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Hypovolemia

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https://www.readbyqxmd.com/read/28101456/overview-of-albumin-and-its-purification-methods
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28059836/neurally-mediated-syncope-during-cesarean-delivery-a-case-report
#7
Seiko Sato, Erisa Nakamori, Go Kusumoto, Kenji Shigematsu, Ken Yamaura
A 28-year-old woman with preeclampsia at 32 weeks of gestation underwent a cesarean delivery under spinal anesthesia. Administration of nitroglycerin at 200 μg to relax uterine smooth muscles and the application of fundal pressure led to severe bradycardia and loss of consciousness, followed by cardiac arrest. Delivery was completed immediately and recovery was achieved 10 seconds later following cardiopulmonary resuscitation. Neurally mediated syncope was considered the cause of cardiac arrest. Anesthetists should be aware of the potential risk during cesarean delivery following the administration of nitroglycerin, fundal pressure, regional anesthesia, and hypovolemia because of preeclampsia...
January 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28057472/glutamatergic-modulation-of-noradrenaline-release-in-the-rat-median-preoptic-area
#8
Makoto Takahashi, Yasushi Hayashi, Junichi Tanaka
The present study was carried out to investigate whether glutamatergic receptor mechanisms modulate the release of noradrenaline (NA) in the region of the median preoptic nucleus (MnPO) using intracerebral microdialysis techniques in freely moving rats. Perfusion of N-methyl-d-asparatate (NMDA, 10 and 50μM) through the microdialysis probe significantly enhanced dialysate NA concentration in the region of the MnPO. Local perfusion of the NMDA antagonist dizocilpine (MK801, 10 and 50μM) did not change the basal release of NA in the MnPO area...
January 2, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28028565/severe-cerebral-hypovolemia-on-perfusion-ct-and-lower-body-weight-are-associated-with-parenchymal-haemorrhage-after-thrombolysis
#9
S Tsetsou, M Amiguet, A Eskandari, R Meuli, P Maeder, B Jiang, M Wintermark, P Michel
INTRODUCTION: Haemorrhagic transformation of acute ischemic stroke (AIS) and particularly parenchymal haemorrhage (PH) remains a feared complication of intravenous thrombolysis (IVT). We aimed to identify clinical and perfusion CT (PCT) variables which are independently associated with PHs. METHODS: In this observational cohort study, based on the Acute Stroke Registry Analysis of Lausanne (ASTRAL) from 2003 to December 2013, we selected patients with AIS involving the middle cerebral artery (MCA) territory who were thrombolysed within 4...
December 27, 2016: Neuroradiology
https://www.readbyqxmd.com/read/28003877/hemodynamic-monitoring-in-the-critically-ill-an-overview-of-current-cardiac-output-monitoring-methods
#10
REVIEW
Johan Huygh, Yannick Peeters, Jelle Bernards, Manu L N G Malbrain
Critically ill patients are often hemodynamically unstable (or at risk of becoming unstable) owing to hypovolemia, cardiac dysfunction, or alterations of vasomotor function, leading to organ dysfunction, deterioration into multi-organ failure, and eventually death. With hemodynamic monitoring, we aim to guide our medical management so as to prevent or treat organ failure and improve the outcomes of our patients. Therapeutic measures may include fluid resuscitation, vasopressors, or inotropic agents. Both resuscitation and de-resuscitation phases can be guided using hemodynamic monitoring...
2016: F1000Research
https://www.readbyqxmd.com/read/28003210/plasma-hyperosmolality-improves-tolerance-to-combined-heat-stress-and-central-hypovolemia-in-humans
#11
Daniel Gagnon, Steven A Romero, Hai Ngo, Paula Ys Poh, Craig G Crandall
: Heat stress profoundly impairs tolerance to central hypovolemia in humans, via a number of mechanisms including heat-induced hypovolemia. However, heat stress also elevates plasma osmolality; the effects of which on tolerance to central hypovolemia remain unknown. This study examined the effect of plasma hyperosmolality on tolerance to central hypovolemia in heat stressed humans. Using a counterbalanced and cross-over design, 12 subjects (1 female) received intravenous infusion of either 0...
December 21, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27990642/anemia-tolerance-during-normo-hypo-and-hypervolemia
#12
Malte Krömker, Patrick Lauscher, Harry Kertscho, Kai Zacharowski, Peter Rosenberger, Jens Meier
BACKGROUND: Restrictive intraoperative fluid management has been demonstrated to improve outcome of visceral and lung surgery in several studies. However, subsequent hypovolemia (HOV) may be accompanied by a decrease of anemia tolerance, resulting in increased transfusion needs. We therefore investigated the effect of volume status on anemia tolerance. STUDY DESIGN AND METHODS: Eighteen domestic pigs of either sex (mean weight, 23.5 ± 4.8 kg) were anesthetized, ventilated, and randomized into three experimental groups: normovolemia (no intervention), HOV (blood loss of 40% of blood volume), and hypervolemia (HEV; volume infusion of 40% of blood volume)...
December 19, 2016: Transfusion
https://www.readbyqxmd.com/read/27984669/the-influence-of-ringer-s-lactate-or-hes-130-0-4-administration-on-the-integrity-of-the-small-intestinal-mucosa-in-a-pig-hemorrhagic-shock-model-under-general-anesthesia
#13
Ana Liza Ortiz, Helena Vala, Carlos Venâncio, João Mesquita, Aura Silva, Jose Manuel Gonzalo-Orden, David Ferreira
OBJECTIVE: To determine the effect of fluid resuscitation with 2 different physiological solutions, Ringer's lactate (RL) and hydroxyethyl starch (HES) 130/0.4, on histological lesions of the small intestinal mucosa in anesthetized pigs subjected to severe acute bleeding. DESIGN: Prospective experimental study. SETTING: University teaching hospital. ANIMALS: Twenty-eight healthy Large White pigs, 3 months of age. INTERVENTIONS: Pigs were subjected to severe acute bleeding (30 mL/kg) under total intravenous anesthesia with propofol and remifentanil...
