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https://www.readbyqxmd.com/read/28719636/the-non-diuretic-hypotensive-effects-of-thiazides-are-enhanced-during-volume-depletion-states
#1
Saeed Alshahrani, Robert M Rapoport, Kamyar Zahedi, Min Jiang, Michelle Nieman, Sharon Barone, Andrea L Meredith, John N Lorenz, Jack Rubinstein, Manoocher Soleimani
Thiazide derivatives including Hydrochlorothiazide (HCTZ) represent the most common treatment of mild to moderate hypertension. Thiazides initially enhance diuresis via inhibition of the kidney Na+-Cl- Cotransporter (NCC). However, chronic volume depletion and diuresis are minimal while lowered blood pressure (BP) is maintained on thiazides. Thus, a vasodilator action of thiazides is proposed, likely via Ca2+-activated K+ (BK) channels in vascular smooth muscles. This study ascertains the role of volume depletion induced by salt restriction or salt wasting in NCC KO mice on the non-diuretic hypotensive action of HCTZ...
2017: PloS One
https://www.readbyqxmd.com/read/28715125/acute-alcohol-binge-deteriorates-metabolic-and-respiratory-compensation-capability-after-blunt-chest-trauma-followed-by-hemorrhagic-shock-a-new-research-model
#2
Nils Wagner, Niklas Franz, Scott Dieteren, Mario Perl, Katharina Mörs, Ingo Marzi, Borna Relja
BACKGROUND AND PURPOSE: The clinical relevance of blunt (thoracic) chest trauma (TxT) and hemorrhagic shock is indisputable due to the high prevalence of this injury type, as well as its close association with mortality and/or preventable deaths. Furthermore, there is an ongoing discussion about the influence of alcohol in trauma patients. Thus, we established a model of TxT followed by hemorrhagic shock and resuscitation (H/R) in alcohol-intoxicated rats. EXPERIMENTAL APPROACH: Depending on group allocation, twelve (sub-acute) or two (acute) hours before experimentation, the animals received a single oral dose of alcohol (ethanol, EtOH) or saline (NaCl) followed by TxT, hemorrhagic shock (35 ± 3 mm Hg) and resuscitation (TxT+H/R)...
July 17, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28711077/acute-kidney-injury-in-pregnancy
#3
Belinda Jim, Vesna D Garovic
Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28709157/hypotensive-resuscitation-with-hypertonic-saline-dextran-improves-survival-in-a-rat-model-of-hemorrhagic-shock-at-high-altitude
#4
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
#5
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
#6
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/28701647/the-case-of-a-14-year-old-boy-who-experienced-anaphylaxis-due-to-jellyfish-mastigias-papua-ingestion
#7
Shohei Kubota, Asako Nozawa, Takanori Yanai, Koji Ozasa, Satomi Mori, Kazuyuki Kurihara
We report a case of jellyfish allergy diagnosed via an oral food challenge. A 14-year-old boy had no history of jellyfish stings and had been eating commercially available jellyfish products twice yearly for the past 5-6 years. Five minutes after eating a commercially available boiled jellyfish product (100g), he experienced nausea, wheezing, and erythema and had visited our hospital. We suspected an anaphylactic reaction and treated him with intramuscular adrenaline injection, corticosteroid and antihistamine infusions, volume resuscitation, and salbutamol sulfate inhalation, which resulted in an improvement of the symptoms...
