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https://www.readbyqxmd.com/read/28719483/difficult-intubation-and-ventilation-in-an-infant-with-retropharyngeal-abscess-with-mediastinal-extension
#1
Michael A Bruno, Tomas Drabek, Mioara D Manole
A previously healthy 7-month-old male infant presented for evaluation of fever, deceased oral intake, and intermittent noisy breathing. Physical examination revealed neck tenderness. Soft tissue neck radiographs and computed tomography (CT) scan supported a diagnosis of retropharyngeal swelling with extension to the superior mediastinum. Surgical exploration was planned, and endotracheal intubation was performed in the operating room. Significant cardiorespiratory derangements developed immediately after the tracheal tube was inserted, including hypotension, hypoxia, and bradycardia with signs of cardiac ischemia...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28709157/hypotensive-resuscitation-with-hypertonic-saline-dextran-improves-survival-in-a-rat-model-of-hemorrhagic-shock-at-high-altitude
#2
Jingxiang Zhao, Guoxing You, Bo Wang, Zhenwei Sun, Zhen Wang, Sha Xia, Lian Zhao, Hong Zhou
OBJECTIVE: To compare the efficacy of hypotensive resuscitation with hypertonic saline dextran 70 (HSD) and lactated Ringer (LR) solutions in a rat model of hemorrhagic shock at a simulated altitude of 4,000 m. METHODS: Anesthetized rats were bled to maintain their mean arterial pressure (MAP) at 45 mm Hg for 1 h. The distal quarter of the tail was then amputated to allow free blood loss; rats were simultaneously resuscitated with 4 mL kg HSD (HSD group, n = 10) or 4 mL kg LR (LR group, n = 10), followed by hypotensive resuscitation with LR to maintain MAP at 55 to 60 mm Hg for 1 h...
August 2017: Shock
https://www.readbyqxmd.com/read/28708664/esmolol-administration-to-control-tachycardia-in-an-ovine-model-of-peritonitis
#3
Koji Hosokawa, Fuhong Su, Fabio Silvio Taccone, Emiel Hendrik Post, Adriano José Pereira, Antoine Herpain, Jacques Creteur, Jean-Louis Vincent
BACKGROUND: Excessive adrenergic signaling may be harmful in sepsis. Using β-blockers to reduce sympathetic overactivity may modulate sepsis-induced cardiovascular, metabolic, immunologic, and coagulation alterations. Using a randomized ovine fecal peritonitis model, we investigated whether administration of a short-acting β-blocker, esmolol, could control tachycardia without deleterious effects on hemodynamics, renal perfusion, cerebral perfusion, cerebral metabolism, or outcome. METHODS: After induction of fecal peritonitis, 14 anesthetized, mechanically ventilated, and hemodynamically monitored adult female sheep were randomly assigned to receive a continuous intravenous infusion of esmolol to control heart rate between 80 and 100 bpm (n = 7) or a saline infusion (control group, n = 7)...
July 13, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28707404/sustained-versus-standard-inflations-during-neonatal-resuscitation-to-prevent-mortality-and-improve-respiratory-outcomes
#4
REVIEW
Matteo Bruschettini, Colm Pf O'Donnell, Peter G Davis, Colin J Morley, Lorenzo Moja, Simona Zappettini, Maria Grazia Calevo
BACKGROUND: At birth, infants' lungs are fluid-filled. For newborns to have a successful transition, this fluid must be replaced by air to enable effective breathing. Some infants are judged to have inadequate breathing at birth and are resuscitated with positive pressure ventilation (PPV). Giving prolonged (sustained) inflations at the start of PPV may help clear lung fluid and establish gas volume within the lungs. OBJECTIVES: To assess the efficacy of an initial sustained (> 1 second duration) lung inflation versus standard inflations (≤ 1 second) in newly born infants receiving resuscitation with intermittent PPV...
July 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28702167/clostridium-perfringens-s-necrotizing-acute-pancreatitis-a-case-of-success
#5
Rita Castro, Joana Mendes, Luís Amaral, Rui Quintanilha, Tiago Rama, António Melo
The authors report a case of a 62-year-old man with upper abdominal pain with few hours of onset and vomits. The initial serum amylase was 2306 U/L. The first CT showed signs of a non-complicated acute pancreatitis. He suffered clinical deterioration and for this reason he was admitted on the intensive care unit where he progressed to multiple organ failure in <24 h. A new CT scan was performed that showed pneumoperitoneum and pneumoretroperitoneum. He underwent an exploratory laparotomy and pancreatic necrosectomy and vacuum pack laparostomy were performed...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28699609/fluid-resuscitation-in-acute-pancreatitis
#6
Aydın Şeref Köksal, Erkan Parlak
No abstract text is available yet for this article.
