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Early use of vasopressor

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https://www.readbyqxmd.com/read/28199752/effect-of-transversus-abdominis-plane-block-in-combination-with-general-anesthesia-on-perioperative-opioid-consumption-hemodynamics-and-recovery-in-living-liver-donors-the-prospective-double-blinded-randomized-study
#1
Mehmet Ali Erdogan, Ulku Ozgul, Muharrem Uçar, Rıdvan Yalin, Yusuf Ziya Colak, Cemil Çolak, Huseyin Ilksen Toprak
BACKGROUND: Transversus abdominis plane (TAP) block provides effective postoperative analgesia after abdominal surgeries. It can be also a useful strategy to reduce perioperative opioid consumption, support intraoperative hemodynamic stability and promote early recovery from anesthesia. The aim of this prospective randomized double-blind study was to assess the effect of subcostal TAP blocks on perioperative opioid consumption, hemodynamic and recovery time in living liver donors. METODS: The prospective, double-blinded, randomized controlled study was conducted with 49 living liver donors, aged 18-65 years, who were scheduled to undergo right hepatectomy...
February 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28159011/fluids-and-sepsis-changing-the-paradigm-of-fluid-therapy-a-case-report
#2
Hori Hariyanto, Corry Quando Yahya, Monika Widiastuti, Primartanto Wibowo, Oloan Eduard Tampubolon
BACKGROUND: Over the past 16 years, sepsis management has been guided by large-volume fluid administration to achieve certain hemodynamic optimization as advocated in the Rivers protocol. However, the safety of such practice has been questioned because large-volume fluid administration is associated with fluid overload and carries the worst outcome in patients with sepsis. Researchers in multiple studies have declared that using less fluid leads to increased survival, but they did not describe how to administer fluids in a timely and appropriate manner...
February 4, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28155226/propofol-versus-thiopental-sodium-for-the-treatment-of-refractory-status-epilepticus
#3
REVIEW
Hemanshu Prabhakar, Mani Kalaivani
BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 6, 2015).Failure to respond to antiepileptic drugs in patients with uncontrolled seizure activity such as refractory status epilepticus (RSE) has led to the use of anaesthetic drugs. Coma is induced with anaesthetic drugs to achieve complete control of seizure activity. Thiopental sodium and propofol are popularly used for this purpose. Both agents have been found to be effective...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#4
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28121217/qsofa-has-poor-sensitivity-for-prehospital-identification-of-severe-sepsis-and-septic-shock
#5
Maia Dorsett, Melissa Kroll, Clark S Smith, Phillip Asaro, Stephen Y Liang, Hawnwan P Moy
OBJECTIVES: Sepsis is a common and deadly disease process for which early recognition and intervention can significantly improve clinical outcomes. Despite this, sepsis remains underrecognized and therefore undertreated in the prehospital setting. Recent recommendations by the Society of Critical Care and European Society of Intensive Care Medicine advocate use of the qSOFA (quick Sequential [Sepsis-related] Organ Failure Assessment) score in non-ICU settings to screen for septic patients at greater risk for poor outcomes...
January 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28045780/cardiovascular-responsiveness-to-vasopressin-and-%C3%AE-1-adrenergic-receptor-agonists-after-burn-injury
#6
Ann E Evans, P Geoff Vana, Heather M LaPorte, Richard H Kennedy, Richard L Gamelli, Matthias Majetschak
The effects of burn injury on cardiovascular responsiveness to vasoactive agents are not well understood. The aims of this study were to determine whether burn injury alters cardiovascular reactivity to vasoactive drugs in vivo and intrinsic function of isolated mesenteric resistance arteries. Anesthetized Sprague-Dawley rats were subjected to sham procedure or 30% TBSA dorsal scald burn, followed by crystalloid resuscitation (Parkland Formula). At 24, 72, 96, and 168 hours post burn, rats were reanesthetized, and the mean arterial blood pressure (MAP) responses to various doses of the α1-adrenergic receptor agonist phenylephrine and arginine vasopressin were tested...
December 30, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28034881/impact-of-intravenous-immunoglobulin-on-survival-in-necrotizing-fasciitis-with-vasopressor-dependent-shock-a-propensity-score-matched-analysis-from-130-us-hospitals
#7
Sameer S Kadri, Bruce J Swihart, Stephanie L Bonne, Samuel F Hohmann, Laura V Hennessy, Peter Louras, Heather L Evans, Chanu Rhee, Anthony F Suffredini, David C Hooper, Dean A Follmann, Eileen Bulger, Robert L Danner
BACKGROUND: Shock frequently complicates necrotizing fasciitis (NF) caused by group A streptococcus (GAS) or Staphylococcus aureus (SA). Intravenous immunoglobulin (IVIG) is sometimes administered for presumptive toxic shock syndrome (TSS), but its frequency of use and efficacy are unclear. METHODS: Adult patients with NF and vasopressor-dependent shock undergoing surgical debridement from 2010 to 2014 were identified at 130 U.S. hospitals. IVIG cases were propensity-matched and risk-adjusted...
