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Fluid critical care

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https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#1
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#2
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28620552/refractory-lactic-acidosis-in-small-cell-carcinoma-of-the-lung
#3
Daniel J Oh, Ellen Dinerman, Andrew H Matthews, Abraham W Aron, Katherine M Berg
BACKGROUND: Elevated lactate levels in critically ill patients are most often thought to be indicative of relative tissue hypoxia or type A lactic acidosis. Shock, severe anemia, and thromboembolic events can all cause elevated lactate due to tissue hypoperfusion, as well as the mitochondrial dysfunction thought to occur in sepsis and other critically ill states. Malignancy can also lead to elevation in lactate, a phenomenon described as type B lactic acidosis, which is much less commonly encountered in the critically ill...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28610957/effectiveness-of-heart-rate-control-on-hemodynamics-in-critically-ill-patients-with-atrial-tachyarrhythmias-managed-by-amiodarone
#4
Joe-Elie Salem, Pauline Dureau, Christian Funck-Brentano, Jean-Sébastien Hulot, Maria El-Aissaoui, Nadia Aissaoui, Saik Urien, Christophe Faisy
Atrial tachyarrhythmias (AT) are common in intensive care unit (ICU) patients and might contribute to hemodynamic instability if heart rate (HR) is persistently too rapid. We aimed to assess if HR control below 115 or 130bpm with amiodarone improves hemodynamics in ICU patients with AT. This observational study included 73 ICU patients with disabling AT receiving amiodarone for HR control. A total of 525 changes (mainly within 4-8h) in mean arterial pressure (MAP) and 167 changes in plasma lactate in response to HR variations above 115 or 130bpm were analyzed...
June 10, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28600736/blood-pressure-management-in-children-on-dialysis
#5
F Paglialonga, S Consolo, A Edefonti, G Montini
Hypertension is a leading cause of cardiovascular complications in children on dialysis. Volume overload and activation of the renin-angiotensin-aldosterone system play a major role in the pathophysiology of hypertension. The first step in managing blood pressure (BP) is the careful assessment of ambulatory BP monitoring. Volume control is essential and should start with the accurate identification of dry weight, based on a comprehensive assessment, including bioimpedance analysis and intradialytic blood volume monitoring (BVM)...
June 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#6
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28597121/current-research-priorities-in-perioperative-intensive-care-medicine
#7
REVIEW
Michael A Gillies, Michael Sander, Andrew Shaw, Duminda N Wijeysundera, John Myburgh, Cesar Aldecoa, Ib Jammer, Suzana M Lobo, Naomi Pritchard, Michael P W Grocott, Marcus J Schultz, Rupert M Pearse
INTRODUCTION: Surgical treatments are offered to more patients than ever before, and increasingly to older patients with chronic disease. High-risk patients frequently require critical care either in the immediate postoperative period or after developing complications. The purpose of this review was to identify and prioritise themes for future research in perioperative intensive care medicine. METHODS: We undertook a priority setting process (PSP). A panel was convened, drawn from experts representing a wide geographical area, plus a patient representative...
June 8, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28595555/microdialysis-assessed-adipose-tissue-metabolism-in-critically-ill-patients
#8
Ioannis Ilias, Nikitas Nikitas, Maria Theodorakopoulou, Ioanna Dimopoulou
BACKGROUND: Microdialysis is a minimally invasive technique that allows direct in situ and in vivo sampling, studies and manipulations of the interstitial/extracellular fluid/space. It has been shown to be of use mainly in acute brain injury/neurocritical care. METHODS: Microdialysis has been used to study obesity, diabetes mellitus, inflammation and pharmacokinetics at the adipose tissue level. In critically ill patients (and particularly in those with sepsis or septic shock), within days to weeks, adipose tissue shows profound alterations; under such conditions the implementation of microdialysis can provide researchers with interesting findings...
June 8, 2017: Recent Patents on Endocrine, Metabolic & Immune Drug Discovery
https://www.readbyqxmd.com/read/28578440/adherence-to-surviving-sepsis-guidelines-among-pediatric-intensivists-a-national-survey
#9
Farah C Thabet, Jihad N Zahraa, May S Chehab
To assess the compliance with the 2006 American College of Critical Care-Pediatric Advanced Life Support (ACCM-PALS) guidelines for sepsis management, and the 2012 surviving sepsis campaign (SSC), for the management of pediatric patients with sepsis and to identify the main barriers to adherence to these guidelines. Methods: In November 2015, a prospective cohort study in which a web based electronic survey using a case scenario to explore the usual management of a child with severe sepsis was designed and sent to all consultant pediatric intensivists practicing in Kingdom of Saudi Arabia (KSA)...
June 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#10
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28572520/clinical-management-of-sepsis
#11
S M Lam, A Cw Lau, R Pk Lam, W W Yan
Sepsis is a common cause of hospital admission worldwide and contributes significantly to morbidity and mortality. The definition of sepsis has evolved from the 1991 American College of Chest Physicians/Society of Critical Care Medicine definition based on the criteria of systemic inflammatory response syndrome, to the 2016 Sepsis-3 definition that incorporates the Sequential Organ Failure Assessment score. The landmark trial on protocolised early goal-directed therapy was published in 2001, but three subsequent multicentre randomised controlled trials (ProCESS, ARISE, and ProMISe) in 2014-2015 did not confirm a survival benefit with protocolised care...
