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https://www.readbyqxmd.com/read/28910959/-ischemia-reperfusion-injury-study-in-isolated-mouse-hearts-using-a-pressure-volume-curve
#1
J B Jiang, Z W Huamei, Gourdie Robert G, Zhiwei Zhang
Objective: To establish and assess the feasibility and sensitivity of left ventricular elasticity, compliance and stiffness for study of ischemia/reperfusion injury in an isolated mouse heart model utilizing the pressure-volume curve framework. Methods: An isolated, balloon-in-ventricle, isovolumically contracting, crystalloid-perfused Langendorff heart preparation was set up from 15 male C57/6BL mice aged 12-14 weeks. End-systolic pressure-volume relationship (ESPVR) and end-diastolic pressure-volume relationship (EDPVR) were obtained by measuring left ventricular (LV) systolic pressure (LVSP) and diastolic pressure under different balloon volumes...
September 12, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28901224/coronary-revascularization-in-children-at-a-mexican-cardiac-center-thirteen-year-outcomes
#2
Samuel E Ramírez-Marroquín, Alejandra Iturriaga-Hernández, Juan Calderón-Colmenero, Antonio Benita-Bordes, Jorge L Cervantes-Salazar
BACKGROUND: The indications for pediatric coronary revascularization are diverse. There are a large proportion of patients with sequelae of severe inflammatory diseases such as Kawasaki disease, and other less common causes. METHODS: Retrospective review of ten pediatric patients undergoing coronary artery bypass surgery from January 2004 to December 2016. RESULTS: Ten children and adolescents ranging in age from 2 to 17 (median, 6) years at operation were followed up for as long as 13 years with a median follow-up of 2 years...
September 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28885520/caring-for-trauma-patients-with-coexisting-heart-failure
#3
Karen Bergman Schieman, Kelley Pattison, Conor Early
The coexisting conditions of traumatic injury coupled with a comorbid condition such as heart failure create a complex scenario for the trauma nurse to manage. Initial care of the trauma patient includes following the Advanced Trauma Life Support guidelines and managing the airway, breathing, and circulation (ABC) of the patient. Once the airway is secure and breathing is managed, the team addresses circulation. At this point in the patient's care, the team typically does not know which, if any, comorbid conditions exist...
September 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28878889/preoperative-fluid-retention-increases-blood-loss-during-major-open-abdominal-surgery
#4
Robert G Hahn, Hans Bahlmann, Lena Nilsson
BACKGROUND: Quantification of renal fluid conservation is possible by urine analysis, and the results can indicate dehydration. The present report sought to determine whether this fluid retention correlates with fluid requirements during major abdominal surgeries that have estimated operating times ≥ 2 h. METHODS: Urine colour, specific weight, osmolality and creatinine concentration were used to calculate a composite "fluid retention index" (FRI) in 97 patients prior to major abdominal surgery...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28868168/validity-of-pulse-pressure-variation-ppv-compared-with-stroke-volume-variation-svv-in-predicting-fluid-responsiveness
#5
Abhishek Rathore, Shalendra Singh, Ritesh Lamsal, Priya Taank, Debashish Paul
