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https://www.readbyqxmd.com/read/28331624/comparison-of-hydroxyethyl-starch-regulatory-summaries-from-the-food-and-drug-administration-and-the-european-medicines-agency
#1
Christian J Wiedermann, Klaus Eisendle
This article aims to highlight the positions of the Food and Drug Administration and the European Medicines Agency regarding use and marketing of hydroxyethyl starch (HES) products, and how these have changed over recent years. In 2013, warnings from both agencies advised against use of HES in critically ill patients, including patients with sepsis, when several large randomized controlled trials on volume resuscitation in critical illness failed to observe clinically beneficial effects of HES. In areas such as patient monitoring and requirements for further clinical trials, the FDA and EMA are very much in agreement in their recommendations...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28329897/maternal-labor-delivery-and-perinatal-outcomes-associated-with-placental-abruption-a-systematic-review
#2
Katheryne L Downes, Katherine L Grantz, Edmond D Shenassa
Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption...
March 22, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28321321/associations-between-fluid-balance-and-outcomes-in-critically-ill-children-a-protocol-for-a-systematic-review-and-meta-analysis
#3
Rashid Alobaidi, Catherine Morgan, Rajit K Basu, Erin Stenson, Robin Featherstone, Sumit R Majumdar, Sean M Bagshaw
BACKGROUND: Fluid therapy is a mainstay during the resuscitation of critically ill children. After initial stabilization, excessive fluid accumulation may lead to complications of fluid overload, which has been independently associated with increased risk for mortality and major morbidity in critically ill children. OBJECTIVES: Perform an evidence synthesis to describe the methods used to measure fluid balance, define fluid overload, and evaluate the association between fluid balance and outcomes in critically ill children...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28246141/vasopressor-use-following-traumatic-injury-protocol-for-a-systematic-review
#4
Mathieu Hylands, Augustin Toma, Nicolas Beaudoin, Anne-Julie Frenette, Frederick D'Aragon, Emilie Belley-Côté, Morten Hylander, François Lauzier, Reed Alexander Siemieniuk, Emmanuel Charbonney, Joey Kwong, Jon Henrik Laake, Gordon Guyatt, Per Olav Vandvik, Bram Rochwerg, Robert Green, Ian Ball, Damon Scales, Srinivas Murthy, Sandro Rizoli, Pierre Asfar, François Lamontagne
INTRODUCTION: Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28236379/cruciform-position-for-trauma-resuscitation
#5
Biswadev Mitra, Mark C Fitzgerald, Alexander Olaussen, Prasanthan Thaveenthiran, Jordan Bade-Boon, Katherine Martin, De Villiers Smit, Peter A Cameron
Multiply injured patients represent a particularly demanding subgroup of trauma patients as they require urgent simultaneous clinical assessments using physical examination, ultrasound and invasive monitoring together with critical management, including tracheal intubation, thoracostomies and central venous access. Concurrent access to multiple body regions is essential to facilitate the concept of 'horizontal' resuscitation. The current positioning of trauma patient, with arms adducted, restricts this approach...
February 25, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28220241/-icd-in-elderly-patients
#6
Carsten W Israel
Treatment with an implantable cardioverter-defibrillator (ICD) represents a prognostic but not symptomatic therapy. It should therefore be restricted to patients where an improvement of prognosis is possible and reasonable. ICD implantation should only be performed in patients with a life expectancy of at least 1 year at reasonable quality of life. The decision in which patient improvement of prognosis is no longer a desirable target is problematic, both medically and ethically. It is not entirely clear in which elderly patient an ICD therapy can convey prognostic benefit despite comorbidity and competitive life-threatening diseases, as it is unclear how old age should be defined...
February 20, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28214236/are-hospital-ed-transfers-less-likely-among-nursing-home-residents-with-do-not-hospitalize-orders
#7
Taeko Nakashima, Yuchi Young, Wan-Hsiang Hsu
OBJECTIVES: This study aims to examine whether an advance directive "Do Not Hospitalize" (DNH) would be effective in reducing hospital/emergency department (ED) transfers. Similar effects in residents with dementia were also examined. DESIGN: Cross-sectional study. SETTING/SUBJECTS: New York State (NYS) nursing home residents (n = 43,024). MEASUREMENTS AND ANALYSIS: The Minimum Data Set 2.0 was used to address the study aims...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28150304/effects-of-fluid-restriction-on-measures-of-circulatory-efficacy-in-adults-with-septic-shock
#8
RANDOMIZED CONTROLLED TRIAL
P B Hjortrup, N Haase, J Wetterslev, T Lange, H Bundgaard, B S Rasmussen, N Dey, E Wilkman, L Christensen, D Lodahl, M Bestle, A Perner
BACKGROUND: The haemodynamic consequences of fluid resuscitation in septic shock have not been fully elucidated. Therefore, we assessed circulatory effects in the first 24 h of restriction of resuscitation fluid as compared to standard care in intensive care unit (ICU) patients with septic shock. METHODS: This was a post-hoc analysis of the multicentre CLASSIC randomised trial in which patients with septic shock, who had received the initial fluid resuscitation, were randomised to a protocol restricting resuscitation fluid or a standard care protocol in nine ICUs...
