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https://www.readbyqxmd.com/read/28334540/-acute-kidney-injury-a%C3%A2-current-comprehensive-overview
#1
Štefan Sotak
Acute kidney injury (AKI) is a syndrome characterized by the rapid loss of the glomerular filtration (GF) with consecutive retention of nitrogen-containing substances. It includes conditions from mild injury with slight metabolic derangements to oligoanuric failure with life-threatening metabolic disruption. 130 subjects with this renal injury were hospitalized at the Ist Department of Internal Medicine of the University Hospital of Louis Pasteur and the Medical Faculty of the University of Pavol Jozef Šafárik in Košice in the Slovak Republic in the years 2013, 2014 and 2015...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28325788/decompression-illness-with-hypovolemic-shock-and-neurological-failure-symptoms-after-two-risky-dives-a-case-report
#2
Sebastian Klapa, Johannes Meyne, Wataru Kähler, Frauke Tillmans, Henning Werr, Andreas Binder, Andreas Koch
Hypovolemia is known to be a predisposing factor of decompression illness (DCI) while diving. The typical clinically impressive neurological symptoms of DCI may distract from other symptoms such as an incipient hypovolemic shock. We report the case of a 61-year-old male Caucasian, who presented with an increasing central and peripheral neural failure syndrome and massive hypovolemia after two risky dives. Computed tomography (CT) scans of the chest and Magnetic resonance imaging scans of the head revealed multiple cerebral and pulmonary thromboembolisms...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28318633/capillary-leak-syndrome-etiologies-pathophysiology-and-management
#3
REVIEW
Eric Siddall, Minesh Khatri, Jai Radhakrishnan
In various human diseases, an increase in capillary permeability to proteins leads to the loss of protein-rich fluid from the intravascular to the interstitial space. Although sepsis is the disease most commonly associated with this phenomenon, many other diseases can lead to a "sepsis-like" syndrome with manifestations of diffuse pitting edema, exudative serous cavity effusions, noncardiogenic pulmonary edema, hypotension, and, in some cases, hypovolemic shock with multiple-organ failure. The term capillary leak syndrome has been used to describe this constellation of disease manifestations associated with an increased capillary permeability to proteins...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28272268/firefighter-work-duration-influences-the-extent-of-acute-kidney-injury
#4
Zachary J Schlader, Christopher L Chapman, Suman Sarker, Lindsey Russo, Todd C Rideout, Mark D Parker, Blair D Johnson, David Hostler
PURPOSE: We tested the hypothesis that elevations in biomarkers of acute kidney injury are influenced by the magnitude of hyperthermia and dehydration elicited by two common firefighter work durations. METHODS: Twenty-nine healthy adults (10 females) wearing firefighter protective clothing completed two randomized trials where they walked at 4.8 kph, 5% grade in a 38°C, 50% RH environment. In the SHORT trial, subjects completed two 20 min exercise bouts. In the LONG trial, subjects completed three 20 min exercise bouts...
March 7, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28253850/pulmonary-hypertension-attenuates-the-dynamic-preload-indicators-increase-during-experimental-hypovolemia
#5
Juan P Bouchacourt, Juan Riva, Juan C Grignola
BACKGROUND: Pulse pressure (PPV) and stroke volume (SVV) variations may not be reliable in the setting of pulmonary hypertension and/or right ventricular (RV) failure. We hypothesized that RV afterload increase attenuates SVV and PPV during hypovolemia in a rabbit model of pulmonary embolism (PE) secondary to RV dysfunction. METHODS: Seven anesthetized and mechanically ventilated rabbits were studied during four experimental conditions: normovolemia, blood withdrawal, pulmonary embolism and fluid loading of a colloidal solution...
March 3, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28244622/perioperative-considerations-for-the-food-allergic-pediatric-patient
#6
REVIEW
Patrick G Fernandez, Marco Mikhael
Patients with a history of food allergy and food intolerance are common in the pediatric population and are encountered frequently in the perioperative setting by pediatric anesthesiologists. Perioperatively, food allergy can present on a spectrum ranging from minor acute urticaria to more severe hypovolemia and anaphylactic shock. Allergy to foods including fruits, fish, egg, soy, and peanut are most concerning for their potential to cross-react with perioperative medications. There is little in the anesthesia literature that focuses on the perioperative management of children with food allergies...
February 28, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28213648/-state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept
#7
REVIEW
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperative fluid losses should be discriminated from volume losses (surgical blood loss or interstitial volume losses containing protein)...
