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lactic acidosis in shock

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https://www.readbyqxmd.com/read/28299952/n-acetylcysteine-s-role-in-sepsis-and-potential-benefit-in-patients-with-microcirculatory-derangements
#1
Jason Chertoff
OBJECTIVE: To review the data surrounding the utility of N-acetylcysteine (NAC) in sepsis and identify areas needed for additional research. DATA SOURCES: A review of articles describing the mechanisms of action and clinical use of NAC in sepsis. SUMMARY OF REVIEW: Despite many advances in critical care medicine, still as many as 50% of patients with septic shock die. Treatments thus far have focused on resuscitation and restoration of macrocirculatory targets in the early phases of sepsis, with less focus on microcirculatory dysfunction...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28219394/erratum-to-hemodynamic-consequences-of-severe-lactic-acidosis-in-shock-states-from-bench-to-bedside
#2
Antoine Kimmoun, Emmanuel Novy, Thomas Auchet, Nicolas Ducrocq, Bruno Levy
No abstract text is available yet for this article.
February 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28188168/metformin-associated-lactic-acidosis-treated-with-continuous-renal-replacement-therapy
#3
Akihide Nakamura, Kei Suzuki, Hiroshi Imai, Naoyuki Katayama
Metformin-associated lactic acidosis (MALA) is a rare but life-threatening complication. We report a case of MALA in a man aged 71 years who was treated with continuous renal replacement therapy (CRRT). The patient was brought to the hospital for prolonged and gradual worsening gastrointestinal symptoms. Although he received intravenous treatment, he developed catecholamine-resistant shock, and blood gas analysis revealed lactic acidosis. Bicarbonate and antibiotics for possible sepsis were initiated, but with no clear benefit...
February 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28149822/a-profile-of-metabolic-acidosis-in-patients-with-sepsis-in-an-intensive-care-unit-setting
#4
Kartik Ganesh, R N Sharma, Jaicob Varghese, M G K Pillai
CONTEXT: Metabolic acidosis is frequently found in patients with severe sepsis. An understanding of types of acidosis in sepsis and their evolution over the course of treatment may give us insight into the behavior of acid-base balance in these patients. AIMS: To describe at Intensive Care Unit (ICU) admission and over the first 5 days the composition of metabolic acidosis in patients with sepsis and to evaluate and compare acidosis patterns in survivors and nonsurvivors...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28147428/-lactic-acidosis-due-to-metformin-accumulation-complicating-acute-gastroenteritis
#5
Olga DŽupová, Jana Kulichová
Lactic acidosis is the most severe adverse effect associated with metformin therapy of type 2 diabetes mellitus. The risk increases in patients with impaired renal function, most commonly due to diabetic nephropathy, and may be augmented when concurrent medication with a negative impact on renal function is used. The authors present a series of three patients who were admitted to a department of infectious diseases for acute gastroenteritis and within a few hours developed shock syndrome caused by severe lactic acidosis due to accumulation of metformin...
December 2016: Klinická Mikrobiologie a Infekc̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28134396/-metabolic-acidosis
#6
Giuseppe Regolisti, Filippo Fani, Riccardo Antoniotti, Giuseppe Castellano, Elena Cremaschi, Paolo Greco, Elisabetta Parenti, Santo Morabito, Alice Sabatino, Enrico Fiaccadori
Metabolic acidosis is frequently observed in clinical practice, especially among critically ill patients and/or in the course of renal failure. Complex mechanisms are involved, in most cases identifiable by medical history, pathophysiology-based diagnostic reasoning and measure of some key acid-base parameters that are easily available or calculable. On this basis the bedside differential diagnosis of metabolic acidosis should be started from the identification of the two main subtypes of metabolic acidosis: the high anion gap metabolic acidosis and the normal anion gap (or hyperchloremic) metabolic acidosis...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28077541/the-role-of-bicarbonate-precursors-in-balanced-fluids-during-haemorrhagic-shock-with-and-without-compromised-liver-function
#7
B Ergin, A Kapucu, P Guerci, C Ince
BACKGROUND: Lactate, acetate, and gluconate are anions used in balanced resuscitation fluids, of which lactate and acetate are considered bicarbonate precursors. This study investigated the role of the liver in the ability of balanced and unbalanced solutions to correct acid-base alterations and renal haemodynamics and microvascular oxygenation in a rat model of resuscitated haemorrhagic shock. METHODS: Ringer's lactate, Ringer's acetate, PlasmaLyte, or normal saline were administered following haemorrhagic shock in the presence or absence of a 70% partial liver resection...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27975067/hyperlactatemia-and-the-outcome-of-type-2-diabetic-patients-suffering-acute-myocardial-infarction
#8
Jovanovic Aleksandar, Peric Vladan, Snezana Markovic-Jovanovic, Radojica Stolic, Jadranka Mitic, Tanja Smilic
Background. Increased lactate production is frequent in unregulated/complicated diabetes mellitus. Methods. Three groups, each consisting of 40 patients (type 2 diabetics with myocardial infarction, DM+AMI, nondiabetics suffering myocardial infarction, MI, and diabetics with no apparent cardiovascular pathology, DM group), were tested for pH, serum bicarbonate and electrolytes, blood lactate, and CK-MB. Results. Blood lactate levels were markedly higher in AMI+DM compared to MI group (4.54 ± 1.44 versus 3...
