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https://www.readbyqxmd.com/read/27923389/the-importance-of-albumin-infusion-rate-for-plasma-volume-expansion-following-major-abdominal-surgery-air-study-protocol-for-a-randomised-controlled-trial
#1
Svajunas Statkevicius, Johan Bonnevier, Björn P Bark, Erik Larsson, Carl M Öberg, Päivi Kannisto, Bobby Tingstedt, Peter Bentzer
BACKGROUND: Administration of fluids to restore normovolaemia is one of the most common therapeutic interventions performed peri-operatively and in the critically ill, but no study has evaluated the importance of infusion rate for the plasma volume-expanding effect of a resuscitation fluid. The present study is designed to test the hypothesis that a slow infusion of resuscitation fluid results in better plasma volume expansion than a rapid infusion. METHODS/DESIGN: The study is a single-centre, assessor-blinded, parallel-group, randomised prospective study...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27914760/update-clinical-use-of-plasma-lactate
#2
REVIEW
Íde Gillespie, Patricia G Rosenstein, Dez Hughes
Lactate is an essential, versatile metabolic fuel in cellular bioenergetics. In human emergency and critical care, lactate is used as a biomarker and therapeutic endpoint and evidence is growing in veterinary medicine supporting its clinical utility. Lactate production is a protective response providing ongoing cellular energy during tissue hypoperfusion or hypoxia and mitigating acidosis. Hence, hyperlactatemia is closely associated with disease severity but it is an epiphenomenon as the body attempts to protect itself...
November 30, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27910086/higher-vs-lower-haemoglobin-threshold-for-transfusion-in-septic-shock-subgroup-analyses-of-the-triss-trial
#3
S L Rygård, L B Holst, J Wetterslev, P I Johansson, A Perner
BACKGROUND: Using a restrictive transfusion strategy appears to be safe in sepsis, but there may be subgroups of patients who benefit from transfusion at a higher haemoglobin level. We explored if subgroups of patients with septic shock and anaemia had better outcome when transfused at a higher vs. a lower haemoglobin threshold. METHODS: In post-hoc analyses of the full trial population of 998 patients from the Transfusion Requirements in Septic Shock (TRISS) trial, we investigated the intervention effect on 90-day mortality in patients with severe comorbidity (chronic lung disease, haematological malignancy or metastatic cancer), in patients who had undergone surgery (elective or acute) and in patients with septic shock as defined by the new consensus definition: lactate above 2 mmol/l and the need for vasopressors to maintain a mean arterial pressure above 65 mmHg...
December 2, 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27902388/the-exploration-of-risk-factors-of-concurrent-bacteremia-among-critically-ill-patients-with-severe-dengue
#4
Chin-Ming Chen, Khee-Siang Chan, Kuo-Chen Cheng, Willy Chou, Hui-Chun Chao, Chiu-Yin Yeh, Wen-Liang Yu
We investigated the clinical features of intensive care unit (ICU) patients with a concomitant severe dengue infection and bacteremia to identify risk factors for this comorbidity. The records of all ICU dengue patients admitted during a July 31-November 31, 2015 were reviewed. Patients with "concurrent bacteremia" (positive bacterial blood culture within 72 hours of ICU admission) were identified. ICU admission was required for 142 patients; 22 (15.5%) had concurrent bacteremia. Streptococcus spp. was the most common pathogen, then Escherichia coli, and then Staphylococcus spp...
November 7, 2016: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/27871821/redox-changes-in-the-brains-of-reproductive-female-rats-during-aging
#5
Fernanda Maciel Heemann, Ana Carolina Almeida da Silva, Tiago Boeira Salomon, Jordana Salete Putti, Vanessa Krüger Engers, Fernanda Schäfer Hackenhaar, Mara Silveira Benfato
Reproduction is a critical and demanding phase of an animal's life. In mammals, females usually invest much more in parental care than males, and lactation is the most energetically demanding period of a female's life. Here, we tested whether oxidative stress is a consequence of reproduction in the brains of female Wistar rats. We evaluated the activities of glutathione peroxidase, glutathione S-transferase, and superoxide dismutase; H2O2 consumption; protein carbonylation; NO2 & NO3 levels; and total glutathione, as well as sex hormone levels in brain tissue of animals at 3, 6, 12, and 24months of age...
