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https://www.readbyqxmd.com/read/29931390/do-fetuses-need-vasopressors-just-before-their-birth
#1
EDITORIAL
Hiroyuki Sumikura
No abstract text is available yet for this article.
June 21, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29926549/predicting-mortality-in-patients-with-tuberculous-destroyed-lung-receiving-mechanical-ventilation
#2
Won Young Kim, Mi Hyun Kim, Eun Jung Jo, Jung Seop Eom, Jeongha Mok, Ki Uk Kim, Hye Kyung Park, Min Ki Lee, Kwangha Lee
BACKGROUND: Patients with acute respiratory failure secondary to tuberculous destroyed lung (TDL) have a poor prognosis. The aim of the present retrospective study was to develop a mortality prediction model for TDL patients who require mechanical ventilation. METHODS: Data from consecutive TDL patients who had received mechanical ventilation at a single university-affiliated tertiary care hospital in Korea were reviewed. Binary logistic regression was used to identify factors predicting intensive care unit (ICU) mortality...
June 19, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29924033/is-the-mean-platelet-volume-a-predictive-marker-of-a-high-in-hospital-mortality-of-acute-cardiorenal-syndrome-patients-receiving-continuous-renal-replacement-therapy
#3
Junhui Li, Xiaohua Sheng, Dongsheng Cheng, Feng Wang, Guihua Jian, Yongguang Li, Tao Xu, Xiaoxia Wang, Ying Fan, Niansong Wang
A high mean platelet volume (MPV) level has been demonstrated to predict poor clinical outcomes in patients with cardiovascular disease. However, the relationship between MPV and mortality in patients with acute cardiorenal syndrome (ACRS) is unknown. Therefore, we investigated the predictive value of MPV for in-hospital mortality of patients with ACRS who received continuous renal replacement therapy (CRRT) in this study.We retrospectively analyzed the demographics, etiology, severity of illness, prognosis, and risk factors of ACRS patients who underwent CRRT in our hospital from January 2009 to December 2014...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29923903/pressure-injury-risk-factors-in-critical-care-patients-a-descriptive-analysis
#4
Jill Cox, Sharon Roche, Virginia Murphy
BACKGROUND: Pressure injury (PI) development in the critical care population is multifactorial. Despite the application of evidence-based prevention strategies, PIs do occur and may be unavoidable in some patients. OBJECTIVES: To describe the risk factors associated with PI development in a sample of medical-surgical intensive care unit patients and determine whether these risk factors were congruent with the risk factors proposed in the work of the National Pressure Ulcer Advisory Panel on unavoidable PIs...
July 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29921225/effects-of-acute-ethanol-intoxication-in-an-ovine-peritonitis-model
#5
Koji Hosokawa, Fuhong Su, Fabio Silvio Taccone, Emiel Hendrik Post, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Acute ethanol intoxication has been shown to have contrasting effects on outcomes in sepsis. The aim of this study was to explore the effects of acute ethanol intoxication on hemodynamics, renal function, brain perfusion and lactate/pyruvate in an ovine sepsis model. METHODS: Anesthetized, mechanically ventilated female sheep were randomized to an ethanol group (n = 7), which received 1 g/kg ethanol diluted in intravenous (i.v.) saline infusion or a control group (n = 7), which received the same volume of i...
June 19, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29916860/the-las-vegas-risk-score-for-prediction-of-postoperative-pulmonary-complications-an-observational-study
#6
Ary Serpa Neto, Luiz Guilherme V da Costa, Sabrine N T Hemmes, Jaume Canet, Göran Hedenstierna, Samir Jaber, Michael Hiesmayr, Markus W Hollmann, Gary H Mills, Marcos F Vidal Melo, Rupert Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs. OBJECTIVE: We aimed to develop a new prediction score for PPCs that uses both pre-operative and intra-operative data. DESIGN: This is a secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study...
