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https://www.readbyqxmd.com/read/28210935/the-effect-of-fluid-resuscitation-on-the-effective-circulating-volume-in-patients-undergoing-liver-surgery-a-post-hoc-analysis-of-a-randomized-controlled-trial
#1
Jaap Jan Vos, A F Kalmar, H G D Hendriks, J Bakker, T W L Scheeren
To assess the significance of an analogue of the mean systemic filling pressure (Pmsa) and its derived variables, in providing a physiology based discrimination between responders and non-responders to fluid resuscitation during liver surgery. A post-hoc analysis of data from 30 patients undergoing major hepatic surgery was performed. Patients received 15 ml kg(-1) fluid in 30 min. Fluid responsiveness (FR) was defined as an increase of 20% or greater in cardiac index, measured by FloTrac-Vigileo(®). Dynamic preload variables (pulse pressure variation and stroke volume variation: PPV, SVV) were recorded additionally...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28187154/comparison-of-different-inspiratory-triggering-settings-in-automated-ventilators-during-cardiopulmonary-resuscitation-in-a-porcine-model
#2
Dingyu Tan, Jun Xu, Shihuan Shao, Yangyang Fu, Feng Sun, Yazhi Zhang, Yingying Hu, Joseph Walline, Huadong Zhu, Xuezhong Yu
BACKGROUND: Mechanical ventilation via automated in-hospital ventilators is quite common during cardiopulmonary resuscitation. It is not known whether different inspiratory triggering sensitivity settings of ordinary ventilators have different effects on actual ventilation, gas exchange and hemodynamics during resuscitation. METHODS: 18 pigs enrolled in this study were anaesthetized and intubated. Continuous chest compressions and mechanical ventilation (volume-controlled mode, 100% O2, respiratory rate 10/min, and tidal volumes 10ml/kg) were performed after 3 minutes of ventricular fibrillation...
2017: PloS One
https://www.readbyqxmd.com/read/28180126/providing-a-placental-transfusion-in-newborns-who-need-resuscitation
#3
REVIEW
Anup C Katheria, Melissa K Brown, Wade Rich, Kathy Arnell
Over the past decade, there have been several studies and reviews on the importance of providing a placental transfusion to the newborn. Allowing a placental transfusion to occur by delaying the clamping of the umbilical cord is an extremely effective method of enhancing arterial oxygen content, increasing cardiac output, and improving oxygen delivery. However, premature and term newborns who require resuscitation have impaired transitional hemodynamics and may warrant different methods to actively provide a placental transfusion while still allowing for resuscitation...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28166165/automated-variable-aortic-control-vs-complete-aortic-occlusion-in-a-swine-model-of-hemorrhage
#4
Timothy K Williams, Lucas P Neff, M Austin Johnson, Rachel M Russo, Sarah-Ashley Ferencz, Anders J Davidson, Nathan F Clement, J Kevin Grayson, Todd E Rasmussen
BACKGROUND: Future endovascular hemorrhage control devices will require features that mitigate the adverse effects of vessel occlusion. Permissive regional hypoperfusion (PRH) with variable aortic control (VAC) is a novel strategy to minimize hemorrhage and reduce the ischemic burden of complete aortic occlusion (AO). The objective of this study was to compare PRH with VAC to AO in a lethal model of hemorrhage. METHODS: Twenty-five swine underwent cannulation of the supraceliac aorta, with diversion of aortic flow through an automated extracorporeal circuit...
February 4, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28159434/-and-if-it-happened-to-children-adapting-medical-care-during-terrorist-attacks-with-multiple-pediatric-victims
#5
L Alix-Séguin, N Lodé, G Orliaguet, E Chamorro, F Kerroué, C Lorge, A Moreira
In light of the recent terrorist attacks in Europe, we need to reconsider the organization of rescue and medical management and plan for an attack involving multiple pediatric victims. To ensure quick surgical management, but also to minimize risk for on-site teams (direct threats from secondary terrorist attacks targeting deployed emergency services), it is crucial to evacuate patients in a swift but orderly fashion. Children are vulnerable targets in terrorist attacks. Their anatomical and physiological characteristics make it likely that pediatric victims will suffer more brain injuries and require more, often advanced, airway management...
