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https://www.readbyqxmd.com/read/27913992/c-type-natriuretic-peptide-prevents-kidney-injury-and-attenuates-oxidative-and-inflammatory-responses-in-hemorrhagic-shock
#1
Gan Chen, Xiang Song, Yujing Yin, Sha Xia, Qingjun Liu, Guoxing You, Lian Zhao, Hong Zhou
Oxidative stress induced by hemorrhagic shock (HS) initiates a systemic inflammatory response, which leads to subsequent kidney injury. This study assessed the efficacy of c-type natriuretic peptide (CNP) in attenuating kidney injury in a rat model of hemorrhagic shock and resuscitation (HS/R). Sodium pentobarbital-anesthetized adult male Wistar rats underwent HS induced by the withdrawal of blood to a mean arterial pressure of 30-35 mmHg for 50 min. Then, the animals received CNP (25 μg/kg) or vehicle (saline) intravenously, followed byresuscitation with 1...
December 2, 2016: Amino Acids
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#2
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27906869/early-and-sustained-vasopressin-infusion-augments-the-hemodynamic-efficacy-of-restrictive-fluid-resuscitation-and-improves-survival-in-a-liver-laceration-model-of-hemorrhagic-shock
#3
Raúl J Gazmuri, Kasen Whitehouse, Kruti Shah, Karla Whittinghill, Alvin Baetiong, Jeejabai Radhakrishnan
BACKGROUND: Current management of hemorrhagic shock favors restrictive fluid resuscitation before control of the bleeding source. We investigated the additional effects of early and sustained vasopressin infusion in a swine model of hemorrhagic shock produced by liver laceration. METHODS: Forty male domestic pigs (32 to 40 kg) had a liver laceration inflicted with an X-shaped blade clamp, 32 received a second laceration at minute 7.5, and 24 received two additional lacerations at minute 15...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27906705/arterial-pressure-variation-in-elective-noncardiac-surgery-identifying-reference-distributions-and-modifying-factors
#4
Michael R Mathis, Samuel A Schechtman, Milo C Engoren, Amy M Shanks, Aleda Thompson, Sachin Kheterpal, Kevin K Tremper
BACKGROUND: Assessment of need for intravascular volume resuscitation remains challenging for anesthesiologists. Dynamic waveform indices, including systolic and pulse pressure variation, are demonstrated as reliable measures of fluid responsiveness for mechanically ventilated patients. Despite widespread use, real-world reference distributions for systolic and pulse pressure variation values have not been established for euvolemic intraoperative patients. The authors sought to establish systolic and pulse pressure variation reference distributions and assess the impact of modifying factors...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27906641/time-to-cooling-is-associated-with-resuscitation-outcomes
#5
Robert B Schock, Andreas Janata, W Frank Peacock, Nathan S Deal, Sarathi Kalra, Fritz Sterz
Our purpose was to analyze evidence related to timing of cooling from studies of targeted temperature management (TTM) after return of spontaneous circulation (ROSC) after cardiac arrest and to recommend directions for future therapy optimization. We conducted a preliminary review of studies of both animals and patients treated with post-ROSC TTM and hypothesized that a more rapid cooling strategy in the absence of volume-adding cold infusions would provide improved outcomes in comparison with slower cooling...
December 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27903540/greater-volume-but-not-higher-density-of-abdominal-aortic-calcium-is-associated-with-increased-cardiovascular-disease-risk-mesa-multi-ethnic-study-of-atherosclerosis
#6
Nketi I Forbang, Erin D Michos, Robyn L McClelland, Rosemay A Remigio-Baker, Matthew A Allison, Veit Sandfort, Joachim H Ix, Isac Thomas, Dena E Rifkin, Michael H Criqui
BACKGROUND: Abdominal aortic calcium (AAC) and coronary artery calcium (CAC) independently and similarly predict cardiovascular disease (CVD) events. The standard AAC and CAC score, the Agatston method, upweights for greater calcium density, thereby modeling higher calcium density as a CVD hazard. METHODS AND RESULTS: Computed tomography scans were used to measure AAC and CAC volume and density in a multiethnic cohort of community-dwelling individuals, and Cox proportional hazard was used to determine their independent association with incident coronary heart disease (CHD, defined as myocardial infarction, resuscitated cardiac arrest, or CHD death), cardiovascular disease (CVD, defined as CHD plus stroke and stroke death), and all-cause mortality...