April 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28044331/cerebral-oximetry-and-its-role-in-adult-cardiac-non-cardiac-surgery-and-resuscitation-from-cardiac-arrest
#9
REVIEW
D W Green, G Kunst
Monitors using near-infra red spectroscopy to assess cerebral oxygenation levels non-invasively in discrete areas of the brain have been used clinically for over 20 years. Interest has intensified recently, especially during cardiac surgery, and there are now five commercially available devices. Despite the attraction of being able to measure oxygen supply/demand in such a critical area, there has been only limited uptake of this technology in overall clinical anaesthetic practice. This narrative review aims to explore not only the rationale for using this technology but also the factors which have restricted its more widespread use...
January 2017: Anaesthesia
https://www.readbyqxmd.com/read/28041551/-haemostatic-resuscitation-in-bleeding-trauma-patients
#10
Jakob Stensballe, Pär I Johansson, Jacob Steinmetz
Trauma haemorrhage is a common reversible cause of death. Haemostatic resuscitation focuses on replacing the lost blood with transfusions equivalent to whole blood as early as possible. In Denmark, the optimal ratio for transfusions in massive bleeding is four packs of red blood cells, four packs of plasma and one pool of platelets (equal to ratio 1:1:1 in USA). Haemostatic resuscitation also includes a restricted use of crystalloids, early tranexamic acid, and a goal-directed transfusion therapy by using viscoelastic haemostatic assays to detect coagulopathy and the need for additional transfusions or pro-haemostatics...
December 26, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28033136/permissive-hypotension-and-trauma-can-fluid-restriction-reduce-the-incidence-of-ards
#11
Melissa Kolarik, Eric Roberts
Emergency care, including the resuscitation of patients involved in traumatic events, has evolved over the years. A prior practice of utilizing large volumes of crystalloids has been found to contribute to complications such as coagulopathy, fluid overload, and adult respiratory distress syndrome (ARDS). In contrast, permissive hypotension is a method of fluid restriction that allows for low blood pressure and mean arterial pressure during the resuscitation period. When permissive hypotension occurs and fluids are restricted in trauma patients, the incidence of ARDS can be reduced significantly with improvement in patient outcomes...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28027250/important-developments-in-burn-care
#12
Kevin J Zuo, Abelardo Medina, Edward E Tredget
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Explain the epidemiology of severe burn injury in the context of socioeconomic status, gender, age, and burn cause. 2. Describe challenges with burn depth evaluation and novel methods of adjunctive assessment. 3. Summarize the survival and functional outcomes of severe burn injury. 4. State strategies of fluid resuscitation, endpoints to guide fluid titration, and sequelae of overresuscitation. 5. Recognize preventative measures of sepsis...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28004964/patient-safety-under-deep-sedation-for-digestive-endoscopic-procedures
#13
Julián Álvarez, Rafael Cabadas, Manuel de la Matta
Deep sedation with Propofol has become popular in recent years. The safety of this technique when administered by non-anaesthesiologists has created much controversy which at times is masked in a contentious debate on the economic sustainability of the health system. In 2011, the Spanish Society of Anaesthesiology, Resuscitation and Pain Therapy, along with 20 other organisations from European countries, revoked the recommendations of the European Society of Gastrointestinal Endoscopy on the administration of Propofol by non-anaesthesiologists, citing that it is "extremely dangerous for the safety and quality of endoscopic procedures"...
December 22, 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27915124/a-literature-review-examining-the-barriers-to-the-implementation-of-family-witnessed-resuscitation-in-the-emergency-department
#14
REVIEW
Catherine Johnson
BACKGROUND: Caring for people near death in the Emergency Department (ED) is challenging for professionals, duty bound to respond to the needs of the dying. Family witnessed resuscitation (FWR) is practiced internationally, allowing relatives to be present at the time of a patient's death, offering comfort to the dying and aiding the bereaved along a healthy grief trajectory. AIM: The literature review elicits barriers to the implementation of FWR in the ED, examining why practice is sporadic despite numerous professional bodies calling for implementation...
