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https://www.readbyqxmd.com/read/29201378/time-to-re-think-the-use-of-dobutamine-in-sepsis
#1
Ryota Sato, Michitaka Nasu
Dobutamine is commonly used worldwide and included in the protocol for early goal-directed therapy (EGDT). Since the use of dobutamine in EGDT was reported, it has been considered to be an important component, especially in the treatment of septic patients with myocardial dysfunction. However, it is questionable whether dobutamine improves the mortality of sepsis and septic shock. In three recent randomized controlled trials (ProCESS, ProMISe, and ARISE trials), the frequency of dobutamine use was significantly higher in the EGDT group than in the standard care group, but there were no significant differences in the mortality between the groups...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29092973/landiolol-is-effective-for-the-treatment-of-tachycardia-induced-cardiogenic-shock-in-patients-during-septic-shock-therapy
#2
Yoh Arita, Takatsugu Segawa, Shohei Yamamoto, Shinji Hasegawa
Septic shock is a life-threatening condition that occurs when the blood pressure drops to a low level after an infection. Atrial fibrillation (AF) is the most common arrhythmia to complicate its course. Beta (β)-blockers are often administrated to manage supraventricular tachyarrhythmias observed in patients presenting with sepsis. A 74-year-old woman presenting with sepsis demonstrated AF tachycardia characterised by severe hypotension. She was refractory to conventional therapy including verapamil and digoxin; therefore, treatment using landiolol (an ultrashort-acting β-blocker) was initiated...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28854537/prognostic-significance-of-central-venous-to-arterial-carbon-dioxide-difference-during-the-first-24-hours-of-septic-shock-in-patients-with-and-without-impaired-cardiac-function
#3
G Muller, E Mercier, P Vignon, M Henry-Lagarrigue, T Kamel, A Desachy, V Botoc, G Plantefève, J P Frat, F Bellec, J P Quenot, P F Dequin, T Boulain
Objective: To investigate the prognostic significance of central venous-to-arterial carbon dioxide difference (cv-art CO 2 gap) during septic shock in patients with and without impaired cardiac function. Methods: We performed a prospective cohort study in 10 French intensive care units. Patients suffering from septic shock were assigned to the impaired cardiac function group ('cardiac group', n =123) if they had atrial fibrillation (AF) and/or left ventricular ejection fraction (LVEF) <50% at study entry and to the non-cardiac group ( n =240) otherwise...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28660415/-new-onset-atrial-fibrillation-in-patients-with-sepsis
#4
REVIEW
M Keller, R Meierhenrich
BACKGROUND: Atrial fibrillation is the most common new onset arrhythmia in patients hospitalized with sepsis; however, there are no specific treatment guidelines and the ideal therapeutic approaches still remain unclear. OBJECTIVES: To begin with the current state of knowledge concerning the underling mechanisms, the incidence and prognostic impact of new onset atrial fibrillation during sepsis are presented. Then a possible therapeutic algorithm for the special situation of sepsis is derived with respect to the currently existing atrial fibrillation guidelines...
October 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28552276/adjuncts-to-blood-component-therapies-for-the-treatment-of-bleeding-in-the-intensive-care-unit
#5
REVIEW
Jerrold H Levy, Kamrouz Ghadimi, Quintin J Quinones, Raquel R Bartz, Ian Welsby
Patients who are critically ill following surgical or traumatic injury often present with coagulopathy as a component of the complex multisystem dysfunction that clinicians must rapidly diagnose and treat in the intensive care environment. Failure to recognize coagulopathy while volume resuscitation with crystalloid or colloid takes place, or an unbalanced transfusion strategy focused on packed red blood cell transfusion can all significantly worsen coagulopathy, leading to increased transfusion requirements and poor outcomes...
April 25, 2017: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/28463737/propafenone-for-supraventricular-arrhythmias-in-septic-shock-comparison-to-amiodarone-and-metoprolol
#6
M Balik, I Kolnikova, M Maly, P Waldauf, G Tavazzi, J Kristof
PURPOSE: The occurence of supraventricular arrhythmias associate with an unfavourable prognosis in septic shock. Propafenone could be a feasible antiarrhythmic. MATERIALS AND METHODS: Patients collected over a period of 24months were divided into the three groups based on antiarrhythmic: Group1(amiodarone), Group2(propafenone), Group3(metoprolol). Type of arrhythmia, cardioversion rates, demographic, haemodynamic, laboratory parameters were recorded in the first 24h...