January 31, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28159011/fluids-and-sepsis-changing-the-paradigm-of-fluid-therapy-a-case-report
#6
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/28150304/effects-of-fluid-restriction-on-measures-of-circulatory-efficacy-in-adults-with-septic-shock
#7
P B Hjortrup, N Haase, J Wetterslev, T Lange, H Bundgaard, B S Rasmussen, N Dey, E Wilkman, L Christensen, D Lodahl, M Bestle, A Perner
BACKGROUND: The haemodynamic consequences of fluid resuscitation in septic shock have not been fully elucidated. Therefore, we assessed circulatory effects in the first 24 h of restriction of resuscitation fluid as compared to standard care in intensive care unit (ICU) patients with septic shock. METHODS: This was a post-hoc analysis of the multicentre CLASSIC randomised trial in which patients with septic shock, who had received the initial fluid resuscitation, were randomised to a protocol restricting resuscitation fluid or a standard care protocol in nine ICUs...
February 1, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28140438/the-comparison-of-humeral-intraosseous-and-intravenous-administration-of-vasopressin-on-return-of-spontaneous-circulation-and-pharmacokinetics-in-a-hypovolemic-cardiac-arrest-swine-model
#8
Mark H Wimmer, Kenneth Heffner, Michael Smithers, Richard Culley, Jennifer Coyner, Michael Loughren, Don Johnson
INTRODUCTION: The American Heart Association (AHA) recommends intravenous (IV) or intraosseous (IO) vasopressin in Advanced Cardiac Life Support (ACLS). Obtaining IV access in hypovolemic cardiac arrest patients can be difficult, and IO access is often obtained in these life threatening situations. No studies have been conducted to determine the effects of humeral IO (HIO) access with vasopressin in the return of spontaneous circulation (ROSC). Our study compared the kinetics of vasopressin and ROSC with HIO with IV access in the hypovolemic swine model...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28137537/randomized-controlled-trial-evaluating-the-efficacy-of-peritoneal-resuscitation-in-the-management-of-trauma-patients-undergoing-damage-control-surgery
#9
Jason W Smith, Paul J Matheson, Glen A Franklin, Brian G Harbrecht, J David Richardson, R Neal Garrison
BACKGROUND: Peritoneal resuscitation (PR) represents a unique modality of treatment for severely injured trauma patients requiring damage control surgery (DCS). These data represent the outcome of a single institution RCT into the efficacy of PR as a management option in these patients. STUDY DESIGN: From 2011-2015, 103 patients were enrolled in a prospective RCT evaluating the utility of PR in the treatment of patients undergoing DCS compared to conventional resuscitation (CR) alone...
January 27, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28132006/ultrasound-and-nicom-in-the-assessment-of-fluid-responsiveness-in-patients-with-mild-sepsis-in-the-emergency-department-a-pilot-study
#10
Martha Oord, Tycho J Olgers, Mirjam Doff-Holman, Mark P M Harms, Jack J M Ligtenberg, Jan C Ter Maaten
OBJECTIVE: We investigated whether combining the caval index, assessment of the global contractility of the heart and measurement of stroke volume with Noninvasive Cardiac Output Monitoring (NICOM) can aid in fluid management in the emergency department (ED) in patients with sepsis. SETTING: A prospective observational single-centre pilot study in a tertiary care centre. PRIMARY AND SECONDARY OUTCOMES: Ultrasound was used to assess the caval index, heart contractility and presence of B-lines in the lungs...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28130687/fluid-administration-in-severe-sepsis-and-septic-shock-patterns-and-outcomes-an-analysis-of-a-large-national-database
#11
Paul E Marik, Walter T Linde-Zwirble, Edward A Bittner, Jennifer Sahatjian, Douglas Hansell
PURPOSE: The optimal strategy of fluid resuscitation in the early hours of severe sepsis and septic shock is controversial, with both an aggressive and conservative approach being recommended. METHODS: We used the 2013 Premier Hospital Discharge database to analyse the administration of fluids on the first ICU day, in 23,513 patients with severe sepsis and septic shock, who were admitted to an ICU from the emergency department. Day 1 fluid was grouped into categories 1 L wide, starting with 1-1...