November 30, 2016: International Emergency Nursing
https://www.readbyqxmd.com/read/27914759/fluid-management-in-patients-with-trauma-restrictive-versus-liberal-approach
#15
REVIEW
Lee Palmer
Massive hemorrhage remains a major cause of traumatic deaths. The ideal fluid resuscitative strategy is much debated. Research has provided inconsistent results regarding which fluid strategy is ideal; the optimum fluid type, timing, and volume remains elusive. Aggressive large-volume resuscitation has been the mainstay based on controlled hemorrhage animal models. For uncontrolled hemorrhagic shock, liberal fluid resuscitative strategies exacerbate the lethal triad, invoke resuscitative injury, and increase mortality while more restrictive fluid strategies tend to ameliorate trauma-induced coagulopathy and favor a greater chance of survival...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27906869/early-and-sustained-vasopressin-infusion-augments-the-hemodynamic-efficacy-of-restrictive-fluid-resuscitation-and-improves-survival-in-a-liver-laceration-model-of-hemorrhagic-shock
#16
Raúl J Gazmuri, Kasen Whitehouse, Karla Whittinghill, Alvin Baetiong, Kruti Shah, Jeejabai Radhakrishnan
BACKGROUND: Current management of hemorrhagic shock favors restrictive fluid resuscitation before control of the bleeding source. We investigated the additional effects of early and sustained vasopressin infusion in a swine model of hemorrhagic shock produced by liver laceration. METHODS: Forty male domestic pigs (32-40 kg) had a liver laceration inflicted with an X-shaped blade clamp, 32 received a second laceration at minute 7.5, and 24 received two additional lacerations at minute 15...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27871539/liberal-or-restrictive-fluid-management-during-elective-surgery-a-systematic-review-and-meta-analysis
#17
REVIEW
Pim B B Schol, Ivon M Terink, Marcus D Lancé, Hubertina C J Scheepers
This article reviews if a restrictive fluid management policy reduces the complication rate if compared to liberal fluid management policy during elective surgery. The PubMed database was explored by 2 independent researchers. We used the following search terms: "Blood transfusion (MESH); transfusion need; fluid therapy (MESH); permissive hypotension; fluid management; resuscitation; restrictive fluid management; liberal fluid management; elective surgery; damage control resuscitation; surgical procedures, operative (MESH); wounds (MESH); injuries (MESH); surgery; trauma patients...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27831907/randomised-crossover-trial-of-rate-feedback-and-force-during-chest-compressions-for-paediatric-cardiopulmonary-resuscitation
#18
Rachael Kathleen Gregson, Tim James Cole, Sophie Skellett, Emmanouil Bagkeris, Denise Welsby, Mark John Peters
OBJECTIVE: To determine the effect of visual feedback on rate of chest compressions, secondarily relating the forces used. DESIGN: Randomised crossover trial. SETTING: Tertiary teaching hospital. SUBJECTS: Fifty trained hospital staff. INTERVENTIONS: A thin sensor-mat placed over the manikin's chest measured rate and force. Rescuers applied compressions to the same paediatric manikin for two sessions...
October 24, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27828823/hold-the-pendulum-rates-of-acute-kidney-injury-are-increased-in-patients-who-receive-resuscitation-volumes-less-than-predicted-by-the-parkland-equation
#19
Stephanie A Mason, Avery B Nathens, Celeste C Finnerty, Richard L Gamelli, Nicole S Gibran, Brett D Arnoldo, Ronald G Tompkins, David N Herndon, Marc G Jeschke
OBJECTIVE: To determine whether restrictive fluid resuscitation results in increased rates of acute kidney injury (AKI) or infectious complications. BACKGROUND: Studies demonstrate that patients often receive volumes in excess of those predicted by the Parkland equation, with potentially detrimental sequelae. However, the consequences of under-resuscitation are not well-studied. METHODS: Data were collected from a multicenter prospective cohort study...
December 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27821597/are-sociodemographic-characteristics-associated-with-spatial-variation-in-the-incidence-of-ohca-and-bystander-cpr-rates-a-population-based-observational-study-in-victoria-australia
#20
Lahn D Straney, Janet E Bray, Ben Beck, Stephen Bernard, Marijana Lijovic, Karen Smith
BACKGROUND: Rates of out-of-hospital cardiac arrest (OHCA) and bystander cardiopulmonary resuscitation (CPR) have been shown to vary considerably in Victoria. We examined the extent to which this variation could be explained by the sociodemographic and population health characteristics of the region. METHODS: Using the Victorian Ambulance Cardiac Arrest Registry, we extracted OHCA cases occurring between 2011 and 2013. We restricted the calculation of bystander CPR rates to those arrests that were witnessed by a bystander...
November 7, 2016: BMJ Open
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