October 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28325719/near-death-by-milk-of-magnesia
#7
Ahmed Alaini, Carlos A Roldan, Karen Servilla, Elizabeth Sage Colombo
We report a case of hypermagnesemia associated with the use of milk of magnesia in a male patient with end-stage renal disease. After experiencing nausea and vomiting, he developed severe bradycardia and then asystole. Resuscitation efforts were successful; however, he developed atrial fibrillation with severe widening of the QRS and diffuse ST elevation, hypothermia, hypotension and apnoea requiring intubation. Initial diagnoses included ST-elevation myocardial infarction, cardiogenic and/or septic shock and hyperkalaemia...
March 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28292220/impact-of-low-dose-hydrocortisone-on-the-incidence-of-atrial-fibrillation-in-patients-with-septic-shock
#8
Yoann Launey, Sigismond Lasocki, Karim Asehnoune, Baptiste Gaudriot, Claire Chassier, Raphael Cinotti, Pascale Le Maguet, Leila Laksiri, Olivier Mimoz, Audrey Tawa, Nicolas Nesseler, Yannick Malledant, Bastien Perrot, Philippe Seguin
PURPOSE: Atrial fibrillation (AF) is common in the intensive care unit (ICU), notably in patients with septic shock for whom inflammation is an already identified risk factor. The aim of this study was to evaluate the effect of low-dose hydrocortisone on AF occurrence in patients with septic shock. METHODS: We performed a prospective nonrandomized observational study in 5 academic ICUs in France. From November 2012 to June 2014, all patients ≥16 years having septic shock were included, except those who had a history of AF, had a pacemaker, and/or experienced AF during hospitalization before the onset of shock or in whom the onset of shock occurred prior to admission to the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28237439/esophagopericardial-fistula-septic-shock-and-intracranial-hemorrhage-with-hydrocephalus-after-lung-transplantation
#9
M M Schuurmans, C Benden, C Moehrlen, C Gubler, M Wilhelm, W Weder, I Inci
A 57-year old woman underwent lung transplantation for non-specific interstitial pneumonia. Primary graft dysfunction was diagnosed requiring continued use of extracorporeal membrane oxygenation (ECMO). Within three days she developed recurring hemothoraces requiring two surgical evacuations. After ECMO removal a series of complications occurred within four months: femoral thrombosis, persisting tachycardic atrial fibrillation, pneumopericardium with an esophagopericardial fistula and purulent pericarditis, septic shock, multiorgan failure and intracerebral hemorrhage with ventricular involvement requiring external ventricular drainage...
May 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/27886982/impact-of-norepinephrine-weight-based-dosing-compared-with-non-weight-based-dosing-in-achieving-time-to-goal-mean-arterial-pressure-in-obese-patients-with-septic-shock
#10
MULTICENTER STUDY
Nina Vadiei, Mitchell J Daley, Manasa S Murthy, Carrie S Shuman
BACKGROUND: Currently, a lack of standardization exists in norepinephrine dosing units, the first-line vasopressor for septic shock. Timely achievement of goal mean arterial pressure (MAP) is dependent on optimal vasopressor dosing. OBJECTIVE: To determine if weight-based dosing (WBD) of norepinephrine leads to earlier time to goal MAP compared with non-WBD in obese patients with septic shock. METHODS: This was a retrospective, multicenter cohort study...