2017: Arerugī, [Allergy]
https://www.readbyqxmd.com/read/28700408/three-versus-four-factor-prothrombin-complex-concentrates-for-factor-based-resuscitation-in-a-porcine-hemorrhagic-shock-model
#8
Donald Michael Moe, Michael Scott Lallemand, John Mason McClellan, Joshua Porter Smith, Shannon T Marko, Matthew J Eckert, Matthew J Martin
BACKGROUND: Bleeding is a leading cause of preventable death following severe injury. Prothrombin complex concentrates (PCC) treat inborn coagulation disorders and reverse oral anticoagulants, but are proposed for use in "factor-based" resuscitation strategies. Few studies exist for this indication in acidosis, or that compare 3-factor (3PCC) versus 4-factor (4PCC) products. We aimed to assess and compare their safety and efficacy in a porcine model of severe hemorrhagic shock and coagulopathy...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697023/clot-dynamics-and-mortality-the-ma-r-ratio
#9
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing TEG to identify those at risk for subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697014/valproic-acid-decreases-brain-lesion-size-and-improves-neurologic-recovery-in-swine-subjected-to-traumatic-brain-injury-hemorrhagic-shock-and-polytrauma
#10
Vahagn C Nikolian, Patrick E Georgoff, Manjunath P Pai, Isabel S Dehaney, Kiril Chtraklin, Hassan Eidy, Mohamed Ghandour, Yanyan Han, Ashok Srinivasan, Yongqing Li, Hasan B Alam
BACKGROUND: We have previously shown that treatment with valproic acid (VPA) decreases brain lesion size in swine models of traumatic brain injury (TBI) and controlled hemorrhage. To translate this treatment into clinical practice, validation of drug efficacy and evaluation of pharmacologic properties in clinically realistic models of injury are necessary. In this study, we evaluate neurologic outcomes and perform pharmacokinetic analysis of a single dose of VPA in swine subjected to TBI, hemorrhagic shock, and visceral hemorrhage...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697004/experimental-models-of-endotheliopathy-impact-of-shock-severity
#11
Nikolaus Hofmann, Johannes Zipperle, Mohammad Jafarmadar, Mostafa Ashmwe, Claudia Keibl, Carina Penzenstadler, Martin Ponschab, Behnaz Jafarmadar, Heinz Redl, Soheyl Bahrami, Herbert Schöchl
BACKGROUND: Hemorrhagic shock (HS) followed by resuscitation is often associated with sympatho-adrenal activation (SAA) and endothelial damage (ED). OBJECTIVE: We aimed to a) evaluate the impact of HS alone on the magnitude of SAA and consecutive ED and b) characterize potential targets for a standardized and reproducible model of HS-induced endotheliopathy in rats. METHODS: Rats were subjected to either a volume controlled HS (40% of total blood volume: v-HS group) or to a lab guided HS (l-HS) targeting base deficit (BD) >5...
July 10, 2017: Shock
https://www.readbyqxmd.com/read/28688660/impact-of-tranexamic-acid-on-coagulation-and-inflammation-in-murine-models-of-traumatic-brain-injury-and-hemorrhage
#12
Ryan M Boudreau, Mark Johnson, Rosalie Veile, Lou Ann Friend, Holly Goetzman, Timothy A Pritts, Charles C Caldwell, Amy T Makley, Michael D Goodman
BACKGROUND: Posttraumatic coagulopathy and inflammation can exacerbate secondary cerebral damage after traumatic brain injury (TBI). Tranexamic acid (TXA) has been shown clinically to reduce mortality in hemorrhaging and head-injured trauma patients and has the potential to mitigate secondary brain injury with its reported antifibrinolytic and antiinflammatory properties. We hypothesized that TXA would improve posttraumatic coagulation and inflammation in a murine model of TBI alone and in a combined injury model of TBI and hemorrhage (TBI/H)...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28685540/impact-of-low-energy-shock-impulse-on-nitric-oxide-serum-levels-in-healthy-rabbits
#13
W Żurawiński, K Sosada, M Muc-Wierzgoń, T Kokot
Nitric oxide (NO) has emerged as a potent effector molecule for a post-resuscitation disease as a result of the low-energy defibrillation. In this article, the authors anlysed the changes of endogenous nitric oxide levels in serum of 35 healthy rabbits after the transthoracic application of low-energy two-phase shock impulse. The animals were randomised into four groups according to the electrical energy dose to be applied during the experiment. Life parameters of the animals were monitored using the BeneViev T5 patient monitor...