June 18, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29915638/cytoreductive-surgery-and-normothermic-intraperitoneal-chemotherapy-for-signet-ring-cell-appendiceal-adenocarcinoma-with-peritoneal-metastases-in-the-setting-of-cirrhosis
#7
Bharat Panuganti, Ea-Sle Chang, Cyril W Helm, Theresa Schwartz, Eddy C Hsueh, Jinhua Piao, Jinping Lai, Jula Veerapong
Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are combined to treat peritoneal surface malignancies (PSM). The objective of cytoreduction is to eradicate macroscopic disease, while HIPEC addresses residual microscopic disease. Currently, there are no protocols guiding treatment of cirrhotic patients with PSM. We report the case of a cirrhotic patient with signet ring cell (SRC) appendiceal adenocarcinoma who underwent normothermic, as opposed to hyperthermic intraperitoneal chemotherapy (IPC)...
June 2018: Gastroenterology Research
https://www.readbyqxmd.com/read/29913033/comparison-of-propofol-based-versus-volatile-based-anaesthesia-and-postoperative-sedation-in-cardiac-surgical-patients-a-prospective-randomized-study
#8
Marcin Wąsowicz, Angela Jerath, Warren Luksun, Vivek Sharma, Nicholas Mitsakakis, Massimilaino Meineri, Rita Katznelson, Terrence Yau, Vivek Rao, William Scott Beattie
BACKGROUND: Clinical trials have shown conflicting results regarding the use of volatile anesthesia before or after the ischemic insult in cardiac surgical patients and effect on myocardial injury. This may be attributable to the failure of continuing volatile agents into the early postoperative period. We hypothesized that combined volatile-based anesthesia and postoperative sedation would decrease the extent of myocardial injury after coronary artery bypass grafting (CABG) when compared to intravenous, propofol-based approach...
June 18, 2018: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29909205/perioperative-mortality-related-to-anesthesia-within-48-h-and-up-to-30-days-following-surgery-a-retrospective-cohort-study-of-11-562-anesthetic-procedures
#9
Luciana C Stefani, Patricia W Gamermann, Amanda Backof, Fernanda Guollo, Rafael M J Borges, Adriana Martin, Wolnei Caumo, Elaine A Felix
STUDY OBJECTIVE: Studying postoperative in-hospital mortality is crucial to the understanding of the perioperative process failures and to the implementation of strategies to improve patient outcomes. We intend to classify the causes of perioperative deaths up to 30 days after procedures requiring anesthesia and to evaluate the risk factors for early (48 h) or late (30 day) mortality. DESIGN: Retrospective cohort study. SETTING: A quaternary University Hospital from South Brazil...
June 14, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29908046/sepsis-induced-acute-kidney-injury-a-disease-of-the-microcirculation
#10
Shuai Ma, Roger G Evans, Naoya Iguchi, Marianne Tare, Helena C Parkington, Rinaldo Bellomo, Clive N May, Yugeesh R Lankadeva
Acute kidney injury (AKI) is a common complication of sepsis and is significantly associated with mortality. Sepsis accounts for more than 50% of the cases of AKI, with a mortality rate of up to 40%. The pathogenesis of septic AKI is complex, but there is emerging evidence that, at least in the first 48 hours, the defects may be functional rather than structural in nature. For example, septic AKI is associated with an absence of histopathological changes, but with microvascular abnormalities and tubular stress...
June 16, 2018: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
https://www.readbyqxmd.com/read/29904442/characteristics-and-factors-associated-with-the-mortality-of-hypotensive-patients-attending-the-emergency-department
#11
Kumpol Amnuaypattanapon, Suwimon Khansompop
Background: The prevalence of hypotension in emergency departments (EDs) is approximately 1-2%, but is associated with a mortality rate of 8-15%. There has never been a study in Thailand examining the epidemiology or the risk factors for early mortality of patients presenting with hypotension in the ED. Therefore, this study aimed to define the characteristics, mortality rate within 48 h and associated factors of hypotensive patients at ED. Methods: Data of patients with hypotension attending the ED of Thammasat University Hospital (TUH) were retrospectively studied...