March 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/27727528/evaluation-of-new-onset-atrial-fibrillation-in-severe-sepsis-and-septic-shock
#11
Rajmadhangi D
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27467907/incidence-predictors-and-outcomes-of-new-onset-atrial-fibrillation-in-critically-ill-patients-with-sepsis-a-cohort-study
#12
Peter M C Klein Klouwenberg, Jos F Frencken, Sanne Kuipers, David S Y Ong, Linda M Peelen, Lonneke A van Vught, Marcus J Schultz, Tom van der Poll, Marc J Bonten, Olaf L Cremer
RATIONALE: Patients admitted to intensive care units with sepsis are prone to developing cardiac dysrhythmias, most commonly atrial fibrillation. OBJECTIVES: To determine the incidence, risk factors, and outcomes of atrial fibrillation in a cohort of critically ill patients with sepsis. METHODS: We assessed the association between atrial fibrillation and mortality using time-dependent competing risks survival analysis. Subsequently, for development of a risk score estimating the probability of a first occurrence of atrial fibrillation within the following 24 hours, we performed logistic regression analysis...
January 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27380528/association-of-heart-rate-with-n-terminal-pro-b-type-natriuretic-peptide-in-septic-patients-a-prospective-observational-cohort-study
#13
Naoki Hayase, Miyuki Yamamoto, Toshifumi Asada, Rei Isshiki, Naoki Yahagi, Kent Doi
BACKGROUND: Excessive sympathetic stress has multiple adverse effects during critical illness including sepsis. Recent studies showed that heart rate control had a significant effect on reducing mortality in septic shock patients. Furthermore, elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in septic patients were reportedly associated with adverse outcome. However, no study has evaluated the relationship between hemodynamic profiles of septic patients and the circulating cardiac biomarker...
July 1, 2016: Shock
https://www.readbyqxmd.com/read/26877443/co-10-are-hospitalised-patients-aged-90-years-and-over-treated-well-for-hypertension-lessons-from-a-prospective-survey
#14
J Bohlender, J Nussberger, B Bohlender
BACKGROUND: Hypertension increases dramatically with age. In clinically stable nonagenarians, ESH guidelines would recommend lowering blood pressure (BP) to 140-150mmHg systolic (SBP) and <90mmHg diastolic (DBP) if it is higher, but it is not clear if all of the oldest old comply with or need these goals. We prospectively analysed antihypertensive treatment decisions and BP outcome in a rural primary care hospital. METHODS: All patients aged >89 years with BP medication admitted to the medical ward were prospectively included over 12 months...
December 2015: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/26822890/left-atrial-appendage-morphology-echocardiographic-characterization-procedural-data-and-in-hospital-outcome-of-patients-receiving-left-atrial-appendage-occlusion-device-implantation-a-prospective-observational-study
#15
Christian Fastner, Michael Behnes, Benjamin Sartorius, Mustafa Yildiz, Kambis Mashayekhi, Ibrahim El-Battrawy, Ralf Lehmann, Stefan Baumann, Tobias Becher, Martin Borggrefe, Ibrahim Akin
BACKGROUND: Implantation of left atrial appendage (LAA) occlusion devices was shown to be a feasible and effective alternative to oral anticoagulation in patients with non-valvular atrial fibrillation. However, only few data about in-hospital and peri-procedural data are currently available. This study aims to report about echocardiographic, procedural and in-hospital data of patients receiving LAA occlusion devices. METHODS: This single-center, prospective and observational study includes consecutively patients being eligible for percutaneous implantation of LAA occlusion devices (either Watchman™ or Amplatzer™ Cardiac Plug 2)...
January 28, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/26691173/phase-ii-study-of-capecitabine-in-substitution-of-5-fu-in-the-chemoradiotherapy-regimen-for-patients-with-localized-squamous-cell-carcinoma-of-the-anal-canal
#16
Suilane Coelho Ribeiro Oliveira, Camila Motta Venchiarutti Moniz, Rachel Riechelmann, Alexandra Kichfy Alex, Maria Ignez Braghirolli, Giovanni Bariani, Caio Nahas, Paulo Marcelo Gehm Hoff
UNLABELLED: This was a phase II study of capecitabine in substitution of 5-fluorouracil (5-FU) in the chemoradiotherapy regimen for patients with localized squamous cell carcinoma of the anal canal. BACKGROUND: Combined chemoradiation with infusional 5-FU and mitomycin is the standard treatment for localized squamous cell carcinoma (SCC) of the anal canal. Capecitabine is an oral fluoropirimidine that has been shown to be equally effective to 5-FU in many solid tumors...