OBJECTIVE: Static monitors for assessing the fluid status during major surgeries and in critically ill patients have been gradually replaced by more accurate dynamic monitors in modern-day anaesthesia practice. Pulse pressure variation (PPV) and systolic pressure variation (SPV) are the two commonly used dynamic indices for assessing fluid responsiveness. METHODS: In this prospective observational study, 50 patients undergoing major surgeries were monitored for PPV and SPV: after the induction of anaesthesia and after the administration of 500 mL of isotonic crystalloid bolus...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28866974/the-plasma-lyte-148-v-saline-plus-study-protocol-a-multicentre-randomised-controlled-trial-of-the-effect-of-intensive-care-fluid-therapy-on-mortality
#6
Naomi E Hammond, Rinaldo Bellomo, Martin Gallagher, David Gattas, Parisa Glass, Diane Mackle, Sharon Micallef, John Myburgh, Manoj Saxena, Colman Taylor, Paul Young, Simon Finfer
BACKGROUND: 0.9% sodium chloride (saline) is the most commonly administered resuscitation fluid on a global basis but emerging evidence suggests that its high chloride content may have important adverse effects. OBJECTIVE: To describe the study protocol for the Plasma- Lyte 148 v Saline study, which will test the hypothesis that in critically ill adult patients the use of Plasma-Lyte 148 (a buffered crystalloid solution) for fluid therapy results in different 90-day all-cause mortality when compared with saline...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28865484/renal-ultrasound-provides-low-utility-in-evaluating-cardiac-surgery-associated-acute-kidney-injury
#7
Allen Young, Todd Crawford, Alejandro Suarez Pierre, J Trent Magruder, Charles Fraser, John Conte, Glenn Whitman, Christopher Sciortino
BACKGROUND: Renal ultrasonography is part of the algorithm in assessing acute kidney injury (AKI). The purpose of this study was to assess the clinical utility of renal US in postoperative cardiac patients who develop AKI. METHODS: We conducted a retrospective study of 90 postoperative cardiac surgery patients at a single institution from 1/19/2010 to 3/19/2016 who underwent renal US for AKI. We reviewed provider documentation to determine whether renal US changed management...
September 2, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28861688/predicting-major-adverse-kidney-events-among-critically-ill%C3%A2-adults-using-the-electronic-health-record
#8
Andrew C McKown, Li Wang, Jonathan P Wanderer, Jesse Ehrenfeld, Todd W Rice, Gordon R Bernard, Matthew W Semler
Prediction of major adverse kidney events in critically ill patients may help target therapy, allow risk adjustment, and facilitate the conduct of clinical trials. In a cohort comprised of all critically ill adults admitted to five intensive care units at a single tertiary care center over one year, we developed a logistic regression model for the outcome of Major Adverse Kidney Events within 30 days (MAKE30), the composite of persistent renal dysfunction, new renal replacement therapy (RRT), and in-hospital mortality...
August 31, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/28857520/a-combination-of-levobupivacaine-and-lidocaine-for-paravertebral-block-in-breast-cancer-patients-undergoing-quadrantectomy-causes-greater-hemodynamic-oscillations-than-levobupivacaine-alone
#9
RANDOMIZED CONTROLLED TRIAL
Miroslav Župčić, Sandra Graf Župčić, Viktor Duzel, Tatjana Šimurina, Livija Šakić, Jurica Fudurić, Jasminka Peršec, Milan Milošević, Zdenko Stanec, Anđelko Korušić, Stjepan Barišin
AIM: To test for differences in hemodynamic and analgesic properties in patients with breast cancer undergoing quadrantectomy with paravertebral block (PVB) induced with a solution of either one or two local anesthetics. METHOD: A prospective, single-center, randomized, double-blinded, controlled trial was conducted from June 2014 until September 2015. A total of 85 women with breast cancer were assigned to receive PVB with either 0.5% levobupivacaine (n=42) or 0...