December 29, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28031654/aortic-root-rupture-during-transcatheter-aortic-valve-implantation-in-a-patient-with-idiopathic-thrombocytopenic-purpura-utility-of-transesophageal-echocardiography-in-early-detection-and-description-of-a-semiconservative-surgical-management-approach
#8
Jaya Chandrasekhar, Marc Ruel, Donna Nicholson, Marino Labinaz
An 87-year-old man with idiopathic thrombocytopenic purpura and platelet count of 56 × 10(9)/L underwent transesophageal echocardiography (TEE)-guided transcatheter aortic valve implantation using a femoral approach. Post valve deployment, a new pericardial effusion was noted which was successfully drained. Despite this, the patient became hypotensive needing vasopressor support with reaccumulation of pericardial fluid. Emergent sternotomy was performed and a perforation of the right ventricular apex was noted which was sealed with a pledgeted suture...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27969574/disparities-in-hemodynamic-resuscitation-of-the-obese-critically-ill-septic-shock-patient
#9
Chere Adams, Calvin Tucker, Bryan Allen, Andrew McRae, Julia Balazh, Spencer Horst, Donald Johnson, Jason Ferreira
BACKGROUND: With a growing obesity epidemic, the approach to care of this patient remains controversial and in many circumstances different than the general population. Appropriate hemodynamic support, although still controversial, remains a cornerstone of septic shock therapy. Catecholamines are currently recommended by guidelines without a preferred dosing strategy. However, the use of weight-based (μg kg(-1) min(-1)) or nonweight-based (μg/min) vasopressor drip rates may impact patient care in these populations...
February 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27955692/is-the-shock-index-based-classification-of-hypovolemic-shock-applicable-in-multiple-injured-patients-with-severe-traumatic-brain-injury-an-analysis-of-the-traumaregister-dgu-%C3%A2
#10
Matthias Fröhlich, Arne Driessen, Andreas Böhmer, Ulrike Nienaber, Alhadi Igressa, Christian Probst, Bertil Bouillon, Marc Maegele, Manuel Mutschler
BACKGROUND: A new classification of hypovolemic shock based on the shock index (SI) was proposed in 2013. This classification contains four classes of shock and shows good correlation with acidosis, blood product need and mortality. Since their applicability was questioned, the aim of this study was to verify the validity of the new classification in multiple injured patients with traumatic brain injury. METHODS: Between 2002 and 2013, data from 40 888 patients from the TraumaRegister DGU(®) were analysed...
December 12, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27940189/hydrocortisone-vitamin-c-and-thiamine-for-the-treatment-of-severe-sepsis-and-septic-shock-a-retrospective-before-after-study
#11
Paul E Marik, Vikramjit Khangoora, Racquel Rivera, Michael H Hooper, John Catravas
BACKGROUND: The global burden of sepsis is estimated as 15 to 19 million cases annually with a mortality rate approaching 60% in low income countries. METHODS: In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone and thiamine during a 7-month period (treatment group) compared to a control group treated in our ICU during the preceding 7 months...
December 6, 2016: Chest
https://www.readbyqxmd.com/read/27859489/elevated-fabp1-serum-levels-are-associated-with-poorer-survival-in-acetaminophen-induced-acute-liver-failure
#12
Constantine J Karvellas, Jaime L Speiser, Mélanie Tremblay, William M Lee, Christopher F Rose
: Acetaminophen (APAP)-induced acute liver failure (ALF) is associated with significant mortality. Traditional prognostic scores lack sensitivity. Serum liver-type fatty acid binding protein (FABP1) early (day 1) or late (day 3-5) levels are associated with 21-day mortality in the absence of liver transplant. Serum samples from 198 APAP-ALF patients (nested case-control study with 99 survivors, 99 nonsurvivors) were analyzed by enzyme-linked immunosorbent assay with clinical data from the US Acute Liver Failure Study Group registry (1998-2014)...
November 18, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27823892/practical-considerations-in-sepsis-resuscitation
#13
Brit Long, Alex Koyfman, Katharine L Modisett, Christian J Woods
BACKGROUND: Sepsis is a common condition managed in the emergency department, and the majority of patients respond to resuscitation measures, including antibiotics and i.v. fluids. However, a proportion of patients will fail to respond to standard treatment. OBJECTIVE: This review elucidates practical considerations for management of sepsis in patients who fail to respond to standard treatment. DISCUSSION: Early goal-directed therapy revolutionized sepsis management...
