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https://www.readbyqxmd.com/read/29923999/abdominal-compartment-syndrome-and-ruptured-aortic-aneurysm-validation-of-a-predictive-test-sca-aar
#1
Betty Leclerc, Lucie Salomon Du Mont, Anne-Laure Parmentier, Guillaume Besch, Simon Rinckenbach
BACKGROUND: The abdominal compartment syndrome (ACS) has been clearly identified as being one of the main causes of mortality after ruptured abdominal aortic aneurysm (rAAA). The ACS is defined as a sustained intra-abdominal pressure > 20 mm Hg associated with a new organ dysfunction or failure. A pilot study was conducted and found that the threshold of 3 among 8 selected criteria, we would predict an ACS occurrence with a 54% positive predictive value and a 92% negative predictive value...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29923896/part-iii-minimum-quality-threshold-in-pre-clinical-sepsis-studies-mqtipss-for-fluid-resuscitation-and-antimicrobial-therapy-endpoints
#2
Judith Hellman, Soheyl Bahrami, Mihaly Boros, Irshad Chaudry, Gerhard Fritsch, Waldemar Gozdzik, Shigeaki Inoue, Peter Radermacher, Mervyn Singer, Marcin F Osuchowski, Markus Huber-Lang
As outlined in the "International Guidelines for Management of Sepsis and Septic Shock: 2016", initial fluid resuscitation and administration of antibiotics are key steps in the early management of sepsis and septic shock. However, such clear guidelines do not exist for pre-clinical sepsis models. To address these shortcomings, the Wiggers-Bernard conference on pre-clinical sepsis models was held in Vienna in May, 2017. The participants reviewed 260 of the most highly cited papers between 2003 and 2012 that used sepsis models...
June 19, 2018: Shock
https://www.readbyqxmd.com/read/29922738/ultrasound-diagnosis-of-cardiac-rupture-caused-by-mechanical-chest-compression
#3
Ying-Tai Shih, Chai-Hock Chua, Sheng-Wen Hou, Li-Wei Lin, Chee-Fah Chong
A 74-year-old male with chronic kidney disease presented to the emergency department with asystole. Mechanical chest compression was started immediately using a piston-type thumper device. The initial potassium level was 7.7 mEq/L and bedside point-of-care ultrasound (POCUS) revealed no pericardial fluid. With standard resuscitation and anti-hyperkalemia treatment, return of spontaneous circulation (ROSC) was achieved within 10 minutes of compressions. At 15 minutes post-ROSC, the patient went into pulseless electrical activity...
June 2018: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29921225/effects-of-acute-ethanol-intoxication-in-an-ovine-peritonitis-model
#4
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/29909265/intrapartum-and-perinatal-results-associated-with-different-degrees-of-staining-of-meconium-stained-amniotic-fluid
#5
Vanesa Rodríguez Fernández, Carlos Nicolás López Ramón Y Cajal, Elena Marín Ortiz, Emilio Couceiro Naveira
OBJECTIVE: To determine the intrapartum and perinatal results associated with different degrees of staining of meconium stained amniotic fluid (MSAF). STUDY DESIGN: In a retrospective cohort study of all singleton deliveries over a period of one year (2015) in a tertiary hospital, we compared different degrees of MSAF (yellow, green and thick) to clear amniotic fluids, and analysed in each group maternal, intrapartum and neonatal variables as well as umbilical cord blood gas analysis...
March 20, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29897100/controlled-hypotension-versus-normotensive-resuscitation-strategy-for-people-with-ruptured-abdominal-aortic-aneurysm
#6
REVIEW
Daniel H Moreno, Daniel G Cacione, Jose Cc Baptista-Silva
BACKGROUND: An abdominal aortic aneurysm (AAA) is the pathological enlargement of the aorta and can develop in both men and women. Progressive aneurysm enlargement can lead to rupture. The rupture of an AAA is frequently fatal and accounts for the death from haemorrhagic shock of at least 45 people per 100,000 population. The outcome of people with ruptured AAA varies among countries and healthcare systems, with mortality ranging from 53% to 90%. Definitive treatment for ruptured AAA includes open surgery or endovascular repair...