November 2016: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27894494/optimal-fluid-therapy-for-traumatic-hemorrhagic-shock
#7
REVIEW
Ronald Chang, John B Holcomb
The resuscitation of traumatic hemorrhagic shock has undergone a paradigm shift in the last 20 years with the advent of damage control resuscitation (DCR). Major principles of DCR include minimization of crystalloid, permissive hypotension, transfusion of a balanced ratio of blood products, and goal-directed correction of coagulopathy. In particular, plasma has replaced crystalloid as the primary means for volume expansion for traumatic hemorrhagic shock. Predicting which patient will require DCR by prompt and accurate activation of a massive transfusion protocol, however, remains a challenge...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27894390/-effects-of-different-fluid-resuscitation-program-on-renal-function-in-swine-during-shock-stage-of-severe-burn
#8
G L Su, W X Huang, J Chen, D J Xue, J J Zhou
Objective: To explore the effects of different fluid resuscitation program on renal function in swine during shock stage of severe burn. Methods: Twenty-four Guangxi Bama miniature swine were inflicted with 40% total body surface area on the back, and then they were divided into four groups according to the random number table, with 6 swine in each group. At post injury hour (PIH) 2, swine in succinylated gelatin group (S), hydroxyethyl starch group (H), and allogeneic plasma group (A) were respectively resuscitated with succinylated gelatin, hydroxyethyl starch 130/0...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27893618/early-resuscitation-with-lyophilized-plasma-provides-equal-neuroprotection-compared-with-fresh-frozen-plasma-in-a-large-animal-survival-model-of-traumatic-brain-injury-and-hemorrhagic-shock
#9
Ihab Halaweish, Ted Bambakidis, Vahagn C Nikolian, Patrick Georgoff, Peter Bruhn, Patryk Piascik, Lisa Buckley, Ashok Srinivasan, Baoling Liu, Yongqing Li, Hasan B Alam
BACKGROUND: Combined traumatic brain injury (TBI) and hemorrhagic shock (HS) is highly lethal. In previous models of combined TBI + HS, we showed that early resuscitation with fresh frozen plasma (FFP) improves neurologic outcomes. Delivering FFP, however, in austere environments is difficult. Lyophilized plasma (LP) is a logistically superior alternative to FFP, but data are limited regarding its efficacy for treatment of TBI. We conducted this study to determine the safety and long-term outcomes of early treatment with LP in a large animal model of TBI + HS...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27887820/real-time-tidal-volume-feedback-guides-optimal-ventilation-during-simulated-cardiopulmonary-resuscitation
#10
Kyoung Min You, Chiwon Lee, Woon Yong Kwon, Jung Chan Lee, Gil Joon Suh, Kyung Su Kim, Min Ji Park, Sungwan Kim
PURPOSE: We performed this study to investigate whether real-time tidal volume feedback increases optimal ventilation and decreases hyperventilation during manikin-simulated cardiopulmonary resuscitation (CPR). BASIC PROCEDURES: We developed a new real-time tidal volume monitoring device (TVD) which estimated tidal volume in real time using a magnetic flowmeter. The TVD was validated with a volume-controlled mechanical ventilator with various tidal volumes. We conducted a randomized, crossover, manikin-simulation study in which 14 participants were randomly divided into a control (without tidal volume feedback, n = 7) and a TVD group (with real-time tidal volume feedback, n = 7) and underwent manikin simulation...
November 4, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27887010/technical-note-rapid-large-volume-resuscitation-at-resuscitative-thoracotomy-by-intra-cardiac-catheterization
#11
Shamir O Cawich, Vijay Naraynsingh
An emergency thoracotomy may be life-saving by achieving four goals: (i) releasing cardiac tamponade, (ii) controlling haemorrhage, (iii) allowing access for internal cardiac massage and (iv) clamping the descending aorta to isolate circulation to the upper torso in damage control surgery. We theorize that a new goal should be achieving rapid, large-volume fluid resuscitation and we describe a technique to achieve this.
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27879559/angiotensin-ii-in-refractory-septic-shock
#12
Elio Antonucci, Patrick J Gleeson, Filippo Annoni, Sara Agosta, Sergio Orlando, Fabio Silvio Taccone, Dimitrios Velissaris, Sabino Scolletta
Refractory septic shock is defined as persistently low mean arterial blood pressure despite volume resuscitation and titrated vasopressors/inotropes in patients with a proven or suspected infection and concomitant organ dysfunction. Its management typically requires high doses of catecholamines, which can induce significant adverse effects such as ischemia and arrhythmias. Angiotensin II (Ang II), a key product of the renin-angiotensin-aldosterone system (RAAS), is a vasopressor agent that could be used in conjunction with other vasopressors to stabilize critically ill patients during refractory septic shock, and reduce catecholamine requirements...
November 21, 2016: Shock
https://www.readbyqxmd.com/read/27878801/strength-training-effects-on-quality-of-prolonged-basic-cardiopulmonary-resuscitation
#13
Cristian Abelairas-Gómez, Roberto Barcala-Furelos, Łukasz Szarpak, Óscar García-García, Álvaro Paz-Domínguez, Sergio López-García, Antonio Rodríguez-Núñez
BACKGROUND: Providing high-quality chest compressions and rescue breaths are a key elements affecting the effectiveness of cardiopulmonary resuscitation (CPR). AIM: To investigate the effects of a strength training program on the quality of prolonged in time basic cardiopulmonary resuscitation on a manikin. METHODS: This was a quasi-experimental.trial. Thirty-nine participants with prior basic life support knowledge were randomized to an experimental or control group...