November 4, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27801303/levosimendan-use-increases-cardiac-performance-after-coronary-artery-bypass-grafting-in-end-stage-renal-disease-patients
#14
Hakan Atalay, Zeki Temizturk, Hasan Baki Altinsoy, Davut Azboy, Salih Colak, Atakan Atalay, Omer Faruk Dogan
BACKGROUND: The effect of levosimendan on myocardial performance has not been studied in dialysis-dependent end-stage renal disease patients who have undergone coronary artery bypass grafting (CABG) surgery. Our aim was to investigate the effect of levosimendan on postoperative hemodynamic effects in end-stage renal disease patients undergoing CABG operation. METHODS: We performed 58 elective isolated CABG operations in end-stage renal disease patients. The study group received levosimendan at a slow bolus dose of 3 µg/kg, followed by a 24-hour infusion of 0...
October 27, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27788216/selepressin-and-arginine-vasopressin-do-not-display-cardiovascular-risk-in-atherosclerotic-rabbit
#15
Olivier Boucheix, Robert Blakytny, Gerard Haroutunian, Marie Henriksson, Regent Laporte, Stephane Milano, Torsten M Reinheimer
BACKGROUND: Septic shock remains associated with significant mortality rates. Arginine vasopressin (AVP) and analogs with V1A receptor agonist activity are increasingly used to treat fluid-resistant vasodilatory hypotension, including catecholamine-refractory septic shock. Clinical studies have been restricted to healthy volunteers and catecholamine-refractory septic shock patients excluding subjects with cardiac co-morbidities because of presumed safety issues. The novel selective V1A receptor agonist selepressin, with short half-life, has been designed to avoid V2 receptor-related complications and long-term V1A receptor activation...
2016: PloS One
https://www.readbyqxmd.com/read/27756870/early-goal-directed-therapy-in-severe-sepsis-and-septic-shock-a-meta-analysis-and-trial-sequential-analysis-of-randomized-controlled-trials
#16
Yao Lu, Han Zhang, Fang Teng, Wen-Jun Xia, Gui-Xiang Sun, Ai-Qing Wen
INTRODUCTION: The Surviving Sepsis Campaign guidelines recommend early goal-directed therapy (EGDT) for the resuscitation of patients with sepsis; however, the recent evidences quickly evolve and convey conflicting results. We performed a meta-analysis to evaluate the effect of EGDT on mortality in adults with severe sepsis and septic shock. METHODS: We searched electronic databases to identify randomized controlled trials that compared EGDT with usual care or lactate-guided therapy in adults with severe sepsis and septic shock...
October 18, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27740465/perioperative-management-of-a-bilateral-forearm-allograft
#17
M Clerc, J Prothet, T Rimmelé
Composite tissue allotransplantation (CTA) is a complex procedure requiring a multidisciplinary collaboration between surgeons, anesthetists, and transplantation specialists. We will describe the perioperative management of a bilateral forearm allograft performed at our facility. A 40-year-old man who lost both forearms was registered on the transplant waiting list; a suitable graft was available 11months later. Anesthesia required planning for vascular access, hemodynamic monitoring, fluid therapy management and prevention of deep vein thrombosis...
June 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27720568/the-impact-of-push-dose-phenylephrine-use-on-subsequent-preload-expansion-in-the-ed-setting
#18
Madison B Schwartz, Jason A Ferreira, Patrick M Aaronson
BACKGROUND: The utilization of bolus-dose phenylephrine (PHE) has transitioned to the emergency department (ED) for the treatment of acutely hypotensive patients, despite a paucity of literature in this setting. METHODS: This was a single center retrospective chart review of the utilization of bolus-dosed PHE for acute hypotension in the ED at an academic non-forprofit hospital. The primary objective of this study is to report the frequency of patients that were initiated on a continuous vasopressor infusion (CVI) within 30 minutes after the first administration of bolus-dose PHE...
December 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27716694/perioperative-utility-of-goal-directed-therapy-in-high-risk-cardiac-patients-undergoing-coronary-artery-bypass-grafting-a-clinical-outcome-and-biomarker-based-study
#19
Poonam Malhotra Kapoor, Rohan Magoon, Rajinder Rawat, Yatin Mehta
Goal-directed therapy (GDT) encompasses guidance of intravenous (IV) fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27666884/-predictive-value-of-early-lactate-area-for-mortality-in-elderly-patients-with-septic-shock
#20
J X Zhang, M Yin, X M Chen, C Li, D W Wu, S F Ding, B F Du, H P Guo, W D Qin, H N Yang, H Wang
Objective: To investigate the predictive value of early lactate area for mortality in elderly patients with septic shock. Methods: From January 2012 to December 2013, a prospective study was conducted in the Department of Critical Care Medicine, Qilu Hospital of Shandong University. A total of 115 septic shock patients with age ≥65 years were included in the study. Serum lactate was measured every 6 hours, the lactate indicators, including early lactate area, APACHE Ⅱ score etc were recorded. Results: The overall 28-day mortality rate was 67...
September 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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