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Fluid critical care

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https://www.readbyqxmd.com/read/28217778/a-critical-insight-into-the-development-pipeline-of-microfluidic-immunoassay-devices-for-the-sensitive-quantitation-of-protein-biomarkers-at-the-point-of-care
#1
REVIEW
Ana I Barbosa, Nuno M Reis
The latest clinical procedures for the timely and cost-effective diagnosis of chronic and acute clinical conditions, such as cardiovascular diseases, cancer, chronic respiratory diseases, diabetes or sepsis (i.e. the biggest causes of death worldwide), involve the quantitation of specific protein biomarkers released into the blood stream or other physiological fluids (e.g. urine or saliva). The clinical thresholds are usually in the femtomolar to picolomar range, and consequently the measurement of these protein biomarkers heavily relies on highly sophisticated, bulky and automated equipment in centralised pathology laboratories...
February 20, 2017: Analyst
https://www.readbyqxmd.com/read/28217595/impact-of-pre-hospital-care-on-the-outcome-of-children-arriving-with-agonal-breathing-to-a-pediatric-emergency-service-in-south-india
#2
Debasis Das Adhikari, Krishna Mahathi, Urmi Ghosh, Indira Agarwal, Anila Chacko, Ebor Jacob, Kala Ebenezer
BACKGROUND: Data on the prehospital interventions received by critically ill children at arrival to Paediatric Emergency Services (PES) is limited in developing countries. This study aims to describe the pre-hospital care scenario, transport and their impact on outcome in non-traumatic, acutely ill children presenting in PES with agonal breathing. METHODS: Prospective observational study done on children aged below 15 years arriving in PES with agonal breathing due to non-trauma related causes...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28196107/fluid-overload-and-survival-in-critically-ill-patients-with-acute-kidney-injury-receiving-continuous-renal-replacement-therapy
#3
Il Young Kim, Joo Hui Kim, Dong Won Lee, Soo Bong Lee, Harin Rhee, Eun Young Seong, Ihm Soo Kwak, Sang Heon Song
BACKGROUND: Fluid overload is known to be associated with increased mortality in patients with acute kidney injury (AKI) who are critically ill. In this study, we intended to uncover whether the adverse effect of fluid overload on survival could be applied to all of the patients with AKI who received continuous renal replacement therapy (CRRT). METHODS: We analyzed 341 patients with AKI who received CRRT in our intensive care units. The presence of fluid overload was defined as a minimum 10% increase in body weight from the baseline...
2017: PloS One
https://www.readbyqxmd.com/read/28192732/reproductive-decisions-after-the-diagnosis-of-amniotic-fluid-embolism
#4
Amirhossein Moaddab, Miranda Klassen, Cynthia D Priester, Elvira H Munoz, Michael A Belfort, Steven L Clark, Gary A Dildy
OBJECTIVE: This study aims to describe the subsequent reproductive outcomes in women who either correctly or incorrectly were diagnosed with amniotic fluid embolism (AFE). STUDY DESIGN: Medical records were obtained, abstracted and reviewed by authors with extensive experience in critical care obstetrics. Telephone interviews of all survivors were conducted to determine obstetrical and contraceptive history. A subgroup underwent further telephone interview to address subsequent reproductive decisions...
January 23, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28190602/prevention-of-acute-kidney-injury-in-intensive-care-units
#5
S Mas-Font, J Ros-Martinez, C Pérez-Calvo, P Villa-Díaz, S Aldunate-Calvo, E Moreno-Clari
Acute kidney injury (AKI) is a growing concern in Intensive Care Units. The advanced age of our patients, with the increase in associated morbidity and the complexity of the treatments provided favor the development of AKI. Since no effective treatment for AKI is available, all efforts are aimed at prevention and early detection of the disorder in order to establish secondary preventive measures to impede AKI progression. In critical patients, the most frequent causes are sepsis and situations that result in renal hypoperfusion; preventive measures are therefore directed at securing hydration and correct hemodynamics through fluid perfusion and the use of inotropic or vasoactive drugs, according to the underlying disease condition...
February 9, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28187752/targeting-urine-output-and-30-day-mortality-in-goal-directed-therapy-a-systematic-review-with-meta-analysis-and-meta-regression
#6
Esther N van der Zee, Mohamud Egal, Diederik Gommers, A B Johan Groeneveld
BACKGROUND: Oliguria is associated with a decreased kidney- and organ perfusion, leading to organ damage and increased mortality. While the effects of correcting oliguria on renal outcome have been investigated frequently, whether urine output is a modifiable risk factor for mortality or simply an epiphenomenon remains unclear. We investigated whether targeting urine output, defined as achieving and maintaining urine output above a predefined threshold, in hemodynamic management protocols affects 30-day mortality in perioperative and critical care...
