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Fluid in sepsis

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https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#1
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29774734/something-to-drink-a-personalized-approach-to-fluids-in-sepsis
#2
Elio Antonucci
No abstract text is available yet for this article.
May 15, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29773561/postnatal-brain-growth-assessed-by-sequential-cranial-ultrasonography-in-infants-born-30-weeks-gestational-age
#3
R Cuzzilla, A J Spittle, K J Lee, S Rogerson, F M Cowan, L W Doyle, J L Y Cheong
BACKGROUND AND PURPOSE: Brain growth in the early postnatal period following preterm birth has not been well described. This study of infants born at <30 weeks' gestational age and without major brain injury aimed to accomplish the following: 1) assess the reproducibility of linear measures made from cranial ultrasonography, 2) evaluate brain growth using sequential cranial ultrasonography linear measures from birth to term-equivalent age, and 3) explore perinatal predictors of postnatal brain growth...
May 17, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29771701/dynamic-contrast-enhanced-ultrasound-identifies-microcirculatory-alterations-in-sepsis-induced-acute-kidney-injury
#4
Alexandre Lima, Tom van Rooij, Bulent Ergin, Michele Sorelli, Yasin Ince, Patricia A C Specht, Egbert G Mik, Leonardo Bocchi, Klazina Kooiman, Nico de Jong, Can Ince
OBJECTIVES: We developed quantitative methods to analyze microbubble kinetics based on renal contrast-enhanced ultrasound imaging combined with measurements of sublingual microcirculation on a fixed area to quantify early microvascular alterations in sepsis-induced acute kidney injury. DESIGN: Prospective controlled animal experiment study. SETTING: Hospital-affiliated animal research institution. SUBJECTS: Fifteen female pigs...
May 15, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#5
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29762033/isolation-synthesis-and-antisepsis-effects-of-a-c-methylcoumarinochromone-isolated-from-abronia-nana-cell-culture
#6
Wonhwa Lee, Doohyun Lee, Yuri Lee, Taeho Lee, Kyung-Sik Song, Eun-Ju Yang, Jong-Sup Bae
Only a few isoflavones have been isolated from plants of the genus Abronia. The biological properties of compounds isolated from Abronia species have not been well established, and their antisepsis effects have not been reported yet. In the present study, a new C-methylcoumarinochromone, was isolated from Abronia nana suspension cultures. Its structure was deduced as 9,11-dihydroxy-10-methylcoumarinochromone (boeravinone Y, 1) by spectroscopic data analysis and verified by chemical synthesis. The potential inhibitory effects of 1 against high mobility group box 1 (HMGB1)-mediated septic responses were investigated...
May 15, 2018: Journal of Natural Products
https://www.readbyqxmd.com/read/29756282/acute-arthritis-predictive-factors-and-current-practice-in-the-approach-to-diagnosis-and-management-across-two-hospitals-in-sydney
#7
Katrina Pavic, Jay Pandya, Sophie Sebak, Amith Shetty, David Spencer, N Nicholas Manolios
BACKGROUND: Literature pertaining to the predictive factors for septic arthritis is limited. AIMS: The primary objective was to investigate the predictive factors for septic arthritis. The secondary objectives were to investigate the predictive factors for crystal arthritis and to explore current practises in the management of acute arthritis. METHODS: A retrospective analysis was undertaken. All patients with an acute arthritis who underwent a joint aspiration for diagnostic and management purposes were considered for inclusion...
