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https://www.readbyqxmd.com/read/28445586/predictors-of-outcome-among-patients-on-extracorporeal-membrane-oxygenation-as-a-bridge-to-lung-transplantation
#1
Amit Banga, Elizabeth Batchelor, Manish Mohanka, Srinivas Bollineni, Vaidehi Kaza, Jessica Mullins, Melissa Tran, Pietro Bajona, Matthias Peltz, Michael Wait, Fernando Torres
BACKGROUND: There is a lack of data regarding clinical variables associated with successful bridge to lung transplantation (LT) using extracorporeal membrane oxygenation (ECMO) support. METHODS: We reviewed the institutional database for patients supported with veno-venous (VV) or veno-arterial ECMO as a bridge to LT (n=25; mean age:50.6±14.2 years). We recorded clinical and laboratory variables, findings on echocardiogram and development of organ dysfunction along with hospital and one-year survival...
April 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28438182/forced-fluid-removal-versus-usual-care-in-intensive-care-patients-with-high-risk-acute-kidney-injury-and-severe-fluid-overload-ffaki-study-protocol-for-a-randomised-controlled-pilot-trial
#2
Rasmus E Berthelsen, Theis Itenov, Anders Perner, Jens-Ulrik Jensen, Michael Ibsen, Andreas Emil Kryger Jensen, Morten Bestle
BACKGROUND: Intravenous administration of fluids is an essential part of critical care. While some fluid administration is likely beneficial, there is increasing observational evidence that the development of fluid overload is associated with increased mortality. There are no randomised trials to confirm this association in patients with acute kidney injury. We aim to perform a pilot trial to test the feasibility of forced fluid removal compared to standard care in patients with acute kidney injury and severe fluid overload, the FFAKI trial...
April 24, 2017: Trials
https://www.readbyqxmd.com/read/28429903/causes-of-interruptions-in-postoperative-enteral-nutrition-in-children-with-congenital-heart-disease
#3
Jirong Qi, Zhuo Li, Yueshuang Cun, Xiaonan Li
BACKGROUND AND OBJECTIVES: Perioperative nutritional support has become a hot topic in the clinical management of congenital heart disease (CHD). Postoperative enteral nutrition (EN) offers many benefits, such as protection of the intestinal mucosa, reduced risk of infection, and low clinical costs. Interruptions in EN frequently influence nutritional support and clinical outcomes. We, therefore, aimed to determine the causes of interruptions in postoperative EN in CHD patients and discuss clinical counter measures...
May 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#4
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28421299/compared-effects-of-calcium-and-sodium-polystyrene-sulfonate-on-mineral-and-bone-metabolism-and-volume-overload-in-pre-dialysis-patients-with-hyperkalemia
#5
Yosuke Nakayama, Kaoru Ueda, Sho-Ichi Yamagishi, Miki Sugiyama, Chika Yoshida, Yuka Kurokawa, Nao Nakamura, Tomofumi Moriyama, Goh Kodama, Tomohisa Minezaki, Sakuya Ito, Akiko Nagata, Kensei Taguchi, Junko Yano, Yusuke Kaida, Kazutaka Shibatomi, Kei Fukami
BACKGROUND: Hyperkalemia is prevalent in end-stage renal disease patients, being involved in life-threatening arrhythmias. Although polystyrene sulfonate (PS) is commonly used for the treatment of hyperkalemia, direct comparison of effects between calcium and sodium PS (CPS and SPS) on mineral and bone metabolism has not yet been studied. METHODS: In a randomized and crossover design, 20 pre-dialysis patients with hyperkalemia (>5 mmol/l) received either oral CPS or SPS therapy for 4 weeks...
