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Respiratory acidosis

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https://www.readbyqxmd.com/read/29649820/accuracy-of-acid-base-diagnoses-using-the-central-venous-blood-gas-in-the-medical-intensive-care-unit
#1
Sarah J Schrauben, Dan Negoianu, Cristiana Costa, Raphael M Cohen, Stanley Goldfarb, Barry D Fuchs, Jeffrey S Berns
BACKGROUND: Acid-base disturbances are frequent in critically ill patients. Arterial blood gas (ABG) is the gold standard in the diagnosis of these disturbances, but it is invasive with potential hazards. For patients with a central venous catheter, venous blood gas (VBG) sampling may be an alternative, less-invasive diagnostic tool. However, the accuracy of a central VBG-based acid-base disorder diagnosis compared to an ABG is unknown. The primary objective of this study was to assess the accuracy of a central VBG-based acid-base disorder diagnosis compared to the "gold standard" ABG in critically ill patients...
April 12, 2018: Nephron
https://www.readbyqxmd.com/read/29643635/regional-anesthesia-is-safe-and-effective-for-lower-limb-orthopedic-surgery-in-patient-with-renal-tubular-acidosis-and-hypokalemia
#2
Indira Gurajala, Sapna Annaji Nikhar, Kavitha Jayaram, Ramachandran Gopinath
Renal tubular acidosis (RTA) with hypokalemia may precipitate acute respiratory failure and potentially fatal arrhythmias like ventricular fibrillation. Though there are random reports of respiratory failure needing mechanical ventilation and sudden death in patients with RTA and hypokalemia, the anesthetic management of these patients has not been clearly elucidated. Acidosis and hypokalemia have significant interactions with both general and local anesthetics and alter their effect substantially. Proper preoperative planning and optimization are required for the safe conduct of anesthesia in this subset of patients...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29622717/scorpion-bite-induced-unilateral-pulmonary-oedema
#3
Nandakishore Bompelli, Rakesh Reddy C, Anirudda Deshpande
A 24-year-old woman came to the emergency room of our hospital, 6 hours after a sting to the pulp of her middle finger of her left upper limb by an Indian red scorpion. On examination, she had tachycardia, tachypnoea, hypotension and low oxygen saturation at room temperature. On auscultation, there was poor air entry in all areas of the right lung along with crackles. The left lung field was normal on auscultation. Chest X-ray showed unilateral haziness of right lung field. Two-dimensional echocardiography showed clinical findings of myocarditis...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29618761/qil1-dependent-assembly-of-micos-complex-lethal-mutation-in-c19orf70-resulting-in-liver-disease-and-severe-neurological-retardation
#4
J Gödiker, M Grüneberg, I DuChesne, J Reunert, S Rust, C Westermann, Y Wada, G Classen, C D Langhans, K P Schlingmann, R J Rodenburg, R Pohlmann, T Marquardt
Seven subunits of the mitochondrial contact site and cristae junction (CJ) organizing system (MICOS) in humans have been recently described in function and structure. QIL1 (also named MIC13) is a small complex that is crucial for the maintenance and assembling of MICOS. A novel mutation of an essential splice site in the C19orf70 gene encoding QIL1 induces severe mitochondrial encephalopathy, hepatopathy and lactate acidosis consistent with psychomotor retardation. In addition, bilateral kidney stones were observed...
April 4, 2018: Journal of Human Genetics
https://www.readbyqxmd.com/read/29614848/outcomes-of-mitochondrial-derived-diseases-a-single-center-experience
#5
Sahin Erdol, Halil Saglam
BACKGROUND: The purpose of this study is to help elucidate which part of the mitochondria is causing a problem through anamnesis, physical examination, and routine biochemical tests in the event of a suspected mitochondrial disease case. METHODS: The data were obtained retrospectively from the medical records of 75 cases; the mitochondrial-derived disease (MDD) cases were observed in our center from 2011 to 2017. RESULTS: The most commonly observed MDDs were oxidative phosphorylation disorders at 44%, followed by fatty acid oxidation disorder at 40%, pyruvate metabolism disorder at 12%, and ketone metabolism disorder at 4%, respectively...