February 10, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28187026/an-algorithmic-approach-to-the-suspected-septic-wrist
#7
Jeffrey R Claiborne, Leslie G Branch, Michael Reynolds, Anthony J Defranzo
An acutely painful, erythematous wrist can be due to a variety of pathologic processes, including crystalline arthropathy, infection, trauma, osteoarthritis, and systemic disease. The broad differential diagnosis of the inflamed wrist and nonspecific clinical findings make accurate diagnosis challenging. There is no published clinical or laboratory criterion that reliably differentiates septic wrist arthritis from a sterile inflammatory arthropathy. For septic joint patients, long-term results are notably poorer in patients with a delay in treatment, therefore establishing evidenced-based guidelines deserves attention...
February 10, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28181934/novel-pump-control-technology-accelerates-drug-delivery-onset-in-a-model-of-pediatric-drug-infusion
#8
Michael J Parker, Mark A Lovich, Amy C Tsao, Hao Deng, Timothy Houle, Robert A Peterfreund
BACKGROUND: Laboratory data suggest that newly initiated drug infusions reach steady-state delivery after a significant time lag. Depending on drug and carrier flow rates and the infusion system's common volume, lag times may exceed 20 or more minutes, especially in the neonatal/pediatric critical care environment. This study tested the hypothesis that a computer-executed algorithm controlling infusion pumps in a coordinated fashion predictably hastens the achievement of the intended steady-state drug delivery in a model of neonatal/pediatric drug infusion...
February 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28177273/-you-feel-like-your-whole-world-is-caving-in-a-qualitative-study-of-primary-care-patients-conceptualisations-of-emotional-distress
#9
Adam Wa Geraghty, Miriam Santer, Samantha Williams, Jennifer Mc Sharry, Paul Little, Ricardo F Muñoz, Tony Kendrick, Michael Moore
General practitioners are tasked with determining the nature of patients' emotional distress and providing appropriate care. For patients whose symptoms appear to fall near the 'boundaries' of psychiatric disorder, this can be difficult with important implications for treatment. There is a lack of qualitative research among patients with symptoms severe enough to warrant consultation, but where general practitioners have refrained from diagnosis. We aimed to explore how patients in this potentially large group conceptualise their symptoms and consequently investigate lay understandings of complex distinctions between emotional distress and psychiatric disorder...
October 1, 2016: Health (London)
https://www.readbyqxmd.com/read/28176670/cerebrospinal-fluid-pleocytosis-in-critical-care-patients-with-seizures
#10
Carly Scramstad, Alan C Jackson
OBJECTIVES: To assess the etiology of cerebrospinal fluid (CSF) pleocytosis in critical care patients with seizure(s) or status epilepticus (SE). Many previous studies, some performed decades ago, concluded that CSF pleocytosis may be entirely attributable to seizure activity. METHODS: We undertook a retrospective chart review of adult patients with an admitting or acquired diagnosis of seizure(s) or SE in critical care units at the Winnipeg Health Sciences Centre between 2009 and 2012...
February 8, 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28169966/perioperative-management-of-adult-patients-with-external-ventricular-and-lumbar-drains-guidelines-from-the-society-for-neuroscience-in-anesthesiology-and-critical-care
#11
Abhijit V Lele, Amie L Hoefnagel, Nina Schloemerkemper, David A Wyler, Nophanan Chaikittisilpa, Monica S Vavilala, Bhiken I Naik, James H Williams, Lakshmikumar Venkat Raghavan, Ines P Koerner
External ventricular drains and lumbar drains are commonly used to divert cerebrospinal fluid and to measure cerebrospinal fluid pressure. Although commonly encountered in the perioperative setting and critical for the care of neurosurgical patients, there are no guidelines regarding their management in the perioperative period. To address this gap in the literature, The Society for Neuroscience in Anesthesiology & Critical Care tasked an expert group to generate evidence-based guidelines. The document generated targets clinicians involved in perioperative care of patients with indwelling external ventricular and lumbar drains...
February 6, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28153190/acute-pd-evidence-guidelines-and-controversies-%C3%A2
#12
REVIEW
Daniela Ponce, Andre Balbi, Brett Cullis
Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD...