April 18, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28419150/disparities-in-dialysis-allocation-an-audit-from-the-new-south-africa
#6
Kajiru G Kilonzo, Erika S W Jones, Ikechi G Okpechi, Nicola Wearne, Zunaid Barday, Charles R Swanepoel, Karen Yeates, Brian L Rayner
End Stage Kidney Disease (ESKD) is a public health problem with an enormous economic burden. In resource limited settings management of ESKD is often rationed. Racial and socio-economic inequalities in selecting candidates have been previously documented in South Africa. New guidelines for dialysis developed in the Western Cape have focused on prioritizing treatment. With this in mind we aimed at exploring whether the new guidelines would improve inequalities previously documented. A retrospective study of patients presented to the selection committee was conducted at Groote Schuur Hospital...
2017: PloS One
https://www.readbyqxmd.com/read/28414691/mr-proadm-elevation-upon-icu-admission-predicts-the-outcome-of-septic-patients-and-is-correlated-with-upcoming-fluid-overload
#7
Pierre-Emmanuel Charles, Edwige Péju, Allyriane Dantec, Rémi Bruyère, Nicolas Meunier-Beillard, Auguste Dargent, Sébastien Prin, Darius Wilson, Jean-Pierre Quenot
BACKGROUND: Among septic patients admitted to the intensive care unit (ICU), early recognition of those with the highest risk of death is of paramount importance. We evaluated the prognostic value of Procalcitonin (PCT), mid regional-proadrenomedullin (MR-proADM), copeptine and CT-proendothelin 1 (CT-ProET 1) concentrations. METHODS: This was a prospective cohort study, which included 173 septic patient admitted to one ICU. Blood samples for biomarker measurements were obtained upon admission and on day 5...
April 26, 2017: Shock
https://www.readbyqxmd.com/read/28413417/the-dialysis-sodium-gradient-a-modifiable-risk-factor-for-fluid-overload
#8
Emilie Trinh, Catherine Weber
BACKGROUND: Fluid overload in patients on conventional hemodialysis is a frequent complication, associated with increased cardiovascular morbidity and mortality. The dialysate sodium prescription is a potential modifiable risk factor. Our primary objective was to describe associations between dialysate-to-serum sodium gradient and parameters of fluid status. A secondary objective was to evaluate the 6-month risk of hospitalization and mortality in relation to sodium gradient. METHODS: We performed a cross-sectional study of 110 prevalent conventional hemodialysis patients at a single center...
January 2017: Nephron Extra
https://www.readbyqxmd.com/read/28412109/reengineering-valve-patients-postdischarge-management-for-adapting-to-bundled-payment-models
#9
Michael S Koeckert, Patricia A Ursomanno, Mathew R Williams, Michael Querijero, Elias A Zias, Didier F Loulmet, Kevin Kirchen, Eugene A Grossi, Aubrey C Galloway
BACKGROUND: Bundled Payments for Care Improvement (BPCI) initiatives were developed by Medicare in an effort to reduce expenditures while preserving quality of care. Payment model 2 reimburses based on a target price for 90-day episode of care postprocedure. The challenge for valve patients is the historically high (>35%) 90-day readmission rate. We analyzed our institutional cardiac surgical service line adaptation to this initiative. METHODS: On May 1, 2015, we instituted a readmission reduction initiative (RRI) that included presurgical risk stratification, comprehensive predischarge planning, and standardized postdischarge management led by cardiac nurse practitioners (CNPs) who attempt to guide any postdischarge encounters (PDEs)...