November 23, 2016: Kardiologia Polska
https://www.readbyqxmd.com/read/27873263/effects-of-volume-resuscitation-on-the-microcirculation-in-animal-models-of-lipopolysaccharide-sepsis-a-systematic-review
#14
REVIEW
Nchafatso G Obonyo, Jonathon P Fanning, Angela S Y Ng, Leticia P Pimenta, Kiran Shekar, David G Platts, Kathryn Maitland, John F Fraser
BACKGROUND: Recent research has identified an increased rate of mortality associated with fluid bolus therapy for severe sepsis and septic shock, but the mechanisms are still not well understood. Fluid resuscitation therapy administered for sepsis and septic shock targets restoration of the macro-circulation, but the pathogenesis of sepsis is complex and includes microcirculatory dysfunction. OBJECTIVE: The objective of the study is to systematically review data comparing the effects of different types of fluid resuscitation on the microcirculation in clinically relevant animal models of lipopolysaccharide-induced sepsis...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27869558/polynitroxylated-pegylated-hemoglobin-a-novel-small-volume-therapeutic-for-traumatic-brain-injury-resuscitation-comparison-to-whole-blood-and-dose-response-evaluation
#15
Erik C Brockman, Travis C Jackson, C Edward Dixon, Hulya Bayir, Robert Clark, Vincent A Vagni, Keri L Janesko, Catherine Byrd, Li Ma, Carleton J C Hsia, Patrick M Kochanek
: Resuscitation with polynitroxylated pegylated hemoglobin (PNPH), a PEGylated bovine hemoglobin decorated with nitroxides, eliminated the need for fluid administration, reduced ICP and brain edema, and produced neuroprotection in vitro and in vivo vs. lactated Ringer's (LR) in experimental traumatic brain injury (TBI) plus hemorrhagic shock (HS). HYPOTHESIS: Resuscitation with PNPH will improve acute physiology vs. whole blood after TBI+HS and will be safe and effective across a wide dosage range...
November 21, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27849901/259-use-of-circulating-blood-volume-measurements-may-impact-mortality-in-early-shock-resuscitation
#16
Ellie Cohen, David Inouye, Michael Hayashi, Jonathan Praeger, Scott Harvey, Danny Takanishi, Christina Minami, Mihae Yu
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27828823/hold-the-pendulum-rates-of-acute-kidney-injury-are-increased-in-patients-who-receive-resuscitation-volumes-less-than-predicted-by-the-parkland-equation
#17
Stephanie A Mason, Avery B Nathens, Celeste C Finnerty, Richard L Gamelli, Nicole S Gibran, Brett D Arnoldo, Ronald G Tompkins, David N Herndon, Marc G Jeschke
OBJECTIVE: To determine whether restrictive fluid resuscitation results in increased rates of acute kidney injury (AKI) or infectious complications. BACKGROUND: Studies demonstrate that patients often receive volumes in excess of those predicted by the Parkland equation, with potentially detrimental sequelae. However, the consequences of under-resuscitation are not well-studied. METHODS: Data were collected from a multicenter prospective cohort study...
December 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27823892/practical-considerations-in-sepsis-resuscitation
#18
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/27822741/isolated-brain-trauma-in-cats-triggers-rapid-onset-of-hypovolemia
#19
Peter Bentzer, Per-Olof Grände
BACKGROUND: Hemodynamic instability responsive to fluid resuscitation is common after a traumatic brain injury (TBI), also in the absence of systemic hemorrhage. The present study tests if an isolated severe TBI induces a decrease in plasma volume (PV). METHODS: The study was performed in three groups of anesthetized and tracheostomized male cats (n = 21). In one group (n = 8), the cats were prepared with a cranial borehole (10 mm i.d) used to expose the brain to a fluid percussion brain injury (FPI) (1...
November 7, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27820718/mannose-binding-lectin-levels-in-critically-ill-children-with-severe-infections
#20
Erik C Madsen, Emily R Levy, Kate Madden, Anna A Agan, Ryan M Sullivan, Dionne A Graham, Adrienne G Randolph
OBJECTIVES: Low mannose-binding lectin levels and haplotypes associated with low mannose-binding lectin production have been associated with infection and severe sepsis. We tested the hypothesis that mannose-binding lectin levels would be associated with severe infection in a large cohort of critically ill children. DESIGN: Prospective cohort study. SETTING: Medical and Surgical PICUs, Boston Children's Hospital. PATIENTS: Children less than 21 years old admitted to the ICUs from November 2009 to November 2010...
November 3, 2016: Pediatric Critical Care Medicine
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