March 28, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29593918/a-case-of-polymicrobial-bacteremia-in-a-patient-undergoing-chemotherapy
#6
Kyoko Arahata, Ryo Yamaguchi, Takeshi Terashima
We report an aggressive case of polymicrobial bacteremia in a patient with renal pelvis carcinoma. A 76-year-old man developed watery diarrhea after undergoing chemotherapy. He became unconscious and went into shock. Laboratory data showed severe neutropenia, renal failure, and lactic acidosis. Chest radiography showed multiple opacities. He died despite aggressive fluid resuscitation, catecholamine administration, antibiotic treatment, and mechanical ventilation. Blood culture isolates included Escherichia coli , Klebsiella pneumoniae , Streptococcus pneumoniae , Acinetobacter baumannii , and Moraxella catarrhalis ...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29593914/rituximab-induced-pulmonary-edema-managed-with-extracorporeal-life-support
#7
Jacob R Miller, Warren Isakow, Muhammad F Masood, Patrick Aguilar, Kristen M Sanfilippo, Keki R Balsara, Akinobu Itoh
Though rare, rituximab has been reported to induce severe pulmonary edema. We describe the first report of ECLS utilization for this indication. A 31-year-old female with severe thrombotic thrombocytopenic purpura developed florid pulmonary edema after rituximab infusion. Despite advanced ventilatory settings, she developed severe respiratory acidosis and remained hypoxemic with a significant vasopressor requirement. Since her pulmonary insult was likely transient, ECLS was considered. Due to combined cardiorespiratory failure, she received support with peripheral venoarterial ECLS...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29593728/the-acid-base-balance-and-gender-in-inflammation-a-mini-review
#8
REVIEW
Georges Jacques Casimir, Nicolas Lefèvre, Francis Corazza, Jean Duchateau, Mustapha Chamekh
In humans, acid-base balance is crucial to cell homeostasis. Acidosis is observed in numerous inflammatory processes, primarily acute conditions such as sepsis, trauma, or acute respiratory distress where females tend to exhibit better prognosis compared with males. The mechanisms underlying these gender-dependent differences are multiple, probably involving hormonal and genetic factors, particularly the X chromosome. Although pH influences multiple immunological functions, gender differences in acid-base balance have been poorly investigated...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29581058/nuchal-cord-at-delivery-and-perinatal-outcomes-single-center-retrospective-study-with-emphasis-on-fetal-acid-base-balance
#9
REVIEW
Rohitkumar Vasa, Roger Dimitrov, Shivani Patel
AIM: Our study objectives were to evaluate umbilical cord blood acid-base balance in presence of nuchal cord at delivery, effects of nuchal cord at delivery on perinatal outcomes and incidence of nuchal cord in a racially diverse population. METHODS: Perinatal records of 2530 women (predominantly African American and Hispanic) who delivered in 2012 were examined. Perinatal outcomes of women who delivered a baby with nuchal cord were compared with those without nuchal cord...
March 5, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29579581/midazolam-addition-to-analgosedation-for-pulmonary-vein-isolation-may-increase-risk-of-hypercapnia-and-acidosis
#10
Bernhard M Kaess, Florian Feurich, Gerd Bürkle, Joachim R Ehrlich
BACKGROUND: Pulmonary vein isolation (PVI) is generally performed under analgosedation, but sedation protocols vary and no optimal protocol has been defined. We investigated procedural, respiratory and hemodynamic parameters in patients undergoing PVI using analgosedation either with or without midazolam. METHODS: In a prospective observational study, we compared n = 43 consecutive patients (54% male, mean age 62 years) undergoing PVI using analgosedation either with or without midazolam added to propofol and fentanyl...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29570107/extensive-myocardial-calcification-in-critically-ill-patients
#11
Natacha Kapandji, Alban Redheuil, Pierre Fouret, Guillaume Hékimian, Guillaume Lebreton, Nicolas Bréchot, Charles-Edouard Luyt, Philippe Cluzel, Alain Combes, Matthieu Schmidt
OBJECTIVES: To describe an unusual complication on extracorporeal membrane oxygenation. DATA SOURCES: Clinical observation. STUDY SELECTION: Case report. DATA EXTRACTION: Relevant clinical information. DATA SYNTHESIS: We report the cases of three young patients who developed extensive myocardial calcifications on prolonged extracorporeal membrane oxygenation support for severe acute respiratory distress syndrome with septic cardiomyopathy, postresuscitation cardiogenic shock, and septic shock complicating severe acute respiratory distress syndrome, respectively...