March 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28407819/-association-between-fluid-overload-and-acute-renal-injury-after-congenital-heart-disease-surgery-in-infants
#10
De-Qiang Luo, Zi-Li Chen, Wei Dai, Feng Chen
OBJECTIVE: To study the association between fluid overload and acute kidney injury (AKI) after congenital heart disease surgery in infants. METHODS: A retrospective analysis was performed on 88 infants aged less than 6 months who underwent a radical surgery for congenital heart disease. The treatment outcomes were compared between the infants with AKI after surgery and those without. The effect of cumulative fluid overload on treatment outcomes 2 days after surgery was analyzed...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28406863/fluid-overload-and-kidney-injury-score-a-multidimensional-real-time-assessment-of-renal-disease-burden-in-the-critically-ill-patient
#11
Ayse Akcan-Arikan, Daniel J Gebhard, Megan A Arnold, Laura L Loftis, Curtis E Kennedy
OBJECTIVE: Interruptive acute kidney injury alerts are reported to decrease acute kidney injury-related mortality in adults. Critically ill children have multiple acute kidney injury risk factors; although recognition has improved due to standardized definitions, subtle changes in serum creatinine make acute kidney injury recognition challenging. Age and body habitus variability prevent a uniform maximum threshold of creatinine. Exposure of nephrotoxic medications is common but not accounted for in kidney injury scores...
April 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28403599/renal-extracapsular-hypoechoic-rim-and-kidney-cortical-thickness
#12
Simone Brardi, Gabriele Cevenini, Roberto Ponchietti, Giuseppe Romano, Ennio Duranti
OBJECTIVES: A renal extracapsular hypoechoic rim was previously recognized and interpreted as a typical sonographic finding of renal failure. Subsequently it was hypothesized that the hypoechoic rim could be produced by a state of sodium retention and oedema caused by nephropathy but not necessarily associated with renal failure. In order to get this cleared we performed a retrospective analysis of 80 renal ultrasound examinations, carried out at our center, in 41 of which it was found a renal extracapsular hypoechoic rim...
March 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28395370/intra-articular-tranexamic-acid-in-primary-total-knee-arthroplasty-meta-analysis
#13
Joseph T Moskal, Susan G Capps
Total knee arthroplasty (TKA) is associated with an increased need for blood transfusions and thus an increase in risks associated with blood transfusion such as transfusion reactions, infections, fluid overload, and altered mental status. Tranexamic acid (TXA) is an antifibrinolytic medication that can reduce perioperative blood loss in TKA. However, the best method of delivery has not been defined although topical intra-articular TXA (IA-TXA) may have a theoretical advantage as it is applied directly when and where it is needed to control bleeding...
April 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28381437/is-fluid-overload-a-target-to-treat-sleep-disordered-breathing-in-patients-with-end-stage-renal-disease-and-what-are-the-underlying-mechanisms
#14
EDITORIAL
Michael Arzt, Danny J Eckert
No abstract text is available yet for this article.
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28381432/the-effect-of-fluid-overload-on-sleep-apnoea-severity-in-haemodialysis-patients
#15
Owen D Lyons, Toru Inami, Elisa Perger, Azadeh Yadollahi, Christopher T Chan, T Douglas Bradley
As in heart failure, obstructive and central sleep apnoea (OSA and CSA, respectively) are common in end-stage renal disease. Fluid overload characterises end-stage renal disease and heart failure, and in heart failure plays a role in the pathogenesis of OSA and CSA. We postulated that in end-stage renal disease patients, those with sleep apnoea would have greater fluid volume overload than those without.End-stage renal disease patients on thrice-weekly haemodialysis underwent overnight polysomnography on a nondialysis day to determine their apnoea-hypopnoea index (AHI)...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28379920/acute-kidney-injury-in-mechanically-ventilated-patients-the-risk-factor-profile-depends-on-the-timing-of-aki-onset
#16
Raúl Lombardi, Nicolás Nin, Oscar Peñuelas, Alejandro Ferreiro, Fernando Rios, Maria Carmen Marin, Konstantinos Raymondos, Jose A Lorente, Younsuck Koh, Javier Hurtado, Marco Gonzalez, Fekri Abroug, Manuel Jibaja, Yaseen Arabi, Rui Moreno, Dimitros Matamis, Antonio Anzueto, Andres Esteban
BACKGROUND.: Acute kidney injury (AKI) is a frequent complication in patients under mechanical ventilation (MV). We aimed to assess the risk factors for AKI with particular emphasis on those potentially preventable. STUDY DESIGN, SETTING AND PARTICIPANTS.: Retrospective analysis of a large, multinational database of MV patients with >24 hours of MV and normal renal function at admission. AKI was defined according to creatinine-based KDIGO criteria. Risk factors were analyzed according to the time point at which AKI occurred: early (≤48 hours after ICU admission, AKIE) and late (day 3 to day 7 of ICU stay, AKIL)...