August 31, 2017: Croatian Medical Journal
https://www.readbyqxmd.com/read/28851407/restricted-fluid-resuscitation-in-sepsis-associated-hypotension-refresh-study-protocol-for-a-pilot-randomised-controlled-trial
#10
Stephen P J Macdonald, David McD Taylor, Gerben Keijzers, Glenn Arendts, Daniel M Fatovich, Frances B Kinnear, Simon G A Brown, Rinaldo Bellomo, Sally Burrows, John F Fraser, Edward Litton, Juan Carlos Ascencio-Lane, Matthew Anstey, David McCutcheon, Lisa Smart, Ioana Vlad, James Winearls, Bradley Wibrow
BACKGROUND: Guidelines recommend an initial intravenous (IV) fluid bolus of 30 ml/kg isotonic crystalloid for patients with sepsis and hypotension. However, there is a lack of evidence from clinical trials to support this. Accumulating observational data suggest harm associated with the injudicious use of fluids in sepsis. There is currently equipoise regarding liberal or restricted fluid-volume resuscitation as first-line treatment for sepsis-related hypotension. A randomised trial comparing these two approaches is, therefore, justified...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28837512/the-management-of-acute-pancreatitis-in-the-pediatric-population-a-clinical-report-from-the-naspghan-pancreas-committee
#11
Maisam Abu-El-Haija, Soma Kumar, J Antonio Quiros, Keshawadhana Balakrishnan, Bradley Barth, Samuel Bitton, John F Eisses, Elsie Jazmin Foglio, Victor Fox, Denease Francis, A Jay Freeman, Tanja Gonska, Amit S Grover, Sohail Z Husain, Rakesh Kumar, Sameer Lapsia, Tom Lin, Quin Y Liu, Asim Maqbool, Zachary M Sellers, Flora Szabo, Aliye Uc, Steven L Werlin, Veronique D Morinville
BACKGROUND: While the incidence of acute pancreatitis (AP) in children is increasing, management recommendations rely on adult published guidelines. Pediatric-specific recommendations are needed. METHODS: The NASPGHAN Pancreas committee performed a MEDLINE review using several pre-selected key terms relating to management considerations in adult and pediatric AP. The literature was summarized, quality of evidence reviewed, and statements of recommendations developed...
August 23, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28834855/choice-of-fluids-for-resuscitation-of-the-critically-ill-what-nurses-need-to-know
#12
Whitney Gross, Michael Samarin, Lauren A Kimmons
Fluid administration is one of the most universal interventions in the intensive care unit; however, there remains a lack of optimal fluid choice in clinical practice. With increasing evidence suggesting that the choice and dose of fluid may influence patient outcomes, it is important to have an understanding of the differences between the various fluid products and these potential effects in order for nurses to navigate the critically ill patient. This article reviews properties, adverse effects, and monitoring of commonly used colloid and crystalloid fluids, providing information that may aid in fluid selection in the intensive care unit...
October 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28834579/topical-flurbiprofen-toxicosis-in-a-cat
#13
Elizabeth M Yi, Elizabeth Leech
OBJECTIVE: To describe the clinical presentation and treatment of a cat with flurbiprofen toxicosis due to topical cream exposure. CASE SUMMARY: A 3-year-old castrated male domestic shorthair cat presented to an emergency and referral center for acute lethargy, hematemesis, and anemia. Severe azotemia was observed on serum biochemistry panel. The patient's anemia was treated with packed RBC transfusion, and treatment with crystalloid fluids, famotidine, pantoprazole, ampicillin, and sucralfate were begun on presentation...
August 23, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28833697/effect-of-intravenously-administered-crystalloid-solutions-on-acid-base-balance-in-domestic-animals
#14
REVIEW
W Muir
Intravenous fluid therapy can alter plasma acid-base balance. The Stewart approach to acid-base balance is uniquely suited to identify and quantify the effects of the cationic and anionic constituents of crystalloid solutions on plasma pH. The plasma strong ion difference (SID) and weak acid concentrations are similar to those of the administered fluid, more so at higher administration rates and with larger volumes. A crystalloid's in vivo effects on plasma pH are described by 3 general rules: SID > [HCO3-] increases plasma pH (alkalosis); SID < [HCO3-] decreases plasma pH (alkalosis); and SID = [HCO3-] yields no change in plasma pH...