November 18, 2016: Experimental Gerontology
https://www.readbyqxmd.com/read/27857510/the-diagnostic-accuracy-of-serum-procalcitonin-for-bacteremia-in-critically-ill-children
#6
Marianne E Nellis, Steven Pon, Ashley E Giambrone, Nana E Coleman, Jonathan Reiss, Elizabeth Mauer, Bruce M Greenwald
BACKGROUND: Bacterial sepsis is frequently encountered in children admitted to the Pediatric Intensive Care Unit (PICU) and requires early recognition and treatment. Procalcitonin (PCT) is a serum biomarker with a high sensitivity to predict bacteremia in critically-ill adults. This study sought to evaluate the diagnostic accuracy of PCT for bacteremia in febrile children in the PICU. METHODS: This retrospective observational study used data from children admitted to the PICU from October 2010 to October 2012...
November 2016: Infectious Diseases in Clinical Practice: IDCP
https://www.readbyqxmd.com/read/27849433/differential-regulation-of-macrophage-glucose-metabolism-by-macrophage-colony-stimulating-factor-and-granulocyte-macrophage-colony-stimulating-factor-implications-for-18-f-fdg-pet-imaging-of-vessel-wall-inflammation
#7
Sina Tavakoli, John D Short, Kevin Downs, Huynh Nga Nguyen, Yanlai Lai, Wei Zhang, Paul Jerabek, Beth Goins, Mehran M Sadeghi, Reto Asmis
Purpose To determine the divergence of immunometabolic phenotypes of macrophages stimulated with macrophage colony-stimulating factor (M-CSF) and granulocyte-M-CSF (GM-CSF) and its implications for fluorine 18 ((18)F) fluorodeoxyglucose (FDG) imaging of atherosclerosis. Materials and Methods This study was approved by the animal care committee. Uptake of 2-deoxyglucose and various indexes of oxidative and glycolytic metabolism were evaluated in nonactivated murine peritoneal macrophages (MΦ0) and macrophages stimulated with M-CSF (MΦM-CSF) or GM-CSF (MΦGM-CSF)...
November 16, 2016: Radiology
https://www.readbyqxmd.com/read/27843178/the-handheld-blood-lactate-analyser-versus-the-blood-gas-based-analyser-for-measurement-of-serum-lactate-and-its-prognostic-significance-in-severe-sepsis
#8
Shivinder Singh, Abhishek Bhardawaj, Ratnesh Shukla, Trimbak Jhadav, Anoop Sharma, D Basannar
BACKGROUND: This study was done to compare the accuracy of the Lactate Pro LT 1710 (Arkray Inc., Kyoto, Japan) with the Combiline Plus (Eschweiler GmbH & Co. KG Holzkoppelweg, Kiel, Germany), and also, to analyze the prognostic significance of serum lactates and Simplified Acute Physiology Score 3 (SAPS 3) in patients of severe sepsis. METHODS: 106 patients of severe sepsis admitted to the ICU were screened. The serum lactate from an arterial sample analyzed in both the machines was recorded at admission and at 48 h...
