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intravenous fluid therapy

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https://www.readbyqxmd.com/read/28944301/intravenous-rehydration-of-malnourished-children-with-acute-gastroenteritis-and-severe-dehydration-a-systematic-review
#1
Kirsty A Houston, Jack G Gibb, Kathryn Maitland
Background: Rehydration strategies in children with severe acute malnutrition (SAM) and severe dehydration are extremely cautious. The World Health Organization (WHO) SAM guidelines advise strongly against intravenous fluids unless the child is shocked or severely dehydrated and unable to tolerate oral fluids. Otherwise, guidelines recommend oral or nasogastric rehydration using low sodium oral rehydration solutions. There is limited evidence to support these recommendations. Methods: We conducted a systematic review of randomised controlled trials (RCTs) and observational studies on 15 (th) June 2017 comparing different strategies of rehydration therapy in children with acute gastroenteritis and severe dehydration, specifically relating to intravenous rehydration, using standard search terms...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28940440/continuous-infusion-vs-intermittent-bolus-injection-of-furosemide-in-acute-decompensated-heart-failure-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#2
REVIEW
K T Ng, J L L Yap
Loop diuretics remain a fundamental pharmacological therapy to remove excess fluid and improve symptom control in acute decompensated heart failure. Several recent randomised controlled trials have examined the clinical benefit of continuous vs. bolus furosemide in acute decompensated heart failure, but have reported conflicting findings. The aim of this review was to compare the effects of continuous and bolus furosemide with regard to mortality, length of hospital stay and its efficacy profile in acute decompensated heart failure...
September 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28940011/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#3
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in Critical Care Medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
September 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28937238/effects-of-roflumilast-a-phosphodiesterase-4-inhibitor-on-the-lung-functions-in-a-saline-lavage-induced-model-of-acute-lung-injury
#4
P Kosutova, P Mikolka, M Kolomaznik, S Rezakova, A Calkovska, D Mokra
Acute lung injury (ALI) is associated with deterioration of alveolar-capillary lining and transmigration and activation of inflammatory cells. Whereas a selective phosphodiesterase-4 (PDE4) inhibitor roflumilast has exerted potent anti-inflammatory properties, this study evaluated if its intravenous delivery can influence inflammation, edema formation, and respiratory parameters in rabbits with a lavage-induced model of ALI. ALI was induced by repetitive saline lung lavage (30 ml/kg). Animals were divided into 3 groups: ALI without therapy (ALI), ALI treated with roflumilast i...
September 22, 2017: Physiological Research
https://www.readbyqxmd.com/read/28933805/perioperative-administration-of-buffered-versus-non-buffered-crystalloid-intravenous-fluid-to-improve-outcomes-following-adult-surgical-procedures
#5
REVIEW
Sohail Bampoe, Peter M Odor, Ahilanandan Dushianthan, Elliott Bennett-Guerrero, Suzie Cro, Tong J Gan, Michael Pw Grocott, Michael Fm James, Michael G Mythen, Catherine Mn O'Malley, Anthony M Roche, Kathy Rowan, Edward Burdett
BACKGROUND: Perioperative fluid strategies influence clinical outcomes following major surgery. Many intravenous fluid preparations are based on simple solutions, such as normal saline, that feature an electrolyte composition that differs from that of physiological plasma. Buffered fluids have a theoretical advantage of containing a substrate that acts to maintain the body's acid-base status - typically a bicarbonate or a bicarbonate precursor such as maleate, gluconate, lactate, or acetate...
September 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28927775/-pasteurella-multocida-meningoencephalitis-in-a-14-year-old-child
#6
L Kuoch, F Villedieu, G Favaretto, J Toulouse, L Mignot, M Jokic
Pasteurella multocida is generally responsible for local infections through animal bites. It can be a cause of meningitis, which tends to affect people at the extreme ages of life or suffering from immunodeficiency. A 14-year-old teenager was hospitalized with typical signs of bacterial meningitis. P. multocida was evidenced in the cerebrospinal fluid. Progression was marked by a degradation on the 4th day of treatment, despite intravenous antibiotic therapy with third-generation cephalosporin, followed by a single seizure on the 7th day of treatment...
September 15, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28925502/randomized-clinical-trial-of-antibiotic-therapy-for-uncomplicated-appendicitis
#7
H C Park, M J Kim, B H Lee
BACKGROUND: Uncomplicated appendicitis may resolve spontaneously or require treatment with antibiotics or appendicectomy. The aim of this randomized trial was to compare the outcome of a non-antibiotic management strategy with that of antibiotic therapy in uncomplicated appendicitis. METHODS: Patients presenting to a university teaching hospital with CT-verified uncomplicated simple appendicitis (appendiceal diameter no larger than 11 mm and without any signs of perforation) were randomized to management with a no-antibiotic regimen with supportive care (intravenous fluids, analgesia and antipyretics as necessary) or a 4-day course of antibiotics with supportive care...
