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fluid and electrolyte

Po-Hao Chen, Hsien-Yuan Lane, Chieh-Hsin Lin
Neuroleptic malignant syndrome (NMS) is one of the most severe iatrogenic emergencies in clinical service. The symptoms including sudden consciousness change, critical temperature elevation and electrolytes imbalance followed by mutli-organ system failure were common in NMS. In addition to aggressive interventions with intravenous fluid resuscitation and antipyretics, several antidotes have been suggested to prevent further progression of the muscle damage. Dantrolene has been reported to be one of the most effective treatments for NMS...
November 30, 2016: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
Clarice L S Lopes, Paula Pitta Pinheiro, Luzia S Barberena, Guilherme U Eckert
OBJECTIVE: To describe the characteristics of children aged 0-14 years diagnosed with diabetic ketoacidosis and compare the following outcomes between children with prior diagnosis of type 1 diabetes mellitus (DM1) and children without prior diagnosis of DM1: length of hospital stay, severity on admission, insulin dosage, time of continuous insulin use, volume of fluids infused during treatment, and complications. METHODS: A retrospective descriptive study with review of medical records of patients admitted to the pediatric intensive care unit of a referral hospital from June 2013 to July 2015...
October 19, 2016: Jornal de Pediatria
Heni Rachmawati, Annisa Rahma, Loaye Al Shaal, Rainer H Müller, Cornelia M Keck
We have successfully developed curcumin nanosuspension intended for oral delivery. The main purpose is to improve bioavailability through enhancing its solubility. The nanoparticles were stabilized using various stabilizers, including polyvinyl pyrrolidone (PVP), polyvinyl alcohol (PVA), sodium carboxymethylcellulose (Na-CMC), d-α-tocopheryl polyethylene glycol 1000 succinate (TPGS), and sodium dodecyl sulfate (SDS). The average diameter of particles, microscopic appearance, and sedimentation of each preparation was observed and compared...
October 18, 2016: Scientia Pharmaceutica
Mordjane Boukhet, Fabien Piguet, Hadjer Ouldali, Manuela Pastoriza-Gallego, Juan Pelta, Abdelghani Oukhaled
The transport of macromolecules through nanopores is involved in many biological functions and is today at the basis of promising technological applications. Nevertheless the interpretation of the dynamics of the macromolecule/nanopore interaction is still misunderstood and under debate. At the nanoscale, inside biomimetic channels under an external applied voltage, electrophoresis, which is the electric force acting on electrically charged molecules, and electroosmotic flow (EOF), which is the fluid transport associated with ions, contribute to the direction and magnitude of the molecular transport...
October 20, 2016: Nanoscale
Zhiming Zhu
Management of hypertension in diabetes is critical for reducing cardiovascular mortality and morbidity. Dietary approaches for controlling high blood pressure have historically focused on sodium. Thus, many guidelines recommend that patients with type 2 diabetes reduce high sodium intake. Nonetheless, the potential benefits of sodium reduction are debatable. The kidney has a crucial role in glucose filtration and reabsorption in addition to its regulation of fluid and electrolyte homeostasis. A key factor linking sodium uptake and glucose transport is the sodium-glucose cotransporter 2 (SGLT2) in renal proximal tubular cells...
September 2016: Journal of Hypertension
Richard Wainford, Casey Carmichael, Kathryn Walsh
OBJECTIVE: We have demonstrated a critical role of CNS Gαi2 proteins in sodium homeostasis and blood pressure regulation. These studies tested the hypothesis that increased total body sodium activates the afferent renal afferent nerves to evoke sympathoinhibition to facilitate sodium homeostasis and normotension, via a PVN signal transduction pathway involving Gαi2 proteins, in the Sprague-Dawley (SD) rat. DESIGN AND METHOD: Conscious SD rats, having undergone sham or renal afferent nerve denervation (Renal-CAP) underwent an IV volume expansion (VE; 5% BW), HR, MAP, natriuresis and PVN neuronal activation were assessed (N = 5/group)...
September 2016: Journal of Hypertension
Robert Sümpelmann, Karin Becke, Sebastian Brenner, Christian Breschan, Christoph Eich, Claudia Höhne, Martin Jöhr, Franz-Josef Kretz, Gernot Marx, Lars Pape, Markus Schreiber, Jochen Strauss, Markus Weiss
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2...