July 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28697124/effect-of-intravenous-fluids-and-analgesia-on-dysmotility-in-patients-with-acute-pancreatitis-a-prospective-cohort-study
#7
Landy M Wu, Sayali A Pendharkar, Varsha M Asrani, John A Windsor, Maxim S Petrov
OBJECTIVES: Analgesia and intravenous fluid resuscitation are cornerstones of initial patient management in acute pancreatitis (AP). The aim was to investigate the effect of intravenous fluids and analgesia on gastrointestinal motility in the early course of AP. METHODS: Gastrointestinal dysmotility was assessed using the Gastroparesis Cardinal Symptom Index (GCSI). One-way analysis of variance and analysis of covariance were conducted, adjusting for age, sex, body mass index, severity of AP, preexisting diabetes mellitus, and time from first symptom onset to hospital admission...
August 2017: Pancreas
https://www.readbyqxmd.com/read/28685464/hemoglobin-based-oxygen-carrier-hboc-development-in-trauma-previous-regulatory-challenges-lessons-learned-and-a-path-forward
#8
Peter E Keipert
Historically, hemoglobin-based oxygen carriers (HBOCs) were being developed as "blood substitutes," despite their transient circulatory half-life (~ 24 h) vs. transfused red blood cells (RBCs). More recently, HBOC commercial development focused on "oxygen therapeutic" indications to provide a temporary oxygenation bridge until medical or surgical interventions (including RBC transfusion, if required) can be initiated. This included the early trauma trials with HemAssist (®) (BAXTER), Hemopure (®) (BIOPURE) and PolyHeme (®) (NORTHFIELD) for resuscitating hypotensive shock...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28682837/closed-loop-and-decision-assist-guided-fluid-therapy-of-human-hemorrhage
#9
Gabriel Hundeshagen, George C Kramer, Nicole Ribeiro Marques, Michael G Salter, Aristides K Koutrouvelis, Husong Li, Daneshvari R Solanki, Alexander Indrikovs, Roger Seeton, Sheryl N Henkel, Michael P Kinsky
OBJECTIVES: We sought to evaluate the efficacy, efficiency, and physiologic consequences of automated, endpoint-directed resuscitation systems and compare them to formula-based bolus resuscitation. DESIGN: Experimental human hemorrhage and resuscitation. SETTING: Clinical Research Laboratory. SUBJECTS: Healthy volunteers. INTERVENTIONS: Subjects (n = 7) were subjected to hemorrhage and underwent a randomized fluid resuscitation scheme on separate visits 1) formula-based bolus resuscitation; 2) semiautonomous (decision assist) fluid administration; and 3) fully autonomous (closed loop) resuscitation...
July 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28681128/role-of-vital-trace-elements-in-nanocurcumin-centered-formulation-a-novel-approach-to-resuscitate-the-immune-system
#10
Mahendra Kumar Trivedi, Mayank Gangwar, Sambhu Charan Mondal, Snehasis Jana
The present paper described the immunomodulatory potential of novel nanocurcumin-based formulation enriched with trace elements and vitamins on cyclophosphamide-induced immunosuppression in rat model. Major immune-related assays were monitored such as hemagglutination assay, delayed-type hypersensitivity (DTH) reaction, cellular immune response, IgG, IgE, IgM, cerebrospinal fluid biomarkers, hematological study, antioxidant profile, and lipid biomarkers. Chemical characterization of novel formulation showed retention time (R t ) 18...
July 5, 2017: Biological Trace Element Research
https://www.readbyqxmd.com/read/28679339/characteristics-of-a-pseudomonas-aeruginosa-induced-porcine-sepsis-model-for-multi-organ-metabolic-flux-measurements
#11
Gabriella A M Ten Have, Renske C I Deutz, Mariëlle P K J Engelen, Robert R Wolfe, Nicolaas E P Deutz
Survival of sepsis is related to loss of muscle mass. Therefore, it is imperative to further define and understand the basic alterations in nutrient metabolism in order to improve targeted sepsis nutritional therapies. We developed and evaluated a controlled hyperdynamic severe sepsis pig model that can be used for in vivo multi-organ metabolic studies in a conscious state. In this catheterized pig model, bacteremia was induced intravenously with 10(9) CFU/h Pseudomonas aeruginosa (PA) in 13 pigs for 18 h...
January 1, 2017: Laboratory Animals
https://www.readbyqxmd.com/read/28673368/compliance-of-tranexamic-acid-administration-to-trauma-patients-at-a-level-one-trauma-centre
#12
Abeer Ghawnni, Angela Coates, Julian Owen
Introduction Current practice for the treatment of traumatic hemorrhage includes fluid resuscitation and the administration of blood products. The administration of tranexamic acid (TXA) within 8 hours of injury has been shown to significantly reduce mortality in a large, prospective, randomized controlled trial. As a result, TXA is widely used in trauma centres to manage trauma patients with major bleeding. The primary aim of this study was to assess the compliance of TXA administration at a level-one trauma centre in Hamilton, Ontario, Canada...