March 2016: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/26640039/ibrutinib-in-combination-with-rituximab-in-relapsed-or-refractory-mantle-cell-lymphoma-a-single-centre-open-label-phase-2-trial
#17
Michael L Wang, Hun Lee, Hubert Chuang, Nicolaus Wagner-Bartak, Frederick Hagemeister, Jason Westin, Luis Fayad, Felipe Samaniego, Francesco Turturro, Yasuhiro Oki, Wendy Chen, Maria Badillo, Krystle Nomie, Maria DeLa Rosa, Donglu Zhao, Laura Lam, Alicia Addison, Hui Zhang, Ken H Young, Shaoying Li, David Santos, L Jeffrey Medeiros, Richard Champlin, Jorge Romaguera, Leo Zhang
BACKGROUND: Ibrutinib is approved in the EU, USA, and other countries for patients with mantle cell lymphoma who received one previous therapy. In a previous phase 2 study with single-agent ibrutinib, the proportion of patients who achieved an objective response was 68%; 38 (34%) of 111 patients had transient lymphocytosis. We hypothesised that adding rituximab could target mantle cell lymphoma cells associated with redistribution lymphocytosis, leading to more potent antitumour activity...
January 2016: Lancet Oncology
https://www.readbyqxmd.com/read/26541953/major-publications-in-the-critical-care-pharmacotherapy-literature-january-december-2014
#18
Sarah A Day, Michaelia Cucci, Molly E Droege, Jenna M Holzhausen, Bridgette Kram, Shawn Kram, Mehrnaz Pajoumand, Christine R Parker, Mona K Patel, Gregory J Peitz, Alia Poore, Charles J Turck, Megan A Van Berkel, Adrian Wong, Amanda Zomp, Megan A Rech
PURPOSE: Nine recently published articles and one guideline with important implications for critical care pharmacy practice are summarized. SUMMARY: The Critical Care Pharmacotherapy Literature Update (CCPLU) group includes more than 40 experienced critical care pharmacists across the United States. Group members monitor 29 peer-reviewed journals on an ongoing basis to identify literature relevant to pharmacy practice in the critical care setting. After evaluation by CCPLU group members, selected articles are chosen for summarization and distribution to group members nationwide based on applicability to practice, relevance, and study design and strength...
November 15, 2015: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/26512582/current-epidemiology-and-outcome-of-infective-endocarditis-a-multicenter-prospective-cohort-study
#19
MULTICENTER STUDY
Patricia Muñoz, Martha Kestler, Arístides De Alarcon, José María Miro, Javier Bermejo, Hugo Rodríguez-Abella, Maria Carmen Fariñas, Manuel Cobo Belaustegui, Carlos Mestres, Pedro Llinares, Miguel Goenaga, Enrique Navas, José Antonio Oteo, Paola Tarabini, Emilio Bouza
The aim of the study was to describe the epidemiologic and clinical characteristics and identify the risk factors of short-term and 1-year mortality in a recent cohort of patients with infective endocarditis (IE).From January 2008, multidisciplinary teams have prospectively collected all consecutive cases of IE, diagnosed according to the Duke criteria, in 25 Spanish hospitals.Overall, 1804 patients were diagnosed. The median age was 69 years (interquartile range, 55-77), 68.0% were men, and 37.1% of the cases were nosocomial or health care-related IE...
October 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26180432/the-comparison-of-stroke-volume-variation-with-central-venous-pressure-in-predicting-fluid-responsiveness-in-septic-patients-with-acute-circulatory-failure
#20
Santhalakshmi Angappan, Satyen Parida, Arumugam Vasudevan, Ashok Shankar Badhe
PURPOSE: The present study was designed to investigate the efficacy of stroke volume variation (SVV) in predicting fluid responsiveness and compare it to traditional measures of volume status assessment like central venous pressure (CVP). METHODS: Forty-five mechanically ventilated patients in sepsis with acute circulatory failure. Patients were not included when they had atrial fibrillation, other severe arrhythmias, permanent pacemaker, or needed mechanical cardiac support...
July 2015: Indian Journal of Critical Care Medicine
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