May 14, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29753517/liberal-versus-restrictive-intravenous-fluid-therapy-for-early-septic-shock-rationale-for-a-randomized-trial
#8
Wesley H Self, Matthew W Semler, Rinaldo Bellomo, Samuel M Brown, Bennett P deBoisblanc, Matthew C Exline, Adit A Ginde, Colin K Grissom, David R Janz, Alan E Jones, Kathleen D Liu, Stephen P J Macdonald, Chadwick D Miller, Pauline K Park, Lora A Reineck, Todd W Rice, Jay S Steingrub, Daniel Talmor, Donald M Yealy, Ivor S Douglas, Nathan I Shapiro
Prompt intravenous fluid therapy is a fundamental treatment for patients with septic shock. However, the optimal approach for administering intravenous fluid in septic shock resuscitation is unknown. Two competing strategies are emerging: a liberal fluids approach, consisting of a larger volume of initial fluid (50 to 75 mL/kg [4 to 6 L in an 80-kg adult] during the first 6 hours) and later use of vasopressors, versus a restrictive fluids approach, consisting of a smaller volume of initial fluid (≤30 mL/kg [≤2 to 3 L]), with earlier reliance on vasopressor infusions to maintain blood pressure and perfusion...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#9
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29740065/comparison-of-first-line-and-second-line-terlipressin-versus-sole-norepinephrine-in-fulminant-ovine-septic-shock
#10
Tim G Kampmeier, Philip H Arnemann, Michael Hessler, Laura M Seidel, Karsten Becker, Andrea Morelli, Sebastian W Rehberg, Christian Ertmer
The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V1 -selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study explored and compared the effects of first-line vs. second-line infusion of TP or sole norepinephrine regarding organ function, fluid and norepinephrine requirements and survival in fulminant ovine septic shock. Peritoneal sepsis was induced in 23 ewes after laparotomy and faecal withdrawal from the caecum...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29736287/acute-parotitis-after-lower-limb-amputation-a-case-report-of-a-rare-complication
#11
Konstantinos Ioannis Avgerinos, Nikolaos Degermetzoglou, Sofia Theofanidou, Georgia Kritikou, Ioannis Bountouris
Background: Postoperative parotitis is a rare complication that occurs usually after abdominal surgery. Parotitis has never been described as a complication of vascular operations, in literature. In the present article, we describe a case of a postamputation parotitis along with its management and its possible pathogenesis. Case Report: An 83-year-old diabetic man was emergently admitted to hospital because of gangrene below the right ankle and sepsis. The patient underwent a lower limb amputation above the knee...
2018: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/29724246/haemoglobin-concentration-and-volume-of-intravenous-fluids-in-septic-shock-in-the-arise-trial
#12
Matthew J Maiden, Mark E Finnis, Sandra Peake, Simon McRae, Anthony Delaney, Michael Bailey, Rinaldo Bellomo
BACKGROUND: Intravenous fluids may contribute to lower haemoglobin levels in patients with septic shock. We sought to determine the relationship between the changes in haemoglobin concentration and the volume of intravenous fluids administered during resuscitation from septic shock. METHODS: We performed a retrospective cohort study of patients enrolled in the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial who were not transfused red blood cells (N = 1275)...
May 3, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29722636/recent-advances-in-nanomedicine-for-sepsis-treatment
#13
Simseok A Yuk, Diego A Sanchez-Rodriguez, Michael D Tsifansky, Yoon Yeo
Sepsis and septic shock are life-threating conditions, which form a continuum of the body's response to overwhelming infection. The current treatment consists of fluid and metabolic resuscitation, hemodynamic and end-organ support, and timely initiation of antibiotics. However, these measures may be ineffective and the sepsis-related mortality toll remains substantial; therefore, an urgent need exists for new therapies. Recently, several nanoparticle (NP) systems have shown excellent protective effects against sepsis in preclinical models, suggesting a potential utility in the management of sepsis and septic shock...
May 1, 2018: Therapeutic Delivery
https://www.readbyqxmd.com/read/29721511/vitamin-d-status-and-its-influence-on-outcomes-following-major-burn-injury-and-critical-illness
#14
REVIEW
Khaled Al-Tarrah, Martin Hewison, Naiem Moiemen, Janet M Lord
Vitamin D deficiency is common among the general population. It is also observed in up to 76% of critically ill patients. Despite the high prevalence of hypovitaminosis D in critical illness, vitamin D is often overlooked by medical staff as the clinical implications and consequences of vitamin D deficiency in acute contexts remain to be fully understood. Vitamin D has a broad range of pleotropic effects on various processes and systems including the immune-inflammatory response. 1α,25-dihydroxyvitamin D (1,25(OH)2 D), has been shown to promote a tolerogenic immune response limiting deleterious inflammatory effects, modulation of the innate immune system, and enhancement of anti-microbial peptides...
2018: Burns and trauma
https://www.readbyqxmd.com/read/29716791/predictors-of-30-day-readmission-following-pancreatic-surgery-a-retrospective-review
#15
Leo I Amodu, Jamil Alexis, Aron Soleiman, Meredith Akerman, Poppy Addison, Toni Iurcotta, Horacio L Rodriguez Rilo
BACKGROUND: Pancreatectomies have been identified as procedures with an increased risk of readmission. In surgical patients, readmissions within 30 days of discharge are usually procedure-related. We sought to determine predictors of 30-day readmission following pancreatic resections in a large healthcare system. METHODS: We retrospectively collected information from the records of 383 patients who underwent pancreatic resections from 2004-2013. To find the predictors of readmission in the 30 days after discharge, we performed a univariate screen of possible variables using the Fisher's exact test for categorical variables and the Mann-Whitney U test for continuous variables...