July 4, 2017: CJEM
https://www.readbyqxmd.com/read/28673224/fluid-resuscitation-in-critically-ill-patients-timing-and-dose-matters
#13
K Lall, G Roberts, U Buehner
Fluid management is a complex subject in healthcare, particularly when pertaining to critically ill patients. Following a literature search on international recommendations regarding fluid administration for shocked patients, an audit was undertaken at Rotorua Public Hospital, New Zealand, to assess how the local fluid resuscitation strategy could be improved. The first part of the audit looked at the fluid resuscitation approach used to treat shocked patients admitted to the ICU of Rotorua Hospital in 2014 and changes required to achieve best practice recommendations...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28672146/stroke-volume-guided-resuscitation-in-severe-sepsis-and-septic-shock-improves-outcomes
#14
Heath E Latham, Charles D Bengtson, Lewis Satterwhite, Mindy Stites, Dipti P Subramaniam, G John Chen, Steven Q Simpson
To determine whether stroke volume (SV) guided fluid resuscitation in patients with severe sepsis and septic shock alters Intensive Care Unit (ICU) fluid balance and secondary outcomes, this retrospective cohort study evaluated consecutive patients admitted to an ICU with the primary diagnosis of severe sepsis or septic shock. Cohorts were based on fluid resuscitation guided by changes in SV or by usual care (UC). The SV group comprised 100 patients, with 91 patients in the UC group. Net fluid balance for the ICU stay was lower in the SV group (1...
June 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28671898/patterns-and-outcomes-associated-with-timeliness-of-initial-crystalloid-resuscitation-in-a-prospective-sepsis-and-septic-shock-cohort
#15
Daniel E Leisman, Chananya Goldman, Martin E Doerfler, Kevin D Masick, Susan Dries, Eric Hamilton, Mangala Narasimhan, Gulrukh Zaidi, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The objectives of this study were to 1) assess patterns of early crystalloid resuscitation provided to sepsis and septic shock patients at initial presentation and 2) determine the association between time to initial crystalloid resuscitation with hospital mortality, mechanical ventilation, ICU utilization, and length of stay. DESIGN: Consecutive-sample observational cohort. SETTING: Nine tertiary and community hospitals over 1...
June 30, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28670061/thoracentesis-reverting-cardiac-tamponade-physiology-in-a-patient-with-myxedema-coma-and-large-pleural-effusion
#16
Monia E Werlang, Mario R Pimentel, Jose L Diaz-Gomez
A large pleural effusion causing cardiac tamponade physiology and severe hemodynamic compromise is an uncommon event. We report a case of a 53-year-old woman with severe hypothyroidism presenting with myxedema coma and refractory shock. Her hemodynamic status failed to respond to fluid resuscitation and vasopressors. A transthoracic echocardiogram and chest radiograph demonstrated a pericardial fluid accumulation associated with a large left-sided pleural effusion. Thoracostomy tube insertion resulted in prompt improvement of the patient's hemodynamic status...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28664545/adherence-to-a-pediatric-diabetic-ketoacidosis-protocol-in-children-presenting-to-a-tertiary-care-hospital
#17
Rebecca Ronsley, Nazrul Islam, Claire Ronsley, Daniel L Metzger, Constadina Panagiotopoulos
OBJECTIVE: To review adherence to a provincial diabetic ketoacidosis (DKA) protocol and to assess factors associated with intravenous fluid administration and the length time on an insulin infusion. METHODS: A retrospective chart review was conducted of all DKA admissions to British Columbia Children's Hospital (BCCH) during September 2008 to December 2013. Data collection included diabetes history, estimation of dehydration, insulin and fluid infusion rates, and frequency of laboratory investigations...
June 30, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28661972/continuous-chest-compressions-during-sustained-inflations-in-a-perinatal-asphyxial-cardiac-arrest-lamb-model
#18
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Satyan Lakshminrusimha
OBJECTIVE: Continuous chest compressions are more effective during resuscitation in adults. Sustained inflation rapidly establishes functional residual capacity in fluid-filled lungs at birth. We sought to compare the hemodynamics and success in achieving return of spontaneous circulation in an asphyxial cardiac arrest lamb model with transitioning fetal circulation and fluid-filled lungs between subjects receiving continuous chest compressions during sustained inflation and those receiving conventional 3:1 compression-to-ventilation resuscitation...
June 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28660810/intravenous-fluid-and-electrolyte-administration-in-elective-gastrointestinal-surgery-mechanisms-of-excessive-therapy
#19
R G Simpson, J Quayle, N Stylianides, G Carlson, M Soop
INTRODUCTION While clinical guidelines stress the importance of the judicious perioperative intravenous fluid administration, data show that adherence to these protocols is poor. The reasons have not been identified. We therefore audited the magnitude and indications of fluid and electrolyte administration in a teaching hospital. We hypothesised that epidural analgesia is associated with excessive fluid therapy. MATERIALS AND METHODS Intravenous fluid and electrolyte administration during the day of surgery and the subsequent 2 days in consecutive patients undergoing elective gastrointestinal surgery between November 2013 and May 2014 were retrospectively audited...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28660335/the-ivc-contrast-level-sign
#20
REVIEW
Ho Yuen Frank Wong, Kam Ho Lee
The inferior vena cava (IVC) contrast level sign refers to a contrast-fluid level seen in the IVC on an arterial phase contrast-enhanced computed tomography (CT) scan. This sign has been documented in conditions including cardiac tamponade, myocardial infarction, and cardiac arrest. When this sign is detected, the patient requires immediate attention, with resuscitation initiated as needed, and the referring clinician alerted as soon as possible.
June 29, 2017: Abdominal Radiology
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