March 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28209267/assessment-of-volume-status-and-appropriate-fluid-replenishment-in-the-setting-of-nephrotic-syndrome
#8
Pierluigi Marzuillo, Stefano Guarino, Andrea Apicella, Rosaria Marotta, Vincenzo Tipo, Laura Perrone, Angela La Manna, Giovanni Montini
BACKGROUND: When the permeability of the glomerular filtration barrier increases, leading to proteinuria, nephrotic syndrome (NS) occurs. First episodes or relapses of NS can be concurrent with acute gastroenteritis (AGE) infections. This condition can cause further deterioration of the hypovolemic state, as intravascular water is lost through both AGE-related vomiting/diarrhea and NS-related fluid shifting into the interstitium. In this case report, we wish to raise the issues about the difficult management of children presenting with both NS and AGE...
February 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28202822/-idiopathic-intracranial-hypotension
#9
Iwao Takeshita, Satoshi O Suzuki, Toru Iwaki
Idiopathic intracranial hypotension (hypovolemia) is almost exclusively provoked by cerebrospinal fluid (CSF) leakage through spontaneously rent dural sac. An initial clinical feature of a severe headache with or without nausea/vomiting should be differentiated from a life-threatening stroke. An early diagnosis and proper therapy may guarantee a good outcome, while delays may promote complicated manifestations and irreversible poor outcome in a few patients. In this article, neuro-imaging studies of some demonstrable cases are presented and the outlets of the spinal CSF and spinal CSF pathways are shown with immunohistological staining...
February 2017: Brain and Nerve, Shinkei Kenkyū No Shinpo
https://www.readbyqxmd.com/read/28164835/a-quick-reference-on-hyponatremia
#10
REVIEW
Julien Guillaumin, Stephen P DiBartola
The article focuses on causes of hyponatremia, including hypovolemia, diabetes mellitus and others. Hypovolemia is a major cause of hyponatremia in veterinary medicine. Hypovolemia causes a decrease in effective circulating volume, triggering antidiuretic hormone (ADH) secretion and free water retention, and develops after gastrointestinal losses, renal losses, hemorrhagic shock, hypoadrenocorticism, and other causes of hypovolemia. The article reviews the clinical approach to diagnosing the cause of hyponatremia in critically ill patients, including recognition of the syndrome of inappropriate ADH secretion (SIADH)...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/28135703/vascular-refilling-is-not-reduced-in-dialysis-sessions-with-morbid-events
#11
Susanne Kron, Daniel Schneditz, Til Leimbach, Sabine Aign, Joachim Kron
BACKGROUND: It is commonly believed that insufficient vascular refilling leads to hypovolemia during hemodialysis and contributes to intradialytic morbid events (IME). But data of refilling volumes at the time of IME are lacking. METHODS: We compared the vascular refilling in 10 patients with IME with 14 stable patients with normal blood volume at the dialysis end (66-80 mL/kg). RESULTS: The refilling characteristics in patients with IME did not differ from those in stable patients...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28127476/vasopressin-bolus-protocol-compared-to-desmopressin-ddavp-for-managing-acute-postoperative-central-diabetes-insipidus-and-hypovolemic-shock
#12
Anukrati Shukla, Syeda Alqadri, Ashley Ausmus, Robert Bell, Premkumar Nattanmai, Christopher R Newey
Introduction. Management of postoperative central diabetes insipidus (DI) can be challenging from changes in volume status and serum sodium levels. We report a case successfully using a dilute vasopressin bolus protocol in managing hypovolemic shock in acute, postoperative, central DI. Case Report. Patient presented after bifrontal decompressive craniotomy for severe traumatic brain injury. He developed increased urine output resulting in hypovolemia and hypernatremia. He was resuscitated with intravenous fluids including a dilute vasopressin bolus protocol...
2017: Case Reports in Endocrinology
https://www.readbyqxmd.com/read/28124862/fluid-management-in-thoracic-anesthesia
#13
Mert Şentürk, Mukadder Orhan Sungur, Zerrin Sungur
Fluid management during thoracic anesthesia remains as a challenge for the anesthesiologists. The "safe zone" between volume overload (risk of pulmonary edema) and hypovolemia (potential risk of renal failure) is hard to determine and narrow. Relationship between peroperative fluid administration and postoperative lung injury has been clearly demonstrated but lung injury can even occur after the most restrictive management. Multiple hit hypothesis and endothelial glycocalyx in addition to revised Starling equation can help us understand this dilemma...
January 25, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28122680/the-society-of-thoracic-surgeons-expert-consensus-for-the-resuscitation-of-patients-who-arrest-after-cardiac-surgery
#14
(no author information available yet)
The Society of Thoracic Surgeons Task Force on Resuscitation After Cardiac Surgery provides this professional society perspective on resuscitation in patients who arrest after cardiac surgery. This document was created using a multimodal methodology for evidence generation and includes information from existing guidelines, from the International Liaison Committee on Resuscitation, from our own structured literature reviews on issues particular to cardiac surgery, and from an international survey on resuscitation hosted by CTSNet...