January 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28149031/thoughts-on-the-current-management-of-acute-aluminum-phosphide-toxicity-and-proposals-for-therapy-an-evidence-based-review
#13
REVIEW
Maryam Vasheghani Farahani, Davood Soroosh, Sayed Mahdi Marashi
The majority of aluminum phosphide (ALP) toxicity cases are suicidal attempts. Despite advances in critical care medicine, the mortality rate of ALP remains very high. Unfortunately, knowledge on the toxicokinetics of ALP is very low. An obsolete idea was proposed that inhibition of complex IV of cytochrome C oxidase is responsible for multiorgan dysfunction. However, based on human studies, this effect might be insignificant. Thus, a novel idea proposes that the main mechanism might be vascular wall integrity disruption...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28146331/plasma-exchange-in-the-intensive-care-unit-technical-aspects-and-complications
#14
Aurélie Lemaire, Nathalie Parquet, Lionel Galicier, David Boutboul, Rémi Bertinchamp, Marion Malphettes, Guillaume Dumas, Eric Mariotte, Marie-Noëlle Peraldi, Virginie Souppart, Benoit Schlemmer, Elie Azoulay, Emmanuel Canet
BACKGROUND: Data on plasma exchange therapy in the intensive care unit (ICU) setting are scarce. We aimed to describe the technical aspects and the adverse events associated with the procedure in critically ill patients. METHODS: All adult patients treated by plasma exchange in the medical ICU of the Saint-Louis university hospital between January 1, 2013 and March 31, 2015 were prospectively included. RESULTS: We report on 260 plasma exchange procedures performed in 50 patients...
February 1, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/28144779/focused-cardiac-ultrasound-in-the-early-resuscitation-of-severe-sepsis-and-septic-shock-a-prospective-pilot-study
#15
Hiroshi Sekiguchi, Yohei Harada, Hector R Villarraga, Sunil V Mankad, Ognjen Gajic
PURPOSE: Point-of-care ultrasonography has been increasingly used in the care of critically ill patients; however, reports on its use during active resuscitation are limited. The aim of this study was to investigate the true impact of focused cardiac ultrasound (FCU) during the management of sepsis with early (6-h) resuscitation. METHODS: A prospective pilot observational study was conducted at an academic medical center from March 2011 through July 2012. Patients undergoing resuscitation for severe sepsis or septic shock were prospectively enrolled at medical and combined medical-surgical intensive care units...
January 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28143505/fluid-overload-is-an-independent-risk-factor-for-acute-kidney-injury-in-critically-ill-patients-results-of-a-cohort-study
#16
Nawal Salahuddin, Mustafa Sammani, Ammar Hamdan, Mini Joseph, Yasir Al-Nemary, Rawan Alquaiz, Ranim Dahli, Khalid Maghrabi
BACKGROUND: Acute Kidney injury (AKI) is common and increases mortality in the intensive care unit (ICU). We carried out this study to explore whether fluid overload is an independent risk factor for AKI. METHODS: Single-center prospective, observational study. Consecutively admitted, ICU patients were followed for development of AKI. Intravenous fluid volumes, daily fluid balances were measured, hourly urine volumes, daily creatinine levels were recorded. RESULTS: Three hundred thirty nine patients were included; AKI developed in 141 (41...
February 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28140617/progressive-consent-and-specimen-accrual-models-to-address-sustainability-a-decade-s-experience-at-an-oregon-biorepository
#17
John A Ost, Paul W Newton, Duncan R Neilson, Joseph A Cioffi, P Ashley Wackym, R Serene Perkins
BACKGROUND: The Legacy Biorepository is a College of American Pathologists-accredited biorepository operating within a seven-hospital healthcare system, with a decade's experience in specimen accrual, storage, and distribution. While standardization of our practices through accreditation remains a priority, we along with others face challenges with regard to sustainability. Purposeful changes in our consent process, which we term "progressive consent," are expected to improve sustainability and operational flexibility while increasing our scientific impact...
February 2017: Biopreservation and Biobanking
https://www.readbyqxmd.com/read/28139519/emergence-of-vancomycin-resistant-enterococci-at-a-teaching-hospital-saudi-arabia
#18
Fawzia E Alotaibi, Elham E Bukhari
BACKGROUND: Vancomycin-resistant enterococci (VRE) are a major and emerging hospital-acquired pathogen associated with high mortality, particularly among the critically ill and Intensive Care Units (ICUs) patients. This study aimed to determine the prevalence and demographic and clinical characteristics of VRE among patients admitted to a university hospital in Riyadh, Saudi Arabia. METHODS: A study was conducted during the period from September 2014 to November 2015 at King Khalid University Hospital, a tertiary care hospital in Riyadh, Saudi Arabia, including in-patients with VRE infection...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#19
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28134396/-metabolic-acidosis
#20
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
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