE: To identify predictors and outcome of acute kidney injury (AKI) in children with diabetic ketoacidosis (DKA) admitted to a Pediatric Intensive Care Unit (PICU). METHODS: Retrospective case review of 79 children with DKA admitted between 2011-2014. RESULTS: Twenty eight children developed AKI during the hospital stay; 20 (71.4%) recovered with hydration alone. Serum chloride at 24 hours was independently associated with AKI. Children with AKI had prolonged acidosis and PICU stay and higher mortality...
February 9, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29404689/hyperchloremia-is-independently-associated-with-mortality-in-critically-ill-children-who-ultimately-require-continuous-renal-replacement-therapy
#7
Matthew F Barhight, Jennifer Lusk, John Brinton, Timothy Stidham, Danielle E Soranno, Sarah Faubel, Jens Goebel, Peter M Mourani, Katja M Gist
BACKGROUND: The optimal fluid management in critically ill children is currently under investigation with several studies suggesting that hyperchloremia, chloride load, and the use of chloride-rich fluids contribute to worse outcomes. METHODS: This is a single-center retrospective cohort study of Pediatric Intensive Care Unit patients from 2008 to 2016 requiring continuous renal replacement therapy (CRRT). Patients were excluded if they had end-stage renal disease, a disorder of chloride transport, or concurrent provision of extracorporeal membrane oxygenation therapy...
February 5, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29394222/hyperchloremia-is-associated-with-complicated-course-and-mortality-in-pediatric-patients-with-septic-shock
#8
Erin K Stenson, Natalie Z Cvijanovich, Nick Anas, Geoffrey L Allen, Neal J Thomas, Michael T Bigham, Scott L Weiss, Julie C Fitzgerald, Paul A Checchia, Keith Meyer, Michael Quasney, Mark Hall, Rainer Gedeit, Robert J Freishtat, Jeffrey Nowak, Shekhar S Raj, Shira Gertz, Jocelyn R Grunwell, Hector R Wong
OBJECTIVE: Hyperchloremia is associated with poor outcome among critically ill adults, but it is unknown if a similar association exists among critically ill children. We determined if hyperchloremia is associated with poor outcomes in children with septic shock. DESIGN: Retrospective analysis of a pediatric septic shock database. SETTING: Twenty-nine PICUs in the United States. PATIENTS: Eight hundred ninety children 10 years and younger with septic shock...
February 2018: Pediatric Critical Care Medicine
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
#9
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/29337815/impact-of-moderate-hyperchloremia-on-clinical-outcomes-in-intracerebral-hemorrhage-patients-is-there-still-room-for-continuous-infusion-of-3-hypertonic-saline
#10
Simon Poignant, Marc Laffon
No abstract text is available yet for this article.
February 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29234129/baseline-chloride-levels-are-associated-with-the-incidence-of-contrast-associated-acute-kidney-injury
#11
Hyung Jung Oh, Sungwon Kim, Jung Tak Park, Sang-Joon Kim, Seung Hyeok Han, Tae-Hyun Yoo, Dong-Ryeol Ryu, Shin-Wook Kang, Yong Eun Chung
Although hypo- and hyperchloremia have been associated with worsening renal outcomes, there has been no study that correlates hypo- and hyperchloremia and the incidence of contrast-associated acute kidney injury (CA-AKI). A total of 13,088 patients with less than 2.0 mg/dL of serum creatinine (Cr) who underwent contrast-enhanced abdominal CT (CECT) were included. Patients were divided into 3 groups based on Cl (the hypo-, normo- and hyperchloremia groups). Patients were also classified by baseline Cr (<1...
December 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29197350/effect-of-hyperchloremia-on-acute-kidney-injury-in-critically-ill-septic-patients-a-retrospective-cohort-study
#12
Lenar Yessayan, Javier A Neyra, Fabrizio Canepa-Escaro, George Vasquez-Rios, Michael Heung, Jerry Yee
BACKGROUND: Hyperchloremia is common in critically ill septic patients. The impact of hyperchloremia on the incidence of acute kidney injury (AKI) is not well studied. We investigated the association between hyperchloremia and AKI within the first 72 h of intensive care unit (ICU) admission. METHODS: 6490 ICU adult patients admitted with severe sepsis or septic shock were screened for eligibility. Exclusion criteria included: AKI on admission, baseline estimated glomerular filtration rate (eGFR) <15 ml/min/1...