September 19, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28916401/cart-cell-free-and-concentrated-ascites-reinfusion-therapy-against-malignancy-related-ascites
#8
REVIEW
Tetsuya Ito, Norio Hanafusa
A standard strategy against ascites, a common symptom observed in cirrhotic and cancer patients, includes restriction of sodium intake and use of a diuretic. Paracentesis is a widely applied method against refractory ascites that do not react to such treatment. However, emerging fatigue and hemodynamic instability are possibly attributable to a loss of protein included in ascites. Cell-free and Concentrated Ascites Reinfusion Therapy (CART) is also applied against refractory ascites. CART comprises three processes...
August 30, 2017: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/28916121/controversies-in-corticosteroid-use-for-sepsis
#9
Brit Long, Alex Koyfman
BACKGROUND: Severe sepsis and septic shock are potentially deadly conditions managed in the emergency department (ED). Management centers on source control, fluid resuscitation, broad-spectrum antimicrobials, and vasopressors as needed. The use of corticosteroids is controversial. OBJECTIVE: To evaluate the evidence behind corticosteroid therapy in patients with septic shock. DISCUSSION: Septic shock is associated with severe mortality and morbidity...
September 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28911957/a-double-blind-randomized-experimental-study-on-the-use-of-igm-enriched-polyclonal-immunoglobulins-in-an-animal-model-of-pneumonia-developing-shock
#10
Rosanna Vaschetto, Nausicaa Clemente, Aline Pagni, Teresa Esposito, Federico Longhini, Francesca Mercalli, Elena Boggio, Renzo Boldorini, Annalisa Chiocchetti, Umberto Dianzani, Paolo Navalesi
BACKGROUND: Patients with severe pneumonia often develop septic shock. IgM-enriched immunoglobulins have been proposed as a potential adjuvant therapy for septic shock. While in vitro data are available on the possible mechanisms of action of IgM-enriched immunoglobulins, the results of the in vivo experimental studies are non-univocal and, overall, unconvincing. We designed this double blinded randomized controlled study to test whether IgM-enriched immunoglobulins administered as rescue treatment in a pneumonia model developing shock, could either limit lung damage and/or contain systemic inflammatory response...
September 8, 2017: Immunobiology
https://www.readbyqxmd.com/read/28905944/snakebite-envenoming
#11
REVIEW
José María Gutiérrez, Juan J Calvete, Abdulrazaq G Habib, Robert A Harrison, David J Williams, David A Warrell
Snakebite envenoming is a neglected tropical disease that kills >100,000 people and maims >400,000 people every year. Impoverished populations living in the rural tropics are particularly vulnerable; snakebite envenoming perpetuates the cycle of poverty. Snake venoms are complex mixtures of proteins that exert a wide range of toxic actions. The high variability in snake venom composition is responsible for the various clinical manifestations in envenomings, ranging from local tissue damage to potentially life-threatening systemic effects...
September 14, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/28905004/gastroenteritis-aggressive-versus-slow-treatment-for-rehydration-gastro-a-pilot-rehydration-study-for-severe-dehydration-who-plan-c-versus-slower-rehydration
#12
Kirsty A Houston, Jack G Gibb, Ayub Mpoya, Nchafatso Obonyo, Peter Olupot-Olupot, Margeret Nakuya, Jennifer A Evans, Elizabeth C George, Diana M Gibb, Kathryn Maitland
BACKGROUND: The World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28894842/retroperitoneal-actinomycosis-a-rare-sequela-of-an-infected-obstructing-ureteral-stone
#13
Elizabeth Bearrick, Colby A Dixon, Joshua Rhein, Michael S Borofsky
Background: Actinomycosis is a condition in which Actinomyces, a normal component of the oral and gastrointenstial flora, becomes pathogenic in the setting of damaged tissue, leading to widespread tissue destruction across fascial planes. Prior literature describing this condition is rare, particularly cases involving the retroperitoneum. In this study, we report a case of retroperitoneal actinomycosis caused by an infected, obstructing ureteral stone. Case Presentation: A 48-year-old woman with a history of substance abuse, malnutrition, and gastric bypass presented to the emergency room with a 3-week history of abdominal pain and fevers...