January 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28101456/overview-of-albumin-and-its-purification-methods
#15
REVIEW
Ramin Raoufinia, Ali Mota, Neda Keyhanvar, Fatemeh Safari, Sara Shamekhi, Jalal Abdolalizadeh
As the most frequent plasma protein, albumin constitutes more than 50% of the serum proteins in healthy individuals. It has a key role in oncotic pressure maintenance and it is known as a versatile protein carrier for transportation of various endogenous and exogenous ligands. Reduced amounts of albumin in the body will lead to different kinds of diseases such as hypovolemia and hypoproteinemia. It also has various indications in shocks, burns, cardiopulmonary bypass, acute liver failure and etc. Further applications in research consist of cell culture supplement, drug delivery carrier and protein/drug stabilizer...
December 2016: Advanced Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28101452/severe-hyperkalemia-following-blood-transfusions-is-there-a-link
#16
Christos V Rizos, Haralampos J Milionis, Moses S Elisaf
Patients with gastrointestinal bleeding often require large volume blood transfusion. Among the various side effects of blood transfusion, the increase of potassium levels is a serious one which is often overlooked. We report a case of severe hyperkalemia in a patient with gastric bleeding after large volume transfusion of packed red blood cells. The patient had hyperkalemia at baseline associated with his receiving medication as well as acute renal failure following hypovolemia. The baseline hyperkalemia was further aggravated after massive transfusions of packed red blood cells in a short period of time...
January 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28092783/pulmonary-emboli-cardiac-arrest-with-cpr-complication-liver-laceration-and-massive-abdominal-bleed-a-case-report
#17
John Lundqvist, Jan G Jakobsson
INTRODUCTION: Massive pulmonary emboli may cause right ventricular failure and backward stasis with parenchymal organ swelling thus increasing the risk for laceration, e.g. if CPR is needed. PRESENTATION OF CASE: A 28-year-old Colombian female with no medical history but taking contraceptive pills and having had a recent longer flight was admitted to Danderyds hospital Emergency Department because of respiratory failure. She developed cardiac arrest in the emergence department following the emergent diagnosis of pulmonary emboli...
January 3, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28089598/impact-of-focused-intraoperative-transthoracic-echocardiography-by-anesthesiologists-on-management-in-hemodynamically-unstable-high-risk-noncardiac-surgery-patients
#18
Thomas Kratz, Thorsten Steinfeldt, Maik Exner, Marco Campo Dell Orto, Nina Timmesfeld, Caroline Kratz, Martin Skrodzki, Hinnerk Wulf, Martin Zoremba
OBJECTIVES: Focused transthoracic echocardiography (TTE) is used perioperatively for surgical patients. Intraoperative application of TTE is feasible, but its benefits remain unclear. The intention of this study was to investigate the effect of intraoperative TTE on the management of high-risk noncardiac surgery patients. DESIGN: A prospective interventional study. SETTING: Single-center university hospital. PARTICIPANTS: Fifty consecutive hemodynamically unstable high-risk patients anesthetized for noncardiac surgery...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28079765/early-recurrence-of-tako-tsubo-cardiomyopathy-in-an-elderly-woman-with-amyotrophic-lateral-sclerosis-different-triggers-inducing-different-apical-ballooning-patterns
#19
Francesco Santoro, Riccardo Ieva, Armando Ferraretti, Elena Carapelle, Luisa De Gennaro, Luigi Maria Specchio, Matteo Di Biase, Natale Daniele Brunetti
We report the case of early recurrence of Tako-Tsubo cardiomyopathy in an elderly woman with amyotrophic lateral sclerosis triggered by different stressors. A first episode with typical apical ballooning was anticipated by an emotional stress; a second, characterized by systolic anterior motion of the mitral valve associated with mitral regurgitation and severe intra-ventricular gradient, was precipitated by surgical stress and hypovolemia. We therefore hypothesize both a possible link between amyotrophic lateral sclerosis and Tako-Tsubo cardiomyopathy, and between different stressors and different Tako-Tsubo patterns...
January 11, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28069417/standing-shock-index-an-alternative-to-orthostatic-vital-signs
#20
Michael D Witting
Objective The lack of a sensitive, practical bedside test for hypovolemia has rekindled interest in the shock index (heart rate divided by systolic blood pressure). Here, we compare the effect of blood donation on standing shock index values with its effect on values for the supine shock index and orthostatic change in shock indicies (OCSI). METHODS: This is a re-analysis of data collected for an earlier report. Data were available from 292 adults below age 65 and 44 adults ages 65 and over, donating 450mL of blood...
December 23, 2016: American Journal of Emergency Medicine
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