April 22, 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/29716625/6-hydroxyethyl-starch-hes-130-0-4-diminishes-glycocalyx-degradation-and-decreases-vascular-permeability-during-systemic-and-pulmonary-inflammation-in-mice
#16
Andreas Margraf, Jan M Herter, Katharina Kühne, Anika Stadtmann, Thomas Ermert, Manuel Wenk, Melanie Meersch, Hugo Van Aken, Alexander Zarbock, Jan Rossaint
BACKGROUND: Increased vascular permeability is a pathophysiological hallmark of sepsis and results in increased transcapillary leakage of plasma fluid, hypovolemia, and interstitial edema formation. 6% hydroxyethyl starch (HES 130/0.4) is commonly used to treat hypovolemia to maintain adequate organ perfusion and oxygen delivery. The present study was designed to investigate the effects of 6% HES 130/0.4 on glycocalyx integrity and vascular permeability in lipopolysaccharide (LPS)-induced pulmonary inflammation and systemic inflammation in mice...
May 1, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29710234/association-of-postoperative-readmissions-with-surgical-quality-using-a-delphi-consensus-process-to-identify-relevant-diagnosis-codes
#17
Hillary J Mull, Laura A Graham, Melanie S Morris, Amy K Rosen, Joshua S Richman, Jeffery Whittle, Edith Burns, Todd H Wagner, Laurel A Copeland, Tyler Wahl, Caroline Jones, Robert H Hollis, Kamal M F Itani, Mary T Hawn
Importance: Postoperative readmission data are used to measure hospital performance, yet the extent to which these readmissions reflect surgical quality is unknown. Objective: To establish expert consensus on whether reasons for postoperative readmission are associated with the quality of surgery in the index admission. Design, Setting, and Participants: In a modified Delphi process, a panel of 14 experts in medical and surgical readmissions comprising physicians and nonphysicians from Veterans Affairs (VA) and private-sector institutions reviewed 30-day postoperative readmissions from fiscal years 2008 through 2014 associated with inpatient surgical procedures performed at a VA medical center between October 1, 2007, and September 30, 2014...
April 18, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29696295/expert-statement-for-the-management-of-hypovolemia-in-sepsis
#18
REVIEW
Anders Perner, Maurizio Cecconi, Maria Cronhjort, Michael Darmon, Stephan M Jakob, Ville Pettilä, Iwan C C van der Horst
Hypovolemia is frequent in patients with sepsis and may contribute to worse outcome. The management of these patients is impeded by the low quality of the evidence for many of the specific components of the care. In this paper, we discuss recent advances and controversies in this field and give expert statements for the management of hypovolemia in patients with sepsis including triggers and targets for fluid therapy and volumes and types of fluid to be given. Finally, we point to unanswered questions and suggest a roadmap for future research...
April 25, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29696105/cumulative-positive-fluid-balance-is-a-risk-factor-for-acute-kidney-injury-and-requirement-for-renal-replacement-therapy-after-liver-transplantation
#19
Liana Codes, Ygor Gomes de Souza, Ricardo Azevedo Cruz D'Oliveira, Jorge Luiz Andrade Bastos, Paulo Lisboa Bittencourt
AIM: To analyze whether fluid overload is an independent risk factor of adverse outcomes after liver transplantation (LT). METHODS: One hundred and twenty-one patients submitted to LT were retrospectively evaluated. Data regarding perioperative and postoperative variables previously associated with adverse outcomes after LT were reviewed. Cumulative fluid balance (FB) in the first 12 h and 4 d after surgery were compared with major adverse outcomes after LT. RESULTS: Most of the patients were submitted to a liberal approach of fluid administration with a mean cumulative FB over 5 L and 10 L, respectively, in the first 12 h and 4 d after LT...
April 24, 2018: World Journal of Transplantation
https://www.readbyqxmd.com/read/29690538/adipose-tissue-lactate-clearance-but-not-blood-lactate-clearance-is-associated-with-clinical-outcome-in-sepsis-or-septic-shock-during-the-post-resuscitation-period
#20
Ioannis Ilias, Sofia Apollonatou, Dimitra-Argyro Vassiliadi, Nikitas Nikitas, Maria Theodorakopoulou, Argyris Diamantakis, Anastasia Kotanidou, Ioanna Dimopoulou
No study has directly measured tissue lactate clearance in patients with sepsis during the post-resuscitation period. In this study we aimed to assess in ICU patients with sepsis ( n = 32) or septic shock ( n = 79)&mdash;during the post-resuscitation phase&mdash;the relative kinetics of blood/tissue lactate clearances and to examine whether these are associated with outcome. We measured serially&mdash;over a 48-h period&mdash;blood and adipose tissue interstitial fluid lactate levels (with microdialysis) and we calculated lactate clearance...
April 21, 2018: Metabolites
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