October 2016: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27829711/validation-of-lactate-clearance-at-6-h-for-mortality-prediction-in-critically-ill-children
#9
Rajeev Kumar, Nirmal Kumar
BACKGROUND AND AIMS: To validate the lactate clearance (LC) at 6 h for mortality prediction in Pediatric Intensive Care Unit (PICU)-admitted patients and its comparison with a pediatric index of mortality 2 (PIM 2) score. DESIGN: A prospective, observational study in a tertiary care center. MATERIALS AND METHODS: Children <13 years of age, admitted to PICU were included in the study. Lactate levels were measured at 0 and 6 h of admission for clearance...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27829710/early-norepinephrine-decreases-fluid-and-ventilatory-requirements-in-pediatric-vasodilatory-septic-shock
#10
Suchitra Ranjit, Rajeswari Natraj, Sathish Kumar Kandath, Niranjan Kissoon, Balasubramaniam Ramakrishnan, Paul E Marik
AIMS: We previously reported that vasodilatation was common in pediatric septic shock, regardless of whether they were warm or cold, providing a rationale for early norepinephrine (NE) to increase venous return (VR) and arterial tone. Our primary aim was to evaluate the effect of smaller fluid bolus plus early-NE versus the American College of Critical Care Medicine (ACCM) approach to more liberal fluid boluses and vasoactive-inotropic agents on fluid balance, shock resolution, ventilator support and mortality in children with septic shock...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27829179/combining-quick-sequential-organ-failure-assessment-with-plasma-lactate-concentration-is-comparable-to-standard-sequential-organ-failure-assessment-score-in-predicting-mortality-of-patients-with-and-without-suspected-infection
#11
Kwok M Ho, Norris S H Lan
PURPOSE: We sought to determine whether quick Sequential Organ Failure Assessment (qSOFA) score can be used to predict mortality of patients without suspected infection. MATERIALS AND METHODS: Using prospectively collected data within the first hour of intensive care unit admission, the predictive ability of qSOFA was compared with the Simplified Acute Physiology Score III, Admission Mortality Prediction Model III, Acute Physiology and Chronic Health Evaluation II model, and standard (full-version) SOFA score using area under the receiver operating characteristic (AUROC) curve and Brier score...
October 18, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27810681/changes-in-mammary-histology-and-transcriptome-profiles-by-low-dose-exposure-to-environmental-phenols-at-critical-windows-of-development
#12
Kalpana Gopalakrishnan, Susan L Teitelbaum, Luca Lambertini, James Wetmur, Fabiana Manservisi, Laura Falcioni, Simona Panzacchi, Fiorella Belpoggi, Jia Chen
Exposure to environmental chemicals has been linked to altered mammary development and cancer risk at high doses using animal models. Effects at low doses comparable to human exposure remain poorly understood, especially during critical developmental windows. We investigated the effects of two environmental phenols commonly used in personal care products - methyl paraben (MPB) and triclosan (TCS) - on the histology and transcriptome of normal mammary glands at low doses mimicking human exposure during critical windows of development...
January 2017: Environmental Research
https://www.readbyqxmd.com/read/27749094/balanced-crystalloids-versus-saline-in-the-intensive-care-unit-the-salt-randomized-trial
#13
Matthew W Semler, Jonathan P Wanderer, Jesse M Ehrenfeld, Joanna L Stollings, Wesley H Self, Edward D Siew, Li Wang, Daniel W Byrne, Andrew D Shaw, Gordon R Bernard, Todd W Rice
RATIONALE: Saline is the intravenous fluid most commonly administered to critically ill adults, but may be associated with acute kidney injury and death. Whether use of balanced crystalloids rather than saline affects patient outcomes remains unknown. OBJECTIVES: To pilot a cluster-randomized, multiple-crossover trial using software tools within the electronic health record to compare saline to balanced crystalloids. METHODS: Cluster-randomized, multiple-crossover trial among 974 adults admitted to a tertiary medical intensive care unit from February 3, 2015 through May 31, 2015...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27748410/prognosis-of-alcohol-associated-lactic-acidosis-in-critically-ill-patients-an-8-year-study
#14
Chun-Chieh Yang, Khee-Siang Chan, Kuei-Ling Tseng, Shih-Feng Weng
Lactic acidosis is common in critical care; by contrast, a subtype called alcohol-associated lactic acidosis (AALA) is rarely encountered. The primary purpose of this study was to determine the prognosis of AALA in critically ill patients and the second aim was to determine whether the survival was associated to the peak blood lactate concentration. An 8-year retrospective analysis of adult patients admitted to the intensive care unit (ICU) with AALA between January 2007 and December 2014 was considered in a tertiary care hospital...
October 17, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27706278/fluid-choice-matters-in-critically-ill-patients-with-acute-pancreatitis-lactated-ringer-s-vs-isotonic-saline
#15
Mohammed M Aboelsoud, Osama Siddique, Alexander Morales, Young Seol, Mazen O Al-Qadi
OBJECTIVES: To investigate the effect of different crystal- loid solutions on clinical outcomes in critically-ill patients with acute pancreatitis (AP). METHODS: We conducted a retrospective study of patients with AP admitted to the ICU using the Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) database. We investigated the effect of fluid type; lactated ringer's (LR) vs. isotonic saline (IS) on hospital mortality rates, and ICU length of stay (LOS)...