October 17, 2016: Paediatric Anaesthesia
S Parthasarathy, R Sripriya, N Krishnaveni
Intestinal obstruction is associated with significant morbidity and mortality. Scientific assessment of the cause, site of obstruction, appropriate correction of the fluid deficit and electrolyte imbalance with preoperative stabilization of blood gases is ideal as a preoperative workup. Placement of a preoperative epidural catheter especially in the thoracic interspace takes care of perioperative pain and stress reduction. Intraoperative management by controlled general anesthesia administering a relative high inspired fraction of oxygen with invasive monitoring in selected sick cases is mandatory...
September 2016: Anesthesia, Essays and Researches
Dorota Sikorska, Krzysztof Pawlaczyk, Anna Olewicz-Gawlik, Natasza Czepulis, Bartlomiej Posnik, Ewa Baum, Maria Wanic-Kossowska, Bengt Lindholm, Andrzej Oko
BACKGROUND: Peritoneal dialysis (PD) patients with preserved residual diuresis have a lower risk of death and complications. Here we analyzed associations between residual diuresis and presence of fluid overload and biomarkers of cardiac strain and nutrition in PD patients. METHODS: Among 44 PD patients placed into three subgroups, depending on volume of residual diuresis (group A ≤ 500; group B 600-1900; and group C ≥ 2000 mL/day), we examined: overhydration (OH) assessed by bioimpedance analysis (BIA; yielding OH index OHBIA) and by clinical criteria (edema and hypertension); nutritional status (by subjective global assessment, SGA); metabolic status (electrolytes, serum lipid profile, CRP, and albumin); biomarkers of fluid overload and cardiac strain (N-terminal probrain natriuretic peptide, NT-proBNP, and troponin T, TnT); and, echocardiography and chest X-ray...
October 12, 2016: International Urology and Nephrology
Ce Yang, Jie Gao, Juan Du, Haiyan Wang, Jianxin Jiang, Zhengguo Wang
BACKGROUND: Rescue after a maritime disaster remains a great challenge in emergency medicine. OBJECTIVE: We performed an overview of rescue efforts among the victims in the sunken cruise ship Eastern Star in the 2015 Changjiang River marine disaster, as well as possible preventive measures in maritime transport situations. METHODS: The rescue records of 454 victims of the sunken ship were analyzed retrospectively. Their demographic data, rescue effects, accident inducement, and injury disposition were reviewed...
October 7, 2016: Journal of Emergency Medicine
Jennifer G Jetton, Mark Sorenson
Both acute kidney injury (AKI) and chronic kidney disease (CKD) are seen more frequently in the neonatal intensive care unit (NICU) as advances in supportive care improve the survival of critically ill infants as well as those with severe, congenital kidney and urinary tract anomalies. Many aspects of the infant's care, including fluid balance, electrolyte and mineral homeostasis, acid-base balance, and growth and nutrition require close monitoring by and collaboration among neonatologists, nephrologists, dieticians, and pharmacologists...
October 6, 2016: Seminars in Fetal & Neonatal Medicine
Sarah E Dodd, Christopher J Jankowski, Amy E Krambeck, Bhargavi Gali
Holmium laser enucleation of prostate (HoLEP) is being performed with increasing frequency as a minimally invasive alternative to transurethral resection of the prostate (TURP) for the surgical management of benign prostatic hyperplasia (BPH). HoLEP offers the advantage of use of normal saline for irrigation, instead of glycine which is utilized in TURP, decreasing the likelihood of fluid absorption and effects on serum electrolytes. We describe a patient who underwent HoLEP for BPH and subsequently developed non-ion gap metabolic acidosis and hemodilution associated with volume overload...
October 6, 2016: Journal of Anesthesia
Lawrence E Armstrong, Elaine C Lee, Douglas Casa, Evan C Johnson, Matthew S Ganio, Brendon McDermott, Jakob Vingren, Hymn M Oh, Keith H Williamson
Although case reports of exertional hyponatremia (EH) during prolonged exercise implicate retention of excess fluid, athletes with EH experience either loss, gain, or no change of body weight. Thus, the etiology and predisposing factors of EH may not be the same in all athletes. The present field investigation evaluated two unacquainted recreational cyclists (LC, 31y and AM, 39y) who began exercise with normal serum electrolytes but finished a summer 164-km ride (ambient, 34±5°C) with a serum [Na+] of 130 mmol/L...