December 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29170998/introducing-topmast-the-first-double-blind-randomized-clinical-trial-specifically-dedicated-to-perioperative-maintenance-fluid-therapy-in-adults
#13
Steven Hendrickx, Karen Van Vlimmeren, Ingrid Baar, Walter Verbrugghe, Karolien Dams, Sophie Van Cromphaut, Ella Roelant, Bart Embrecht, Anouk Wittock, Pieter Mertens, Jeroen M Hendriks, Patrick Lauwers, Paul E Van Schil, Amaryllis H Van Craenenbroeck, Tim Van den Wyngaert, Philippe Jorens, Niels Van Regenmortel
BACKGROUND: Although prescribed to every patient undergoing surgery, maintenance fluid therapy is a poorly researched part of perioperative fluid therapy. The tonicity of the chosen solutions, could be an important cause of morbidity, with hyponatremia being a potential side effect of hypotonic solutions, where isotonic solution could lead to fluid overload. METHODS: The TOPMAST-trial is an ongoing prospective single-center double-blind randomized trial comparing an isotonic and a hypotonic maintenance fluid strategy during and after surgery in patients undergoing different types of major thoracic surgery...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29156484/-perioperative-intravenous-fluid-therapy-in-children
#14
Robert Sümpelmann
The objective of this consensus-based S1 Guideline for perioperative fluid therapy in children is to maintain or re-establish the child's homeostasis. Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. For the intraoperative background infusion a physiologically composed balanced isotonic electrolyte solution (BS) with 1 - 2.5% glucose is recommended to maintain normal glucose concentrations and to avoid hyponatremia, hyperchloremia, and lipolysis...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29144182/plasma-lyte-148-vs-hartmann-s-solution-for-cardiopulmonary-bypass-pump-prime-a-prospective-double-blind-randomized-trial
#15
Laurence Weinberg, Elizabeth Chiam, James Hooper, Frank Liskaser, Angela Kim Hawkins, Denise Massie, Andrew Ellis, Chong O Tan, David Story, Rinaldo Bellomo
BACKGROUND: The mechanisms of acid-base changes during cardiopulmonary bypass (CPB) remain unclear. We tested the hypothesis that, when used as CPB pump prime solutions, Plasma-Lyte 148 (PL) and Hartmann's solution (HS) have differential mechanisms of action in their contribution to acid-base changes. METHODS: We performed a prospective, double-blind, randomized trial in adult patients undergoing elective cardiac surgery with CPB. Participants received a CPB prime solution of 2000 mL, with either PL or HS...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29131112/spurious-hyperchloremia-in-the-presence-of-elevated-plasma-salicylate-a-cohort-study
#16
Kianoush B Kashani, Jon H Steuernagle Iv, Qi Qian
BACKGROUND: Acute metabolic acidosis is rarely associated with a reduced or negative anion gap (AG), but several case reports have described such an abnormality occurring in the setting of acute salicylate intoxication. The underlying cause of this phenomenon is unclear. METHODS: In this retrospective cohort study, we reviewed our institutional database to identify all patients admitted for salicylate intoxication at Mayo Clinic (Rochester, MN, USA) from January 2010 through December 2012...
2018: Nephron
https://www.readbyqxmd.com/read/29123653/chloride-in-intensive-care-units-a-key-electrolyte
#17
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/28915195/hyperchloremia-is-associated-with-acute-kidney-injury-in-patients-with-aneurysmal-subarachnoid-hemorrhage-not-sure
#18
Shouyin Jiang, Yehua Shen, Xiaogang Zhao
No abstract text is available yet for this article.
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28742636/the-influence-of-chloride-for-the-interpretation-of-plasma-bicarbonate-during-the-treatment-of-diabetic-ketoacidosis
#19
Juan Pablo Ferreira, Magali Hamui, Milagros Torrents, Romina Carrano, Mabel Ferraro, Ismael Toledo
INTRODUCTION: Hyperchloremic metabolic acidosis can occur in diabetic ketoacidosis (DKA) and may affect the acid-base interpretation during treatment. OBJECTIVES: This study aims to describe the prevalence of hyperchloremia during the treatment of DKA and its effect on the interpretation of bicarbonate value. METHODS: A cross-sectional study, including all cases of DKA in patients aged 1 to 18 years old admitted from 2010 to 2015, was performed...
July 24, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28735991/lack-of-impact-of-hyperchloremia-in-brain-dead-organ-donors-on-the-onset-of-kidney-allograft-function-in-the-recipients
#20
E Uchytilova, M Protus, D Merta, R Kula, E Pokorna, E Kieslichova
BACKGROUND: Hyperchloremia produces renal vasoconstriction and fall in glomerular filtration rate. In 90% of brain-dead organ donors, diabetes insipidus develops, characterized by inappropriate diuresis, hyperosmolality, and hyperchloremia. The aim of this study was to determine the relationship between the serum concentration of chlorides of the donor and the onset of the function of the kidney allograft in the recipient. METHODS: We retrospectively studied 213 donors and kidney allograft recipients...
July 2017: Transplantation Proceedings
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