2017: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/28891689/multimodal-drug-therapy-and-physical-rehabilitation-in-the-successful-treatment-of-capture-myopathy-in-a-lesser-flamingo-phoeniconaias-minor
#14
Michael Stephen McEntire, Carlos R Sanchez
A wild-caught lesser flamingo (Phoeniconaias minor) from the Fort Worth Zoo (Fort Worth, TX, USA) presented with moderate lameness that progressed to the inability to stand 2 days after restraint and handling. Results of blood tests showed severely elevated creatine phosphokinase (CPK) and aspartate aminotransferase (AST) activities, confirming suspected capture myopathy. Intensive supportive therapy, consisting of intravenous fluids and muscle relaxants, along with physical rehabilitation therapy, nutritional support, and anxiolytics, were instituted to aid in relaxation and muscle regeneration...
September 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/28890555/perioperative-fluid-management-from-physiology-to-improving-clinical-outcomes
#15
REVIEW
Victoria A Bennett, Maurizio Cecconi
Perioperative fluid management is a key component in the care of the surgical patient. It is an area that has seen significant changes and developments, however there remains a wide disparity in practice between clinicians. Historically, patients received large volumes of intravenous fluids perioperatively. The concept of goal directed therapy was then introduced, with the early studies showing significant improvements in morbidity and mortality. The current focus is on fluid therapy guided by an individual patient's physiology...
August 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28887078/management-of-residual-subdural-hematoma-after-burr-hole-evacuation-the-role-of-fluid-therapy-and-review-of-the-literature
#16
Nicola Montano, Vito Stifano, Benjamin Skrap, Edoardo Mazzucchi
A vast amount of literature has been published investigating the factors associated to the recurrence of a chronic subdural hematoma (SDH). However, little exists in the literature about the best medical management of the residual SDH in order to prevent the recurrence. Moreover only few studies quantitatively assess clinical and radiological outcomes of residual post-operative SDH. In this study, to our knowledge, we report the first series of chronic SDH with a quantitative outcomes analysis of the effects of fluid therapy on residual post-operative SDH...
September 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28886784/development-of-a-new-infusion-protocol-for-austere-trauma-resuscitations
#17
Stewart A Stancil
Intravenous fluid therapy for hemorrhagic shock has undergone enormous changes since it was first conducted almost 200 years ago. In the past 40 years especially, practices have dramatically changed with regards to fluid resuscitation. In pre-hospital, combat, austere, and rural emergency medicine the stakes are especially high to deliver an effective and logical resuscitation fluid strategy to a patient that is suffering from hemorrhagic shock. This article follows a prior article published in July 2014. It highlights the development of new cutting edge intravenous therapy regimens that maximize hemodynamic outcomes that can be effected by those providers that care for injured patients without the benefit of ample resources...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28884212/routine-sildenafil-does-not-improve-clinical-outcomes-after-fontan-operation
#18
J Leslie Gaddis Collins, Mark A Law, Santiago Borasino, W Clinton Erwin, David C Cleveland, Jeffrey A Alten
Fontan operation can be complicated by persistent chest tube output (CTO) leading to prolonged hospital length of stay (LOS). Postoperative sildenafil administration has been shown to improve clinical outcomes in selected patients after Fontan. We initiated a practice change utilizing intravenous (IV) sildenafil in early postoperative period in all patients undergoing Fontan operation with aim to decrease LOS and CTO. Nineteen patients (February 2014-May 2016) received 0.35 mg/kg sildenafil IV (three doses) followed by enteral, 1 mg/kg every eight hours until hospital discharge...
September 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28882877/clinical-pathway-produces-sustained-improvement-in-acute-gastroenteritis-care
#19
Lori Rutman, Eileen J Klein, Julie C Brown
BACKGROUND AND OBJECTIVES: Despite widespread use of the rotavirus vaccine in the last decade, dehydrating illnesses impact almost 2 billion children worldwide annually. Evidence supports oral rehydration therapy as a first-line treatment of mild to moderate dehydration. Ondansetron has proven to be a safe and effective adjunct in children with vomiting. We implemented a clinical pathway in our pediatric emergency department (ED) in January 2005 to improve care for this common condition...
September 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/28879093/refractory-acute-respiratory-failure-due-to-pneumocystis-jiroveci-pcp-and-cytomegalovirus-cmv-pneumonitis-a-case-report-and-review-of-literature
#20
Kairav Shah, Kartikeya Cherabuddi, Stacy G Beal, Gautam Kalyatanda
BACKGROUND: Opportunistic infections with Pneumocystis jiroveci pneumonia (PCP) are common in patients with HIV (human immunodeficiency virus) and are encountered once the CD4 count decreases below 200 cells/mm3. Cytomegalovirus (CMV) tends to cause disease once the CD4 count drops below 50 cells/mm3. CMV pneumonitis is not common in this population. However, detecting its presence in broncho-alveolar lavage (BAL) fluid has been associated with increased morbidity and mortality. The role of antiviral therapy against CMV remains unclear...
2017: IDCases
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