March 21, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29560164/comparison-of-umbilical-artery-doppler-and-non-stress-test-in-assessment-of-fetal-well-being-in-gestational-diabetes-mellitus-a-prospective-cohort-study
#12
Shirin Niromanesh, Mahboobeh Shirazi, Mitra Eftekhariyazdi, Forough Mortazavi
Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy and is related to poor perinatal outcomes. Reduction of neonatal complications of GDM is feasible by assessment of fetal well-being. Both fetal Doppler and NST are used for the screening of high-risk pregnancies. Objective: We aimed to compare the non-stress test (NST) and umbilical artery (UA) Doppler assessments for evaluation of the adverse perinatal outcomes in GDM...
December 2017: Electronic Physician
https://www.readbyqxmd.com/read/29559356/alpha-lipoic-acid-intoxicat%C3%A4-on-an-adult-case-report-and-l%C3%A4-terature-rev%C3%A4-ew
#13
Duygu Ferek Emir, Ibrahim Ulas Ozturan, Serkan Yilmaz
INTRODUCTION: Alpha lipoic acid (ALA) is a potent antioxidant used to treat a variety of disorders. Although ALA is considered a very safe supplement and intoxication is very rare, acute high-dose ingestions can cause mortality. In this report, we discuss a very rare case of ALA intoxication to increase awareness of this issue. CASE REPORT: A 22-year-old female was referred to our emergency department with ALA intoxication after ingesting a total of 18g of ALA with a suicidal intention...
March 13, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29558860/pregnant-sheep-develop-hypoxaemia-during-short-term-anaesthesia-for-caesarean-delivery
#14
Gabrielle C Musk, Matthew W Kemp
Short-term anaesthesia of the pregnant ewe may be required for caesarean delivery of a preterm foetus within a research protocol. The aim of this study was to evaluate and compare the acid-base and haematological status of the ewe and foetus at the time of surgical delivery by collecting maternal and foetal arterial blood samples. Fifteen date-mated singleton-pregnant merino cross ewes at 122.0 (±0.5) days of gestation were anaesthetised with a combination of midazolam (0.5 mg/kg) and ketamine (10 mg/kg) by intravenous injection...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29544375/obstetric-and-perinatal-outcomes-in-pregnancies-with-isolated-fetal-congenital-heart-abnormalities
#15
Cathy Liu, Jade Lodge, Christopher Flatley, Alexander Gooi, Cameron Ward, Karen Eagleson, Sailesh Kumar
OBJECTIVE: To determine obstetric, intrapartum and perinatal outcomes for pregnancies with isolated fetal congenital heart defects (CHD). METHODS: This was a retrospective cohort study of women that delivered an infant with an isolated major CHD between January 2010 and April 2017 at a major Australian perinatal centre. The study cohort was compared with a cohort of women with infants without CHD. Cardiac abnormalities were broadly subdivided into the following five categories using the International Classification of Diseases Tenth Revision (ICD-10) as a guide - transposition of the great arteries (TGA), septal defects, right heart lesions (RHL), left heart lesions (LHL) and "other"...