April 4, 2017: Shock
https://www.readbyqxmd.com/read/28373014/the-combyn%C3%A2-ecg-adding-haemodynamic-and-fluid-leads-for-the-ecg-part-ii-prediction-of-total-body-water-tbw-extracellular-fluid-ecf-ecf-overload-fat-mass-fm-and-dry-appendicular-muscle-mass-appmm
#17
Falko Skrabal, Georg P Pichler, Mathias Penatzer, Johannes Steinbichl, Anna-Katharina Hanserl, Alfred Leis, Herbert Loibner
Simultaneous with a 12 channel ECG, body composition was analysed by segmental multi-frequency impedance analysis in 101 healthy subjects and in 118 patients with chronic heart failure (CHF, n= 40), chronic renal failure with haemodialysis (HD, n= 20), and miscellaneous internal diseases (n= 58). Whole body DXA and sodium bromide dilution were used as reference methods for total body water (TBW), extracellular fluid (ECF), appendicular muscle mass (AppMM) and fat mass (FM). Empirical prediction equations were developed in a randomized evaluation sample and then evaluated in unknowns...
March 31, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28372680/the-impact-of-anesthesia-on-hemodynamic-and-volume-changes-in-operative-hysteroscopy-a-bioimpedance-randomized-study
#18
Ehab E Moharram, Ahmed M El Attar, Moustafa A Kamel
BACKGROUND: Operative hysteroscopy is accompanied by the use of distention medium. Its absorption can lead to volume overload and hemodynamic disturbances that can lead to serious complications. We investigated the impact of the type of anesthesia on decreasing these complications with the use of noninvasive thoracic bioimpedance. DESIGN: A prospective, randomized, blind study. METHOD: Sixty women, with American Society of Anesthesiologists classifications I-III, undergoing operative hysteroscopy were randomly allocated into 2 groups...
May 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28366564/systematic-investigations-of-peak-deformations-due-to-co-solvent-adsorption-in-preparative-supercritical-fluid-chromatography
#19
Emelie Glenne, Hanna Leek, Magnus Klarqvist, Jörgen Samuelsson, Torgny Fornstedt
Strangely shaped overloaded bands were recently reported using a standard supercritical fluid chromatographic system comprising a diol column as the stationary phase and carbon dioxide with methanol as the mobile phase. Some of these overloaded elution profiles appeared strongly deformed and even had "anti-Langmuirian" shapes although their solute compounds had "Langmuirian" adsorption. To obtain a more complete understanding of the generality of these effects, the investigation was expanded to cover also other common co-solvents, such as ethanol, 2-propanol, and acetonitrile, as well as various stationary phase materials, such as silica, and 2-ethylpyridine...
March 22, 2017: Journal of Chromatography. A
https://www.readbyqxmd.com/read/28365648/passive-leg-raising-and-prediction-of-fluid-responsiveness-systematic-review
#20
Joya D Pickett, Elizabeth Bridges, Patricia A Kritek, JoAnne D Whitney
Fluid boluses are often administered with the aim of improving tissue hypoperfusion in shock. However, only approximately 50% of patients respond to fluid administration with a clinically significant increase in stroke volume. Fluid overload can exacerbate pulmonary edema, precipitate respiratory failure, and prolong mechanical ventilation. Therefore, it is important to predict which hemodynamically unstable patients will increase their stroke volume in response to fluid administration, thereby avoiding deleterious effects...
April 2017: Critical Care Nurse
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