September 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28818494/gts-21-reduces-microvascular-permeability-during-experimental-endotoxemia
#15
Karsten Schmidt, Sukanya Bhakdisongkhram, Florian Uhle, Christoph Philipsenburg, Aleksandar R Zivkovic, Thorsten Brenner, Johann Motsch, Markus A Weigand, Stefan Hofer
INTRODUCTION: No effective pharmacological therapy is currently available to attenuate tissue edema formation due to increased microvascular permeability in sepsis. Cholinergic mediators have been demonstrated to exert anti-inflammatory effects via the α7 nicotinic acetylcholine receptor (α7nAChR) during inflammation. GTS-21, a partial α7nAChR agonist, is an appealing therapeutic substance for sepsis-induced microvascular inflammation due to its demonstrated cholinergic anti-inflammatory properties and its favorable safety profile in clinical trials...
August 14, 2017: Microvascular Research
https://www.readbyqxmd.com/read/28817996/meningioma-with-tyrosine-rich-crystalloids-a-case-report-and-review-of-the-literature
#16
Erik Reinertsen, Stewart G Neill, Kambiz Nael, Daniel J Brat, Costas G Hadjipanayis
We report a case of fibrous meningioma with tyrosine-rich crystalloid in the frontal lobe of a middle-aged woman. The patient presented with a history of several years of worsening headaches and blurry vision, which progressed to include syncopal episodes and right-sided weakness. Imaging demonstrated a dural-based extra-axial mass arising from the right orbital roof and extending superiorly along the right frontal convexity causing right-to-left midline shift. The patient underwent a craniotomy and operative resection...
August 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#17
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28809612/a-retrospective-study-evaluating-the-efficacy-of-identification-and-management-of-sepsis-at-a-district-level-hospital-internal-medicine-department-in-the-western-cape-province-south-africa-in-comparison-with-the-guidelines-stipulated-in-the-2012-survivi
#18
Raisa Bhikoo, Sarah Versfeld, M M De V Basson, Almero H Oosthuizen
BACKGROUND: Currently there is little information on the identification, management and outcomes of patients with sepsis in developing countries. Simple cost-effective measures such as accurate identification of patients with sepsis and early antibiotic administration are achievable targets, within reach without having to make use of unsustainable protocols constructed in developed countries. OBJECTIVES: To assess the ability of clinicians at a district-level hospital to identify and manage sepsis, and to assess patient outcome in terms of in-hospital mortality and length of hospital stay given the above management...
July 28, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28799264/correlation-of-lanthanum-dosage-with-lanthanum-deposition-in-the-gastroduodenal-mucosa-of-dialysis-patients
#19
Kimiaki Hattori, Tamaki Maeda, Shinya Nishida, Miyuki Imanishi, Masahiro Sakaguchi, Yoshifumi Amari, Takuya Moriya, Yoshinobu Hirose
Lanthanum (La) deposition has been observed in gastrointestinal mucosa of dialysis patients treated with La carbonate to treat hyperphosphatemia in the 6 years since its authorization in Japan. We investigated gastrointestinal biopsies from 112 dialysis patients, and found 15 cases of histiocytic aggregation with crystalloids and one case of duodenitis with histiocyte aggregation without crystalloids in the 30 patients treated with La carbonate. No histiocytic lesions were observed in the 82 patients without La carbonate administration...
August 11, 2017: Pathology International
https://www.readbyqxmd.com/read/28782112/lower-vs-higher-fluid-volumes-in-sepsis-protocol-for-a-systematic-review-with-meta-analysis
#20
T S Meyhoff, M H Møller, P B Hjortrup, M Cronhjort, A Perner, J Wetterslev
BACKGROUND: Intravenous fluid administration with crystalloids is recommended in the initial management of sepsis. However, the quality of evidence supporting the recommendation on fluid volumes is low, and clinical equipoise exists. Potential benefits of restricting fluid volumes has been suggested, but the overall benefit or harm in patients with sepsis is unknown. Accordingly, we aim to assess patient-important benefits and harms of lower vs. higher fluid volumes in resuscitation of adult patients with sepsis...
September 2017: Acta Anaesthesiologica Scandinavica
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