June 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29889952/management-of-suspected-tension-pneumothorax-in-tactical-combat-casualty-care-tccc-guidelines-change-17-02
#7
Frank K Butler, John B Holcomb, Stacy Shackelford, Harold R Montgomery, Shawn Anderson, Jeffrey S Cain, Howard R Champion, Cord W Cunningham, Warren C Dorlac, Brendon Drew, Kurt Edwards, John V Gandy, Elon Glassberg, Jennifer Gurney, Theodore Harcke, Donald A Jenkins, Jay Johannigman, Bijan S Kheirabadi, Russ S Kotwal, Lanny F Littlejohn, Matthew Martin, Edward L Mazuchowski, Edward J Otten, Travis Polk, Peter Rhee, Jason M Seery, Zsolt Stockinger, Jeremy Torrisi, Avi Yitzak, Ken Zafren, Scott P Zietlow
This change to the Tactical Combat Casualty Care (TCCC) Guidelines that updates the recommendations for management of suspected tension pneumothorax for combat casualties in the prehospital setting does the following things: (1) Continues the aggressive approach to suspecting and treating tension pneumothorax based on mechanism of injury and respiratory distress that TCCC has advocated for in the past, as opposed to waiting until shock develops as a result of the tension pneumothorax before treating. The new wording does, however, emphasize that shock and cardiac arrest may ensue if the tension pneumothorax is not treated promptly...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/29889726/evolution-of-delivery-room-management-for-meconium-stained-infants-recent-updates
#8
Shilpi Chabra
BACKGROUND: The approach to intrapartum and postnatal management of an infant born through meconium-stained amniotic fluid (MSAF) in the delivery room (DR) has changed several times over the last few decades, leading to confusion and anxiety among health care providers (nurses, nurse practitioners, respiratory therapists, midwives, and physicians). This article provides state-of-the-art insight into the evidence or lack thereof for the changes in guidelines. PURPOSE: To discuss the evidence for evolution of DR management of vigorous and nonvigorous infants born through any type of MSAF...
June 8, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29887676/control-oriented-physiological-modeling-of-hemodynamic-responses-to-blood-volume-perturbation
#9
Ramin Bighamian, Bahram Parvinian, Christopher G Scully, George Kramer, Jin-Oh Hahn
This paper presents a physiological model to reproduce hemodynamic responses to blood volume perturbation. The model consists of three sub-models: a control-theoretic model relating blood volume response to blood volume perturbation; a simple physics-based model relating blood volume to stroke volume and cardiac output; and a phenomenological model relating cardiac output to blood pressure. A unique characteristic of this model is its balance for simplicity and physiological transparency. Initial validity of the model was examined using experimental data collected from 11 animals...
April 2018: Control Engineering Practice
https://www.readbyqxmd.com/read/29885184/an-evaluation-of-management-of-transferred-paediatric-burn-patients
#10
Fatima Naumeri, Ali Ijaz Ahmad, Hafiz Mahmood Ahmad, Uzma Ahmad, Muhammad Zeeshan Sarwar
The aim of study was to evaluate whether adequate initial management and safe transfer of paediatric burn patients was carried out in our setup. Patients transferred from other hospitals/ cities to Paediatric Surgery Department, Mayo Hospital were evaluated in this prospective study. Data was entered in a proforma. Around 90.4% patients on presentation had discrepancy in their burn percentage calculation. No intravenous fluids were administered to 75.4% patients and 71.1% patients did not have any intravenous access...
May 2018: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/29884274/a-young-adult-male-presenting-posttrauma-with-hypotension-despite-fluid-resuscitation
#11
Mohammad A Helwani, Rachel McDonald, Enyo A Ablordeppey
No abstract text is available yet for this article.
June 2018: Chest
https://www.readbyqxmd.com/read/29883040/management-of-postpartum-hemorrhage-how-to-improve-maternal-outcomes
#12
REVIEW
Dacia D C A Henriquez, Kitty W M Bloemenkamp, Johanna G van der Bom
Postpartum hemorrhage is the leading cause of maternal mortality and severe morbidity. Despite efforts to improve maternal outcomes, management of postpartum hemorrhage still faces at least four challenges, discussed in this review. First, current definitions for severe postpartum hemorrhage hamper early identification of women with high risk of adverse outcome. Adaptations to the definitions and the use of clinical tools such as shock index and early warning systems may facilitate this early identification...
June 8, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29882682/unintended-consequences-fluid-resuscitation-worsens-shock-in-an-ovine-model-of-endotoxemia
#13
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/29879520/defining-dogma-quantifying-crystalloid-hemodilution-in-a-prospective-randomized-control-trial-with-blood-donation-as-a-model-for-hemorrhage
#14
Samuel Wade Ross, A Britton Christmas, Peter E Fischer, Haley Holway, Rachel Seymour, Ciara R Huntington, B Todd Heniford, Ronald F Sing
BACKGROUND: The concept of hemodilution after blood loss and crystalloid infusion is a surgical maxim that remains unproven in humans. We sought to quantify the effect of hemodilution after crystalloid administration in voluntary blood donors as a model for acute hemorrhage. STUDY DESIGN: A prospective, randomized control trial was conducted in conjunction with community blood drives. Donors were randomized to receive no IV fluid(noIVF), two liters normal saline(NS), or two liters lactated ringers(LR) after blood donation...