July 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29903693/mechanical-circulatory-support-in-patients-with-cardiogenic-shock-in-intensive-care-units-a-position-paper-of-the-unit%C3%A3-de-soins-intensifs-de-cardiologie-group-of-the-french-society-of-cardiology-endorsed-by-the-groupe-ath%C3%A3-rome-et-cardiologie-interventionnelle
#12
REVIEW
Laurent Bonello, Clement Delmas, Guillaume Schurtz, Guillaume Leurent, Eric Bonnefoy, Nadia Aissaoui, Patrick Henry
Cardiogenic shock (CS) is a major challenge in contemporary cardiology. Despite a better understanding of the pathophysiology of CS, its management has only improved slightly. The prevalence of CS has remained stable over the past decade, but its outcome has seen few improvements, with the 1-month mortality rate still in the range of 40-60%. Inotropes and vasopressors are the first-line therapies for CS, but they are associated with significant hazards, and have well-known deleterious effects. Furthermore, a significant number of patients develop refractory CS with haemodynamic instability, causing critical organ hypoperfusion and/or pulmonary congestion, despite increasing doses of catecholamines...
June 11, 2018: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29896798/renal-effects-of-norepinephrine-induced-variations-in-mean-arterial-pressure-after-liver-transplantation-a-randomized-cross-over-trial
#13
J Skytte Larsson, G Bragadottir, B Redfors, S-E Ricksten
BACKGROUND: Acute kidney injury is commonly seen after liver transplantation. The optimal perioperative target mean arterial pressure (MAP) for renal filtration, perfusion and oxygenation in liver recipients is not known. The effects of norepinephrine-induced changes in MAP on renal blood flow (RBF), oxygen delivery (RDO2 ), glomerular filtration rate (GFR) and renal oxygenation (=renal oxygen extraction, RO2 Ex) were therefore studied early after liver transplantation. METHODS: Ten patients with an intra- and post-operative vasopressor-dependent systemic vasodilation were studied early after liver transplantation during sedation and mechanical ventilation...
June 12, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29893805/vancomycin-monotherapy-may-be-insufficient-to-treat-methicillin-resistant-staphylococcus-aureus-coinfection-in-children-with-influenza-related-critical-illness
#14
Adrienne G Randolph, Ruifei Xu, Tanya Novak, Margaret M Newhams, Juliane Bubeck Wardenburg, Scott L Weiss, Ronald C Sanders, Neal J Thomas, Mark W Hall, Keiko M Tarquinio, Natalie Cvijanovich, Rainer G Gedeit, Edward J Truemper, Barry Markovitz, Mary E Hartman, Kate G Ackerman, John S Giuliano, Steven L Shein, Kristin Moffitt
Background: Respiratory coinfection with influenza virus and methicillin-resistant Staphylococcus aureus (MRSA) causes life-threatening necrotizing pneumonia in children. Sporadic incidence precludes evaluation of antimicrobial efficacy. We assessed the clinical characteristics and outcomes of critically ill children with influenza-MRSA respiratory coinfection and evaluated antibiotic use. Methods: We prospectively enrolled children (<18 years) with influenza infection and acute respiratory failure across 34 pediatric intensive care units Nov 2008 to May 2016...
June 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29889274/posterior-reversible-encephalopathy-syndrome-as-a-complication-of-induced-hypertension-in-subarachnoid-hemorrhage-a-case-control-study
#15
Michelle L Allen, Tobias Kulik, Salah G Keyrouz, Rajat Dhar
BACKGROUND: Induced hypertension (IH) remains the mainstay of medical management for delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH). However, raising blood pressure above normal levels may be associated with systemic and neurological complications, of which posterior reversible encephalopathy syndrome (PRES) has been increasingly recognized. OBJECTIVE: To ascertain the frequency and predisposing factors for PRES during IH therapy. METHODS: We identified 68 patients treated with IH from 345 SAH patients over a 3-yr period...