October 6, 2016: International Journal of Sport Nutrition and Exercise Metabolism
Leila Heidari, Andrea Winquist, Mitchel Klein, Cassandra O'Lenick, Andrew Grundstein, Stefanie Ebelt Sarnat
Identification of populations susceptible to heat effects is critical for targeted prevention and more accurate risk assessment. Fluid and electrolyte imbalance (FEI) may provide an objective indicator of heat morbidity. Data on daily ambient temperature and FEI emergency department (ED) visits were collected in Atlanta, Georgia, USA during 1993-2012. Associations of warm-season same-day temperatures and FEI ED visits were estimated using Poisson generalized linear models. Analyses explored associations between FEI ED visits and various temperature metrics (maximum, minimum, average, and diurnal change in ambient temperature, apparent temperature, and heat index) modeled using linear, quadratic, and cubic terms to allow for non-linear associations...
October 2, 2016: International Journal of Environmental Research and Public Health
Olga Zegarra-Moran, Luis J V Galietta
CFTR protein is an ion channel regulated by cAMP-dependent phosphorylation and expressed in many types of epithelial cells. CFTR-mediated chloride and bicarbonate secretion play an important role in the respiratory and gastrointestinal systems. Pharmacological modulators of CFTR represent promising drugs for a variety of diseases. In particular, correctors and potentiators may restore the activity of CFTR in cystic fibrosis patients. Potentiators are also potentially useful to improve mucociliary clearance in patients with chronic obstructive pulmonary disease...
October 4, 2016: Cellular and Molecular Life Sciences: CMLS
Mei-Yu Hsu, Hsiao-Hui Hsu, Ji-Yan Lyu
Leakage is a common complication of gastrostomy. Exposure of the skin surrounding the gastrostomy tube to moisture or chemical irritants may cause moisture-associated skin damage (MASD) and seriously affect the patient's quality of life. This case study describes a nursing experience with gastrostomy leakage that resulted in MASD. An assessment conducted from July 29, 2015 to August 20, 2015 revealed that heavy gastronomy leakage had caused extensive skin erosion, ulceration, hyperplasia, and superficial infection...
October 2016: Hu Li za Zhi the Journal of Nursing
Tim Heise, Jens Jordan, Christoph Wanner, Martina Heer, Sreeraj Macha, Michaela Mattheus, Søren S Lund, Hans J Woerle, Uli C Broedl
PURPOSE: Our aim was to investigate the effects of the sodium glucose cotransporter 2 inhibitor empagliflozin on urinary and serum glucose and electrolytes, urinary volume, osmolality, and the renin-angiotensin system in patients with type 2 diabetes. METHODS: In an open-label study, 22 patients receiving metformin (median age 56 years; range 40-65 years) received empagliflozin 25 mg once daily for 5 days. Food, fluid, and sodium intake were standardized for 3 days before and during treatment...
September 28, 2016: Clinical Therapeutics
Foroogh Sabzghabaei, Seyed Alireza Heydariezade, Rashin S Joodat
INTRODUCTION: Hemodialysis (HD) has impact on the cardiovascular system by inducing changes in the characteristics of body fluids such as PH, temperature and electrolyte concentrations. In the previous studies, prolongation of the QT interval and increase of QT dispersion have been reported during HD sessions. These changes were more significant while using solutions with less potassium and higher bicarbonate during dialysis. OBJECTIVES: The aim of our study was to investigate the effects of different potassium and bicarbonate concentrations on electrocardiography (ECG) parameters and the electrochemical balance of cell membranes...
2016: Journal of Renal Injury Prevention
Fernando G Zampieri, Alexandre B Libório, Alexandre B Cavalcanti
PURPOSE OF REVIEW: To describe recent advances in the understanding of the role of fluid composition in renal outcomes in critically ill patients. RECENT FINDINGS: The debate on fluid composition is now focused in a pragmatic discussion on fluid electrolyte composition. The resurgence of this debate was propelled by several observational studies that suggested that balanced (i.e., low chloride) solutions were associated with less acute kidney injury in critically ill patients...
September 28, 2016: Current Opinion in Critical Care
Diana F Florescu, Uriel Sandkovsky
Diarrhea is a common complication in solid organ transplant (SOT) recipients and may be attributed to immunosuppressive drugs or infectious organisms such as bacteria, viruses or parasites. Cryptosporidium usually causes self-limited diarrhea in immunocompetent hosts. Although it is estimated that cryptosporidium is involved in about 12% of cases of infectious diarrhea in developing countries and causes approximately 748000 cases each year in the United States, it is still an under recognized and important cause of infectious diarrhea in SOT recipients...
September 24, 2016: World Journal of Transplantation
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