January 27, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28129711/the-effect-of-ppolyhb-on-hemodynamic-stability-and-mesenteric-microcirculation-in-a-rat-model-of-hemorrhagic-shock
#12
Jing Zhao, Chengbin Yan, Lijuan Xu, Kunping Yan, Bao Feng, Mengye Zhao, Geng Niu, Mengdi Wu, Chao Chen, Hongli Zhu
The effects of polymerized porcine hemoglobin (pPolyHb) on hemodynamic stability and maintenance of mesenteric microvascular function were explored in a rat model of hemorrhagic shock (HS). Following controlled hemorrhage, rats were infused with equal volumes of either pPolyHb, hetastarch (HES), or red blood cell (RBC). The results showed that pPolyHb was superior to HES and RBC in restoring hemodynamic stability and reversing anaerobic metabolism. We observed a reduction in the diameter of mesenteric microvasculature after HS...
January 27, 2017: Artificial Cells, Nanomedicine, and Biotechnology
https://www.readbyqxmd.com/read/28127476/vasopressin-bolus-protocol-compared-to-desmopressin-ddavp-for-managing-acute-postoperative-central-diabetes-insipidus-and-hypovolemic-shock
#13
Anukrati Shukla, Syeda Alqadri, Ashley Ausmus, Robert Bell, Premkumar Nattanmai, Christopher R Newey
Introduction. Management of postoperative central diabetes insipidus (DI) can be challenging from changes in volume status and serum sodium levels. We report a case successfully using a dilute vasopressin bolus protocol in managing hypovolemic shock in acute, postoperative, central DI. Case Report. Patient presented after bifrontal decompressive craniotomy for severe traumatic brain injury. He developed increased urine output resulting in hypovolemia and hypernatremia. He was resuscitated with intravenous fluids including a dilute vasopressin bolus protocol...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28118641/effects-of-breathing-and-apnoea-during-sustained-inflations-in-resuscitation-of-preterm-infants
#14
Gianluca Lista, Francesco Cavigioli, Paola Azzurra La Verde, Francesca Castoldi, Ilia Bresesti, Colin J Morley
BACKGROUND: A sustained inflation (SI) at birth in preterm babies may be ineffective unless the infants breathe. Gain in lung volume is associated with breathing during delivery room non-invasive management. OBJECTIVE: To describe the breathing patterns of preterm infants during an SI and correlate to a calculated gain in lung volume. METHODS: Retrospective observational study. Data collected from a respiratory function monitor during SI (25 cmH2O for 15 s then PEEP at 5 cmH2O) through a face mask in preterm infants (gestational age [GA] ≤31 weeks)...
January 25, 2017: Neonatology
https://www.readbyqxmd.com/read/28117180/the-role-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-as-an-adjunct-to-acls-in-non-traumatic-cardiac-arrest-a-review-of-key-concepts-physiology-current-evidence-and-future-directions
#15
James Daley, Jonathan James Morrison, John Sather, Lisa Hile
Non-traumatic cardiac arrest is a major public health problem that carries an extremely high mortality rate. If we hope to increase the survivability of this condition, it is imperative that alternative methods of treatment are given due consideration. Balloon occlusion of the aorta can be used as a method of circulatory support in the critically ill patient. Intra-aortic balloon pumps have been used to temporize patients in cardiogenic shock for decades. More recently, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been utilized in the patient in hemorrhagic shock or cardiac arrest secondary to trauma...