June 8, 2018: Neurosurgery
https://www.readbyqxmd.com/read/29887195/misconceptions-in-acute-heart-failure-diagnosis-and-management-in-the-emergency-department
#16
REVIEW
Brit Long, Alex Koyfman, Eric J Chin
INTRODUCTION: Acute heart failure (AHF) accounts for a significant number of emergency department (ED) visits, and the disease may present along a spectrum with a variety of syndromes. OBJECTIVE: This review evaluates several misconceptions concerning heart failure evaluation and management in the ED, followed by several pearls. DISCUSSION: AHF is a heterogeneous syndrome with a variety of presentations. Physicians often rely on natriuretic peptides, but the evidence behind their use is controversial, and these should not be used in isolation...
June 1, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29882682/unintended-consequences-fluid-resuscitation-worsens-shock-in-an-ovine-model-of-endotoxemia
#17
Liam Byrne, Nchafatso G Obonyo, Sara D Diab, Kimble R Dunster, Margaret R Passmore, Ai-Ching Boon, Louise See Hoe, Sanne Pedersen, Mohd Hashairi Fauzi, Leticia Pretti Pimenta, Frank Van Haren, Christopher M Anstey, Louise Cullen, John-Paul Tung, Kiran Shekar, Kathryn Maitland, John F Fraser
BACKGROUND: Fluid resuscitation is widely considered a life saving intervention in septic shock however recent evidence has questioned both its safety and efficacy in sepsis. This study sought to compare fluid resuscitation with vasopressors with vasopressors alone in a hyperdynamic model of ovine endotoxemia. METHODS: Endotoxemic shock was induced in sixteen sheep after which they received fluid resuscitation with 40mls/kg of 0.9% saline or commenced haemodynamic support with protocolized noradrenaline and vasopressin...
June 8, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29881987/management-and-outcomes-of-acute-respiratory-distress-syndrome-patients-with-and-without-comorbid-conditions
#18
Elie Azoulay, Virginie Lemiale, Bruno Mourvillier, Maite Garrouste-Orgeas, Carole Schwebel, Stéphane Ruckly, Laurent Argaud, Yves Cohen, Bertrand Souweine, Laurent Papazian, Jean Reignier, Guillaume Marcotte, Shidasp Siami, Hatem Kallel, Michael Darmon, Jean-François Timsit
RATIONALE: The standard of care for patients with acute respiratory distress syndrome (ARDS) has been developed based on studies that usually excluded patients with major comorbidities. OBJECTIVES: To describe treatments and outcomes according to comorbidities in patients with ARDS admitted to 19 ICUs (1997-2014). METHODS: Patients were grouped based on comorbidities. Determinants of day-28 mortality were identified by multivariable Cox analysis stratified on center...
June 7, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29878459/safe-use-of-vasopressin-and-angiotensin-ii-for-patients-with-circulatory-shock
#19
Seth R Bauer, Gretchen L Sacha, Simon W Lam
Circulatory shock is a medical emergency that requires rapid intervention to optimize patient outcomes. Although catecholamine vasopressors are considered life-sustaining therapy they are associated with adverse reactions and vasopressin and angiotensin II may be utilized to minimize these adverse effects. However, vasopressin and angiotensin II are also associated with adverse reactions that must be known to the clinician in order to mitigate risk for patients. This review focuses on the known adverse drug effects of vasopressin and angiotensin II while offering potential solutions to minimize harm with these agents...
June 7, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29864039/vitamin-c-should-we-supplement
#20
Angélique M E Spoelstra-de Man, Paul W G Elbers, Heleen M Oudemans-Van Straaten
PURPOSE OF REVIEW: Hypovitaminosis C and vitamin C deficiency are very common in critically ill patients due to increased needs and decreased intake. Because vitamin C has pleiotropic functions, deficiency can aggravate the severity of illness and hamper recovery. RECENT FINDINGS: Vitamin C is a key circulating antioxidant with anti-inflammatory and immune-supporting effects, and a cofactor for important mono and dioxygenase enzymes. An increasing number of preclinical studies in trauma, ischemia/reperfusion, and sepsis models show that vitamin C administered at pharmacological doses attenuates oxidative stress and inflammation, and restores endothelial and organ function...
June 1, 2018: Current Opinion in Critical Care
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