December 16, 2016: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/27968814/practical-assessment-of-volume-status-in-daily-practice
#14
REVIEW
Paula Johnson
Fluid therapy is considered the cornerstone of treatment for patients suffering from various medical ailments particularly in emergency and critical care situations where hypovolemia commonly occurs. The ability to accurately assess a patient's volume status is critical to the decision making process when synthesizing and implementing a fluid therapy plan. Both extremes, over supplementation or not supplementing enough fluid can be detrimental to the patient. Precisely assessing a patient's blood volume without access to advanced often complicated equipment and monitoring devices is challenging...
September 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/27939859/fluid-therapy-for-pediatric-patients
#15
REVIEW
Justine A Lee, Leah A Cohn
Young puppies and kittens have unique physiologic needs in regards to fluid therapy, which must address hydration, vascular fluid volume, electrolyte disturbances, or hypoglycemia. Pediatric patients have a higher fluid requirement compared with adults and can rapidly progress from mild dehydration to hypovolemia. Simultaneously, their small size makes overhydration a real possibility. Patient size complicates fluid administration because catheters used in larger pets may be difficult to place. Routes of fluid administration used in the neonate or pediatric patient include oral, subcutaneous, intraperitoneal, intraosseous, and intravenous...
December 8, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27928711/dry-weight-assessment-by-combined-ultrasound-and-bioimpedance-monitoring-in-low-cardiovascular-risk-hemodialysis-patients-a-randomized-controlled-trial
#16
Dimitrie Siriopol, Mihai Onofriescu, Luminita Voroneanu, Mugurel Apetrii, Ionut Nistor, Simona Hogas, Mehmet Kanbay, Radu Sascau, Dragos Scripcariu, Adrian Covic
PURPOSE: Fluid overload is associated with adverse outcomes in hemodialysis (HD) patients. The precise assessment of hydration status in HD patients remains a major challenge for nephrologists. Our study aimed to explore whether combining two bedside methods, lung ultrasonography (LUS) and bioimpedance, may provide complementary information to guide treatment in specific HD patients. METHODS: In total, 250 HD patients from two dialysis units were included in this randomized clinical trial...
January 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/27923205/spontaneous-rupture-of-splenic-hematoma-in-a-malaria-patient-case-report-and-review-of-literature
#17
Bassem M Abou Hussein, Ali M Al Ani, Omar Al-Mayoofi, Mahpara Mehraj, Afra A Joher, Juanita A Bonilla, Alya S Al-Mazrouei, Faisal M Badri
INTRODUCTION: Blunt abdominal trauma is the most common cause of splenic rupture. Malaria is the most frequent tropical infectious cause of spontaneous splenic rupture. The exact mechanism is not well-defined. CASE REPORT: We report a case of thirty-year-old male patient known to have malaria who presented with spontaneous splenic rupture. A trial of conservative treatment failed and splenecomy was done to control bleeding. CONCLUSION: Spontaneous splenic rupture should be kept in mind in malaria patients presenting with left upper quadrant pain and signs of hypovolemia...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27884959/cardiac-responses-to-exercise-distinguish-postural-orthostatic-tachycardia-syndrome-variants
#18
Paolo T Pianosi, Darrell R Schroeder, Philip R Fischer
We previously showed that one-third of adolescents with postural orthostatic tachycardia syndrome (POTS) have hyperkinetic circulation. In a subsequent cohort, we compare participants with POTS grouped according to cardiac output (Q˙) versus oxygen uptake (V˙O2) function, whose circulatory response to exercise lay at the lower end of this distribution. We hypothesized that such grouping determines the circulatory response to incremental-protocol, upright, cycle ergometry by whatever blend of flow and resistance adjustments best maintains normal blood pressure...
November 2016: Physiological Reports
https://www.readbyqxmd.com/read/27865972/paediatric-urolithiasis-in-emerging-economies
#19
REVIEW
S Adibul Hasan Rizvi, Sajid Sultan, Mirza Naqi Zafar, Bashir Ahmed, Sadaf Aba Umer, S A Anwar Naqvi
BACKGROUND: Paediatric urolithiasis remains endemic in low resource countries. This review highlights the epidemiology, causation and management of urolithiasis in an Asian country in the context of emerging economies. METHODS: A literature review of recent articles with key words paediatric urolithiasis, developing countries, endemic stone disease, stone composition, metabolic risk factors, management of paediatric urolithiasis was undertaken and 51 relevant articles were selected with the main focus on experience of this center in managing stone disease in the last two decades...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27864916/enhanced-contractility-of-intraparenchymal-arterioles-after-global-cerebral-ischemia-in-rat-new-insights-into-the-development-of-delayed-cerebral-hypoperfusion
#20
Stine Spray, Sara Ellinor Johansson, Aneta Radziwon-Balicka, Kristian Agmund Haanes, Karin Warfvinge, Gro Klitgaard Povlsen, Paul A T Kelly, Lars Edvinsson
AIM: Delayed cerebral hypoperfusion is a secondary complication found in the days after transient global cerebral ischemia that worsens the ischemic damage inflicted by the initial transient episode of global cerebral ischemia. A recent study demonstrated increased cerebral vasoconstriction in the large arteries on the brain surface (pial arteries) after global cerebral ischemia. However, smaller arterioles inside the brain (parenchymal arterioles) are equally important in the regulation of cerebral blood flow and yet their pathophysiology after global cerebral ischemia is largely unknown...
November 19, 2016: Acta Physiologica
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