2016: Journal of Diabetes Research
https://www.readbyqxmd.com/read/27974893/recoverable-record-high-lactic-acidosis-in-a-patient-with-glycogen-storage-disease-type-1-a-mixed-type-a-and-type-b-lactate-disorder
#9
Yonatan Oster, Isaiah D Wexler, Samuel N Heyman, Elchanan Fried
A 17-year-old patient with GSD type 1a (von Gierke disease) was hospitalized with an extremely elevated serum lactate following an intercurrent infection and interruption of his frequent intake of carbohydrates. The patient developed shock, oliguric renal failure, and cardiorespiratory failure requiring mechanical ventilation and inotropes. At the peak of metabolic decompensation and clinical instability, serum lactate reached a level of 47.6 mmol/L which was accompanied by a severe anion gap metabolic acidosis with a pH of 6...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27661862/ombitasvir-paritaprevir-ritonavir-dasabuvir-viekira-pak-induced-lactic-acidosis
#10
Catherine L Oberg, Robert J Hiensch, Hooman D Poor
OBJECTIVE: To report a case series of three patients with hepatitis C virus infection who all presented with severe type B lactic acidosis shortly after starting treatment with ombitasvir-paritaprevir-ritonavir-dasabuvir. DESIGN: Case series. SETTING: ICU. PATIENTS: Three patients, all who had HCV cirrhosis with mild hepatic impairment (Child-Pugh A) and had started taking ombitasvir-paritaprevir-ritonavir-dasabuvir within the preceding 2 weeks, presented with similar nonspecific symptoms of lethargy, fatigue, and nausea...
March 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27505323/an-unusual-case-of-cardiogenic-shock-in-which-thiamine-administration-led-to-reversal-of-lactic-acidosis-and-heart-function-recovery-shoshin-beriberi-in-an-adolescent
#11
Michela Cottini, Marco Ranucci, Caterina Facciolo, Angela Satriano, Hassan Kandill, Fabrizio Bettini, Carlo De Vincentis, Mauro Cotza, Andrea Ballotta
No abstract text is available yet for this article.
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27501325/metabolic-resuscitation-in-sepsis-a-necessary-step-beyond-the-hemodynamic
#12
COMMENT
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima
Despite the advances made in monitoring and treatment of sepsis and septic shock, many septic patients ultimately develop multiple organ dysfunction (MODS) and die, suggesting that other players are involved in the pathophysiology of this syndrome. Mitochondrial dysfunction occurs early in sepsis and has a central role in MODS development. MODS severity and recovery of mitochondrial function have been associated with survival. In recent clinical and experimental investigations, mitochondrion-target therapy for sepsis and septic shock has been suggested to reduce MODS severity and mortality...
July 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27389382/pathology-image-of-the-month-rapidly-progressive-hemorrhagic-cellulitis-of-bilateral-lower-extremities-with-subsequent-septic-shock-and-death
#13
Ellen E Connor, Nicole R Jackson, Robin R McGoey
A 51-year-old man presented to a community based emergency department with bilateral lower extremity swelling that began four days prior and that had evolved into recent blister formation on the left lower extremity. Medical history was significant only for hypertension and a recent self-described episode of "food poisoning" five days earlier characterized by diarrhea, nausea, and vomiting that quickly resolved. Physical exam revealed marked bilateral lower extremity edema and an ecchymotic rash below the knee...
May 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/27376570/metformin-and-contrast-induced-acute-kidney-injury-in-diabetic-patients-treated-with-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-amulticenter-study
#14
Marianne Zeller, Mathilde Labalette-Bart, Jean-Michel Juliard, Louis Potier, Laurent J Feldman, Philippe Gabriel Steg, Yves Cottin, Ronan Roussel
AIM: To analyze the association between chronic metformin treatment and the development of contrast-induced acute kidney injury (CI-AKI) after primary percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). METHODS: Patients with type 2 diabetes mellitus (T2DM) treated with PCI <24h in 2 coronary care units were included. Serum creatinine (Cr) was measured before and <48h after PCI. CI-AKI was defined as an increase in Cr>27μmol/l (0...