June 4, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29877961/endovascular-perfusion-augmentation-for-critical-care-partial-aortic-occlusion-for-treatment-of-severe-ischemia-reperfusion-shock
#15
M Austin Johnson, Emily M Tibbits, Guillaume L Hoareau, Meryl A Simon, Anders J Davidson, Erik S DeSoucy, E Robert Faulconer, J Kevin Grayson, Lucas P Neff, Timothy K Williams
BACKGROUND: The resuscitation of patients in shock is materially intensive and many patients are refractory to maximal therapy. We hypothesized that partial inflation of an intra-aortic balloon, termed Endovascular Perfusion Augmentation for Critical Care (EPACC), would minimize material requirements while improving physiologic metrics. METHODS: Swine underwent a 25% controlled bleed and 45 minutes of complete aortic occlusion to create a severe ischemia-reperfusion shock state...
June 5, 2018: Shock
https://www.readbyqxmd.com/read/29872865/-successful-prehospital-emergency-thoracotomy-after-blunt-thoracic-trauma-case-report-and-lessons-learned
#16
Janosch Dahmen, Marko Brade, Christian Gerach, Martin Glombitza, Jan Schmitz, Simon Zeitter, Eva Steinhausen
BACKGROUND: The European Resuscitation Council guidelines for resuscitation in patients with traumatic cardiac arrest recommend the immediate treatment of all reversible causes, if necessary even prior to continuous chest compression. In the case of cardiac tamponade immediate emergency thoracotomy should also be considered. OBJECTIVE: The authors report the case of a 23-year-old male patient with multiple injuries including blunt thoracic trauma, which caused a witnessed cardiac arrest...
June 5, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29871564/early-negative-fluid-balance-is-associated-with-lower-mortality-after-cardiovascular-surgery
#17
Chenglong Li, Hong Wang, Nan Liu, Ming Jia, Haitao Zhang, Xiuming Xi, Xiaotong Hou
BACKGROUND: Early fluid expansion could prevent postoperative organ hypoperfusion. However, excessive fluid resuscitation adversely influences multiple organ systems. This retrospective, observational study aimed to investigate the relationship between early negative fluid balance and postoperative mortality in critically ill adult patients following cardiovascular surgery. METHODS: In total, 567 critically ill patients who had undergone cardiovascular surgery and whose intensive care unit length of stay (LOS) was more than 24 hours were enrolled...
June 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29866671/treatment-of-extreme-hypercalcaemia-the-role-of-haemodialysis
#18
Anna B Basok, Boris Rogachev, Yosef Shmuel Haviv, Marina Vorobiov
A patient with extremely high calcium level of 23.9 mg/dL (5.97 mmol/L) was admitted to our department unconscious with pathological ECG recording, demonstrating shortening of QT interval. The patient was treated by fluid resuscitation, bisphosphonates, salmon calcitonin and steroids. Haemodialysis with low calcium bath had been promptly provided with improvement of consciousness and calcium level. ECG changes disappeared. Subsequent investigations revealed hyperparathyroidism and a large parathyroid adenoma was then surgically removed...
June 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29861371/procalcitonin-as-a-diagnostic-marker-for-sepsis-septic-shock-in-the-emergency-department-a-study-based-on-sepsis-3-definition
#19
Sun Ju Kim, Sumg Oh Hwang, Yong Won Kim, Jun Hyeok Lee, Kyoung-Chul Cha
INTRODUCTION: The recent definition of sepsis was modified based on a scoring system focused on organ failure (Sepsis-3). It would be a time-consuming process to detect the sepsis patient using Sepsis-3. Procalcitonin (PCT) is a well-known biomarker for diagnosing sepsis/septic shock and monitoring the efficacy of treatment. We conducted a study to verify the predictability of PCT for diagnosing sepsis based on Sepsis-3 definition. MATERIALS & METHODS: This is a retrospective cohort study...
May 26, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29858432/what-is-the-evidence-base-for-fluid-resuscitation-in-acute-medicine
#20
Adam Seccombe, Elizabeth Sapey
Intravenous fluids are commonly prescribed but uncertainty remains about how to assess when fluids are required and how much to give, particularly in our multimorbid, polymedicated and ageing population. Furthermore, studies have noted that fluid resuscitation can be harmful even if clinical evidence of hypervolaemia is not present. Two recent guidelines have acknowledged a limited evidence base to guide fluid assessment. A recommended means to assess hypovolaemia includes assessment of fluid responsiveness...
June 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
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