April 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28685447/diet-induced-ketosis-protects-against-focal-cerebral-ischemia-in-mouse
#14
Kui Xu, Lena Ye, Katyayini Sharma, Yongming Jin, Matthew M Harrison, Tylor Caldwell, Jessica M Berthiaume, Yu Luo, Joseph C LaManna, Michelle A Puchowicz
Over the past decade we have consistently shown that ketosis is neuroprotective against ischemic insults in rats. We reported that diet-induced ketotic rats had a significant reduction in infarct volume when subjected to middle cerebral artery occlusion (MCAO), and improved survival and recovery after cardiac arrest and resuscitation. The neuroprotective mechanisms of ketosis (via ketogenic diet; KG) include (i) ketones are alternate energy substrates that can restore energy balance when glucose metabolism is deficient and (ii) ketones modulate cell-signalling pathways that are cytoprotective...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28683810/effect-of-dextran-70-on-outcome-in-severe-sepsis-a-propensity-score-matching-study
#15
Peter Bentzer, Marcus Broman, Thomas Kander
BACKGROUND: Albumin may be beneficial in patients with septic shock but availability is limited and cost is high. The objective of the present study was to investigate if the use of dextran-70 in addition to albumin and crystalloids influences organ failure or mortality in patients with severe sepsis or septic shock. METHODS: Patients with severe sepsis or septic shock (n = 778) admitted to a university hospital intensive care unit (ICU) between 2007 and 2015 that received dextran-70 during resuscitation were propensity score matched to controls at a 1 to 1 ratio...
July 6, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28682946/cerebral-alterations-following-experimental-multiple-trauma-and-hemorrhagic-shock
#16
Nina Vogt, Christiane Herden, Elke Roeb, Martin Roderfeld, Daphne Eschbach, Thorsten Steinfeldt, Hinnerk Wulf, Steffen Ruchholtz, Eberhard Uhl, Karsten Schöller
Multiple trauma (MT) associated with hemorrhagic shock (HS) might lead to cerebral hypoperfusion and brain damage. We investigated cerebral alterations using a new porcine MT/HS model without traumatic brain injury (TBI) and assessed the neuroprotective properties of mild therapeutic hypothermia. Male pigs underwent standardized MT with HS (45% or 50% loss of blood volume) and resuscitation after 90/120 minutes (T90/T120). In additional groups (TH90/TH120) mild hypothermia (33°C) was induced following resuscitation...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28682943/remote-ischemic-post-conditioning-improves-myocardial-dysfunction-via-the-risk-and-safe-pathways-in-a-rat-model-of-severe-hemorrhagic-shock
#17
Jianrong Huang, Dawei Xu, Qinyue Guo, Bing Ou, Qin Ling, Jianhua Li, Zhengfei Yang, Wanchun Tang
INTRODUCTION: Patients who have been resuscitated after severe hemorrhagic shock still have a high mortality rate. Previously published literature has suggested that remote ischemic postconditioning (RIPostC) has a cardioprotective effect, but few studies have focused on RIPostC performed after severe hemorrhagic shock. In this study, we aim to explore the effects and mechanism of RIPostC on myocardial ischemia and reperfusion injuries after hemorrhagic shock. METHODS: Fifty male rats were randomized into four groups: Sham, Control, RIPerC (remote ischemic per-conditioning) and RIPostC...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28682903/acute-abrin-poisoning-treated-with-continuous-renal-replacement-therapy-and-hemoperfusion-successfully-a-case-report
#18
Jiliang Huang, Wenbin Zhang, Xin Li, Shufen Feng, Gang Ye, Hongcheng Wei, Xiaobing Gong
RATIONALE: Abrin is a highly toxic protein obtained from the seeds of Abrus precatorius, but poisoning due to ingestion of A precatorius is extremely rare in China. PATIENT CONCERNS: A 16-year-old girl, perfectly healthy before, was admitted to the department of gastroenterology owing to intentional ingestion of 10 crushed A precatorius seeds, with multiple episodes of somnolent and anxious mental status, vomiting, abdominal pain, diarrhea, hematochezia, and hematuria...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28682837/closed-loop-and-decision-assist-guided-fluid-therapy-of-human-hemorrhage
#19
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/28675548/neopuff-t-piece-resuscitator-mask-ventilation-does-mask-leak-vary-with-different-peak-inspiratory-pressures-in-a-manikin-model
#20
Rajesh Maheshwari, Mark Tracy, Murray Hinder, Audrey Wright
AIM: The aim of this study was to compare mask leak with three different peak inspiratory pressure (PIP) settings during T-piece resuscitator (TPR; Neopuff) mask ventilation on a neonatal manikin model. METHODS: Participants were neonatal unit staff members. They were instructed to provide mask ventilation with a TPR with three PIP settings (20, 30, 40 cm H2 O) chosen in a random order. Each episode was for 2 min with 2-min rest period. Flow rate and positive end-expiratory pressure (PEEP) were kept constant...
July 4, 2017: Journal of Paediatrics and Child Health
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