March 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29532468/tham-administration-reduces-pulmonary-carbon-dioxide-elimination-in-hypercapnia-an-experimental-porcine-study
#16
S Höstman, R Kawati, G Perchiazzi, A Larsson
BACKGROUND: In a previous study, we found a rebound of arterial carbon dioxide tension (PaCO2 ) after stopping THAM buffer administration. We hypothesized that this was due to reduced pulmonary CO2 elimination during THAM administration. The aim of this study was to investigate this hypothesis in an experimental porcine hypercapnic model. METHODS: In seven, initially normoventilated, anesthetized pigs (22-27 kg) minute ventilation was reduced by 66% for 7 h. Two hours after commencing hypoventilation, THAM was infused IV for 3 h in a dose targeting a pH of 7...
March 12, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29528202/early-predictors-of-unresponsiveness-to-high-flow-nasal-cannula-therapy-in-a-pediatric-emergency-department
#17
Anıl Er, Aykut Çağlar, Fatma Akgül, Emel Ulusoy, Hale Çitlenbik, Durgül Yılmaz, Murat Duman
AIM: High-flow nasal cannula (HFNC) is a new treatment option for pediatric respiratory distress and we aimed to assess early predictive factors of unresponsiveness to HFNC therapy in a pediatric emergency department (ED). METHOD: Patients who presented with respiratory distress and were treated by HFNC, were included. The age, gender, weight, medical history, diagnosis, vital signs, oxygen saturation/fraction of inspired oxygen (SpO2 /FiO2 ) ratio, modified Respiratory Distress Assessment Instrument (mRDAI) scores, medical interventions, duration of HFNC therapy, time to escalation, adverse effects, and laboratory test results were obtained from medical and nursing records...
March 12, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29525234/syndrome-of-inappropriate-antidiuretic-hormone-secretion-in-a-mini-breed-puppy-associated-with-aspiration-pneumonia
#18
Rocío Martínez, Carlos Torrente
A 3-month-old intact male Prague ratter was presented to the emergency service for evaluation of progressive lethargy, weakness, coughing and labour breathing after an episode of resistance to oral deworming. The patient exhibited depression, increased respiratory effort and cyanosis at initial presentation. Results of first diagnostic work-up (complete blood cell count, biochemistry panel and thoracic x-rays) were all consistent with aspiration pneumonia. The puppy was initially treated with balanced isotonic crystalloids, broad spectrum antibiotics, nebulization with thoracic coupage and was transferred to an infant incubator with a sustained FiO2 of 40-50%...
December 2017: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/29515400/lactic-acidosis-in-prostate-cancer-consider-the-warburg-effect
#19
Johannes C van der Mijn, Mathijs J Kuiper, Carl E H Siegert, Annabeth E Wassenaar, Carel J M van Noesel, Aernout C Ogilvie
Lactic acidosis is a commonly observed clinical condition that is associated with a poor prognosis, especially in malignancies. We describe a case of an 81-year-old patient who presented with symptoms of tachypnea and general discomfort. Arterial blood gas analysis showed a high anion gap acidosis with a lactate level of 9.5 mmol/L with respiratory compensation. CT scanning showed no signs of pulmonary embolism or other causes of impaired tissue oxygenation. Despite treatment with sodium bicarbonate, the patient developed an adrenalin-resistant cardiac arrest, most likely caused by the acidosis...
September 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/29514541/assessing-acid-base-status-in-circulatory-failure-relationship-between-arterial-and-peripheral-venous-blood-gas-measurements-in-hypovolemic-shock
#20
Scott E Rudkin, Craig L Anderson, Tristan R Grogan, David A Elashoff, Richard M Treger
BACKGROUND AND OBJECTIVES: In severe circulatory failure agreement between arterial and mixed venous or central venous values is poor; venous values are more reflective of tissue acid-base imbalance. No prior study has examined the relationship between peripheral venous blood gas (VBG) values and arterial blood gas (ABG) values in hemodynamic compromise. The objective of this study was to examine the correlation between hemodynamic parameters, specifically systolic blood pressure (SBP) and the arterial-peripheral venous (A-PV) difference for all commonly used acid-base parameters (pH, Pco2 , and bicarbonate)...
January 1, 2018: Journal of Intensive Care Medicine
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