October 4, 2016: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/27667471/the-assessment-of-risk-in-cardiothoracic-intensive-care-arctic-prediction-of-hospital-mortality-after-admission-to-cardiothoracic-critical-care
#16
J Shahin, P Ferrando-Vivas, G S Power, S Biswas, S T Webb, K M Rowan, D A Harrison
The models used to predict outcome after adult general critical care may not be applicable to cardiothoracic critical care. Therefore, we analysed data from the Case Mix Programme to identify variables associated with hospital mortality after admission to cardiothoracic critical care units and to develop a risk-prediction model. We derived predictive models for hospital mortality from variables measured in 17,002 patients within 24 h of admission to five cardiothoracic critical care units. The final model included 10 variables: creatinine; white blood count; mean arterial blood pressure; functional dependency; platelet count; arterial pH; age; Glasgow Coma Score; arterial lactate; and route of admission...
December 2016: Anaesthesia
https://www.readbyqxmd.com/read/27666884/-predictive-value-of-early-lactate-area-for-mortality-in-elderly-patients-with-septic-shock
#17
J X Zhang, M Yin, X M Chen, C Li, D W Wu, S F Ding, B F Du, H P Guo, W D Qin, H N Yang, H Wang
Objective: To investigate the predictive value of early lactate area for mortality in elderly patients with septic shock. Methods: From January 2012 to December 2013, a prospective study was conducted in the Department of Critical Care Medicine, Qilu Hospital of Shandong University. A total of 115 septic shock patients with age ≥65 years were included in the study. Serum lactate was measured every 6 hours, the lactate indicators, including early lactate area, APACHE Ⅱ score etc were recorded. Results: The overall 28-day mortality rate was 67...
September 6, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27659434/mortality-risk-factors-for-patients-with-septic-shock-after-implementation-of-the-surviving-sepsis-campaign-bundles
#18
Je Eun Song, Moo Hyun Kim, Woo Yong Jeong, In Young Jung, Dong Hyun Oh, Yong Chan Kim, Eun Jin Kim, Su Jin Jeong, Nam Su Ku, June Myung Kim, Jun Yong Choi
BACKGROUND: Septic shock remains a leading cause of death, despite advances in critical care management. The Surviving Sepsis Campaign (SSC) has reduced morbidity and mortality. This study evaluated risk factors for mortality in patients with septic shock who received treatment following the SSC bundles. MATERIALS AND METHODS: This retrospective cohort study included patients with septic shock who received treatments following SSC bundles in an urban emergency department between November 2007 and November 2011...
September 2016: Infection & Chemotherapy
https://www.readbyqxmd.com/read/27648771/prehospital-point-of-care-lactate-following-trauma-a-systematic-review
#19
Christopher T Lewis, David N Naumann, Nick Crombie, Mark J Midwinter
BACKGROUND: Serum lactate serves as a surrogate marker for global tissue hypoxia following traumatic injury and has potential to guide resuscitation. Portable, handheld point-of-care monitoring devices enable lactate values to be readily available in the prehospital environment. The current review examines the utility of prehospital lactate (pLa) measurement in the management of trauma. METHODS: MEDLINE and EMBASE databases were searched using predefined criteria (pLa measurement, trauma patients) until March 10, 2016...
October 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27646684/temporal-development-of-gut-microbiota-in-triclocarban-exposed-pregnant-and-neonatal-rats
#20
Rebekah C Kennedy, Russell R Fling, Michael S Robeson, Arnold M Saxton, Robert L Donnell, John L Darcy, David A Bemis, Jiang Liu, Ling Zhao, Jiangang Chen
Alteration of gut microbial colonization process may influence susceptibility of the newborn/infant to infectious and chronic disease. Infectious disease risk leads to widespread use of non-prescription antimicrobials in household products such as Triclocarban (TCC), an antimicrobial compound in personal care products. TCC concentrates in and is transferred through the milk to suckling offspring. TCC exposure during gestation and lactation significantly reduced phylogenetic diversity (PD) among exposed dams and neonates...
September 20, 2016: Scientific Reports
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