January 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28116931/-at-what-age-can-children-perform-effective-cardiopulmonary-resuscitation-effectiveness-of-cardiopulmonary-resuscitation-skills-among-primary-school-children
#16
Bálint Bánfai, Attila Pandur, Emese Pék, Henrietta Csonka, József Betlehem
INTRODUCTION: In cardiac arrest life can be saved by bystanders. AIM: Our aim was to determine at what age can schoolchildren perform correct cardiopulmonary resuscitation. METHOD: 164 schoolchildren (age 7-14) were involved in the study. A basic life support training consisted of 45 minutes education in small groups (8-10 children). They were tested during a 2-minute-long continuous cardiopulmonary resuscitation scenario using the "AMBU CPR Software"...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28112798/multidisciplinary-perioperative-protocol-in-patients-undergoing-acute-high-risk-abdominal-surgery
#17
L T Tengberg, M Bay-Nielsen, T Bisgaard, M Cihoric, M L Lauritsen, N B Foss
BACKGROUND: Acute high-risk abdominal (AHA) surgery carries a very high risk of morbidity and mortality and represents a massive healthcare burden. The aim of the present study was to evaluate the effect of a standardized multidisciplinary perioperative protocol in patients undergoing AHA surgery. METHODS: The AHA study was a prospective single-centre controlled study in consecutive patients undergoing AHA surgery, defined as major abdominal pathology requiring emergency laparotomy or laparoscopy including reoperations after elective gastrointestinal surgery...
January 23, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28096577/the-effect-of-atrial-natriuretic-peptide-infusion-on-intestinal-injury-in-septic-shock
#18
Ghada F Elbaradey, Nagat Sayed Elshmaa, Hossam Hodeib
BACKGROUND AND AIMS: The aim of this study is to assess the effect of atrial natriuretic peptide (ANP) on intestinal ischemia-reperfusion injury in septic shock. MATERIAL AND METHODS: A prospective randomized controlled, observer-blinded study was carried out in surgical Intensive Care Unit (ICU), University Hospital. Forty adult patients in septic shock were randomly divided into two groups, control group (Group C) received normal saline and ANP group (Group A) patients received ANP in the form of 1...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28088009/cardiac-output-and-systemic-vascular-resistance-clinical-assessment-compared-with-a-noninvasive-objective-measurement-in-children-with-shock
#19
Asma Razavi, Christopher J L Newth, Robinder G Khemani, Fernando Beltramo, Patrick A Ross
PURPOSE: To evaluate physician assessment of cardiac output and systemic vascular resistance in patients with shock compared with an ultrasonic cardiac output monitor (USCOM). To explore potential changes in therapy decisions if USCOM data were available using physician intervention answers. STUDY DESIGN: Double-blinded, prospective, observational study in a tertiary hospital pediatric intensive care unit. Forty children (<18years) admitted with shock, requiring ongoing volume resuscitation or inotropic support...
December 28, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28087117/erythropoietin-attenuates-experimental-haemorrhagic-shock-induced-renal-damage-through-an-inos-dependent-mechanism-in-male-wistar-rats
#20
M Ranjbaran, M Kadkhodaee, B Seifi, M Adelipour, B Azarian
AIM: Erythropoietin (EPO) is shown to exert protective effects on different tissues in haemorrhagic shock (HS) states. Nitric oxide (NO), as a multifunctional signaling molecule, is implicated in diverse physiologic and pathologic processes. In order to understand the exact mechanism of EPO protection, in this study we evaluated the role of different NOS enzymes in the EPO signaling pathway in male rats. METHODS: Rats were randomized to five groups: 1) Sham, 2) HS 3) EPO 4) L-NAME, a non-specific NOS inhibitor 5) 1400W, a specific iNOS inhibitor...
February 2017: Injury
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