June 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28561253/obstetric-disorders-in-the-icu
#12
Daniela N Vasquez, Lauren Plante, María N Basualdo, Gustavo G Plotnikow
Pregnant and postpartum patients represent a challenge to critical care physicians, as two patients in one have to be cared for and because specific obstetric disorders, not universally covered in formal critical care training, need to be managed. Pregnancy also alters physiologic norms, so that the critical care physician may either fail to recognize a value as abnormal in pregnancy or mistakenly identify as abnormal a value within the normal range for a pregnant woman. In this article, we will review the most frequent obstetric causes of admission of pregnant/postpartum patients to the intensive care unit (hypertensive disease of pregnancy, obstetric hemorrhage, and obstetric sepsis) along with their diagnostic criteria, clinical presentation, and recommended treatment...
April 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28540552/application-of-ruo2-ni-foam-electrodes-for-remediation-of-ibuprofen-in-soil-matrix-the-effect-of-electrokinetic-parameters
#13
Ching Yuan, Chung-Hsuang Hung, Tzu-Yuan Huang
Pharmaceuticals and personal care products (PPCPs) are an extraordinary and diverse group of chemicals used in veterinary medicine, agriculture, and for human health and cosmetics care. They are considered emerging contaminants and have raised great concern in recent years. Among the PPCPs, ibuprofen (IBP) is one of the most known non-steroidal anti-inflammatory drugs, which has been found at a high concentration in irrigation water in the USA and showed harmful effect for organisms. This study examined IBP degradation performance by an electrokinetic process coupled with 24-96 cm(2) of RuO2/Ni foam (RN) electrodes applied 1-3 V cm(-1) potential gradient for 5-9 days...
May 24, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28536944/fluid-responsiveness-predicted-by-transcutaneous-partial-pressure-of-oxygen-in-patients-with-circulatory-failure-a-prospective-study
#14
Jingyuan Xu, Xiao Peng, Chun Pan, Shixia Cai, Xiwen Zhang, Ming Xue, Yi Yang, Haibo Qiu
BACKGROUND: Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO2) in the critically ill patients. METHODS: This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Shock patients who presented with at least one clinical sign of inadequate tissue perfusion, defined as systolic blood pressure <90 mmHg or a decrease >40 mmHg in previously hypertensive patients or the need for vasopressive drugs; urine output <0...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28530846/monitoring-nutrition-in-critical-illness-what-can-we-use
#15
Suzie Ferrie, Erica Tsang
BACKGROUND: Nutrition monitoring in the context of critical care presents unique challenges. Traditionally used anthropometric and biochemical markers may be difficult to obtain or confounded by factors such as fluid status and the inflammatory response. A previous survey identified 15 parameters in common use, all of which have confounding influences during critical illness. MATERIALS AND METHODS: A literature search was conducted to assess current use of commonly used nutrition-monitoring parameters and to explore other possible methods that might be more useful...
May 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28530809/preparation-of-linear-cryogel-arrays-as-a-microfluidic-platform-for-immunochromatographic-assays
#16
Marc Zinggeler, Patrick L Fosso, Yan Hao, Thomas Brandstetter, Jürgen Rühe
We describe a new microfluidic platform to perform immunochromatographic assays. The platform consists of a linear assembly of small, porous cryogel monoliths functionalized with various biomolecules. The cryogels are anchored in an optically transparent capillary, which serves as the microfluidic carrier. This assembly enables fluid flow by capillary action and simple optical detection. Using an in situ preparation method, individual compartments are generated from small plugs of polymer solutions that are transformed into small individually functionalized cryogel monoliths through a photoinduced cross-linking reaction...
June 6, 2017: Analytical Chemistry
https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#17
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28527880/intensive-monitoring-of-urine-output-is-associated-with-increased-detection-of-acute-kidney-injury-and-improved-outcomes
#18
Kui Jin, Raghavan Murugan, Florentina E Sileanu, Emily Foldes, Priyanka Priyanka, Gilles Clermont, John A Kellum
BACKGROUND: Urine output (UO) is a vital sign for critical ill patients but standards for monitoring and reporting vary widely between ICUs. Careful monitoring of UO could lead to earlier recognition of acute kidney injury (AKI) and better fluid management. We sought to determine if intensity of UO monitoring is associated with outcomes in patients with and without AKI. METHODS: Retrospective cohort study including 15,724 adults admitted to ICUs from 2000-2008. Intensive UO monitoring was defined as hourly recordings and no gaps >3 hours for the first 48 hours after ICU admission...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28525778/inferior-vena-cava-collapsibility-detects-fluid-responsiveness-among-spontaneously-breathing-critically-ill-patients
#19
Keith A Corl, Naomi R George, Justin Romanoff, Andrew T Levinson, Darin B Chheng, Roland C Merchant, Mitchell M Levy, Anthony M Napoli
PURPOSE: Measurement of inferior vena cava collapsibility (cIVC) by point-of-care ultrasound (POCUS) has been proposed as a viable, non-invasive means of assessing fluid responsiveness. We aimed to determine the ability of cIVC to identify patients who will respond to additional intravenous fluid (IVF) administration among spontaneously breathing critically-ill patients. METHODS: Prospective observational trial of spontaneously breathing critically-ill patients...
May 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28524040/-a-case-of-the-severe-human-infection-by-avian-influenza-h7n9-was-rescued-successfully-by-the-sepsis-bundle
#20
Shaohong Wang, Jintao Liu, Haili Luo, Xianguo Pan, Tongmei Yuan, Xuemei Long
One confirmed diagnosis case of severe human infection by avian influenza H7N9 admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Guizhou Medical University on January 12th, 2017 was reported. The patient was treated with the sepsis bundle, and recovered finally, including a series of comprehensive treatments, such as respiratory support, circulation support, antiviral, anti-inflammation, immunization enhancement, critical nursing, fluid management, nutritional support and treatment of complications...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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