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27166007/conundrum-in-an-asthma-exacerbation
#15
Barney Thomas Jesudason Isaac, Thomas McLellan, Johnson Samuel, Bernard Yung
A 66-year-old man, an asthmatic, presented with symptoms suggestive of an acute exacerbation of asthma. His arterial blood gas revealed type 1 respiratory failure (PaO2 <8 kPa or 60 mm Hg with normal or low PaCO2) with a compensated lactic acidosis. He was treated for an asthma exacerbation and sepsis. Despite treatment, his respiratory rate remained elevated although his hypoxaemia improved. There was progressive worsening of the lactic acidosis. Treatment for sepsis was augmented. Peak flow measurements were not used to assess the severity of his exacerbation nor his response to treatment...
May 10, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27042361/acute-warfarin-toxicity-as-initial-manifestation-of-metastatic-liver-disease
#16
Varalaxmi Bhavani Nannaka, Nihar Jani, Masooma Niazi, Dmitry Lvovsky
Near complete infiltration of the liver secondary to metastasis from the head and neck cancer is a rare occurrence. The prognosis of liver failure associated with malignant infiltration is extremely poor; the survival time of patients is extremely low. We present a case of acute warfarin toxicity as initial manifestation of metastatic liver disease. Our patient is a 64-year-old woman presenting with epigastric pain and discomfort, found to have unrecordable International Normalized Ratio. She rapidly deteriorated with acute respiratory failure requiring mechanical ventilation, profound shock requiring high dose vasopressor infusion, severe coagulopathy, worsening liver enzymes with worsening of lactic acidosis and severe metabolic abnormalities, and refractory to aggressive supportive care and died in less than 48 hours...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/26971827/causes-of-death-among-patients-infected-with-hiv-at-a-tertiary-care-hospital-in-china-an-observational-cohort-study
#17
Jiang Xiao, Shuxu Du, Yunfei Tian, Wenjing Su, Di Yang, Hongxin Zhao
The objective of this study was to elucidate the causes of death and mortality in a cohort of inpatients infected with HIV. The causes of death and mortality were evaluated by using the clinical data of 1,076 patients admitted to the Center for Infectious Diseases, Beijing Ditan Hospital, between January 1, 2009, and November 30, 2012, and who were followed for 6 months after discharge. During the 4-year study period, 216 patients had died by the 6-month follow-up (mortality rate, 20.1%). Opportunistic infections were the most common causes of death (42...
August 2016: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/26775158/lactic-acidosis-and-severe-septic-shock-in-metformin-users-a-cohort-study
#18
Keren Doenyas-Barak, Ilia Beberashvili, Ronit Marcus, Shai Efrati
BACKGROUND: High serum lactate is associated with increased mortality in septic shock patients. Metformin alters lactate metabolism, and may affect its prognostic value. We compared, between metformin users and nonusers, the prognosis of extremely elevated plasma lactate levels in patients with septic shock. METHODS: The electronic medical records (EMR) of patients admitted to the emergency room between January 2011 and June 2013 were reviewed. The study cohort comprised patients with an initial diagnosis of septic shock and blood lactate higher than 10 mmol/L...
January 15, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26657404/changes-in-whole-body-oxygen-consumption-and-skeletal-muscle-mitochondria-during-linezolid-induced-lactic-acidosis
#19
Alessandro Protti, Dario Ronchi, Gabriele Bassi, Francesco Fortunato, Andreina Bordoni, Tommaso Rizzuti, Roberto Fumagalli
OBJECTIVE: To better clarify the pathogenesis of linezolid-induced lactic acidosis. DESIGN: Case report. SETTING: ICU. PATIENT: A 64-year-old man who died with linezolid-induced lactic acidosis. INTERVENTIONS: Skeletal muscle was sampled at autopsy to study mitochondrial function. MEASUREMENTS AND MAIN RESULTS: Lactic acidosis developed during continuous infusion of linezolid while oxygen consumption and oxygen extraction were diminishing from 172 to 52 mL/min/m and from 0...
July 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26586710/clinicopathologic-findings-of-hematological-malignancy-a-retrospective-autopsy-study
#20
Jennifer Dierksen, L Maximilian Buja, Lei Chen
Hematological malignancies exhibit many clinical presentations, from ambiguous systemic symptoms to rapid multi-organ failure. By identifying common clinical, laboratory, and autopsy findings in patients with a hematological malignancy, living patients may be diagnosed and treated earlier. We retrospectively reviewed our institution's 2003-2013 autopsy and respective medical records for patients with a hematological malignancy. Clinical, laboratory and autopsy findings were retrieved. 30 patients with hematological malignancy were identified, including 14 "new" cases, defined here as diagnosed either post-mortem (n=6) or within 4 weeks of death (n=8)...
2015: Annals of Clinical and Laboratory Science
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