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Lactate critical care

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https://www.readbyqxmd.com/read/29887410/early-point-of-care-testing-at-triage-reduces-care-time-in-stable-adult-emergency-department-patients
#1
Adam J Singer, Merry Taylor, Deborah LeBlanc, Kristen Meyers, Karol Perez, Henry C Thode, Jesse M Pines
BACKGROUND: Core laboratory testing may increase length of stay and delay care. OBJECTIVES: We compared length of emergency department (ED) care in patients receiving point-of-care testing (POCT) at triage vs. traditional core laboratory testing. METHODS: We conducted a prospective, case-controlled trial of adult patients with prespecified conditions requiring laboratory testing and had POCT performed by a nurse after triage for: a basic metabolic panel, troponin I, lactate, INR (i-STAT System), urinalysis (Beckman Coulter Icon), or urine pregnancy test...
June 7, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29877961/endovascular-perfusion-augmentation-for-critical-care-partial-aortic-occlusion-for-treatment-of-severe-ischemia-reperfusion-shock
#2
M Austin Johnson, Emily M Tibbits, Guillaume L Hoareau, Meryl A Simon, Anders J Davidson, Erik S DeSoucy, E Robert Faulconer, J Kevin Grayson, Lucas P Neff, Timothy K Williams
BACKGROUND: The resuscitation of patients in shock is materially intensive and many patients are refractory to maximal therapy. We hypothesized that partial inflation of an intra-aortic balloon, termed Endovascular Perfusion Augmentation for Critical Care (EPACC), would minimize material requirements while improving physiologic metrics. METHODS: Swine underwent a 25% controlled bleed and 45 minutes of complete aortic occlusion to create a severe ischemia-reperfusion shock state...
June 5, 2018: Shock
https://www.readbyqxmd.com/read/29866138/capillary-and-venous-lactate-measurements-with-a-handheld-device-compared-to-venous-blood-gas-analysis-for-emergency-patients
#3
David Stoll, Erling Englund, Helene Hillborg, Stefan Vedin, Agneta Larsson
BACKGROUND/AIM: Early identification of lactate levels may have a large impact on triage classification and assist in identifying critically ill patients. A handheld device provides a rapid and timesaving measurement of lactate levels adapted to work in a prehospital care setting. I.e., the device is small, fast, and easy-to-use. The aim of this study was to evaluate the Accutrend Plus handheld lactate analyzer in comparison to the reference in-hospital method. METHODS: Patients triaged as minimum yellow according to the RETTS System (Rapid Emergency Triage and Treatment System) and transported to hospital by ambulance were selected and a written consent to participate was obtained prior to inclusion in the study...
June 5, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29859130/thromboelastometry-guided-hemostatic-therapy-for-hemorrhagic-shock-in-the-postoperative-period-of-vascular-surgery-a-case-report
#4
Tomaz Crochemore, Felicio A Savioli
BACKGROUND: Hemorrhagic shock is a medical emergency that often complicates vascular surgery and can lead to death. Hemorrhagic shock is characterized by hypoperfusion and hemodynamic abnormalities leading to the collapse of homeostasis due to massive blood loss. Early diagnosis is critical for a favorable outcome. Thromboelastometry has been considered an effective tool for bleeding management in critically ill patients. Thromboelastometry can guide transfusion therapy quickly, reducing the need for blood products...
June 2, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29852090/-you-know-if-you-quit-that-s-failure-right-barriers-to-professional-lactation-certification
#5
Erin V Thomas
BACKGROUND: Researchers have confirmed that breastfeeding disparities persist and that International Board Certified Lactation Consultants (IBCLCs) play a key role in reducing them. However, there continues to be a limited availability of IBCLCs throughout the United States, with racial minorities facing persistent barriers during the certification process. Research aim: Using a critical race theory framework, the aim was to describe the barriers and supports that IBCLCs experience during the course of their certification...
May 1, 2018: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/29845614/risk-factors-for-intensive-care-unit-acquired-weakness-a-systematic-review-and-meta-analysis
#6
REVIEW
Tao Yang, Zhiqiang Li, Li Jiang, Yinhua Wang, Xiuming Xi
Intensive care unit-acquired weakness (ICUAW) occurs frequently in the context of critical illness without alternative plausible cause and specific treatment options, and it is important to identify and summarize the independent risk factors for ICUAW. PubMed, Embase, Central, China Biological Medicine, China National Knowledge Infrastructure, VIP and Wanfang databases were searched from database inception until 10 July 2017. Prospective cohort studies on adult ICU patients who were diagnosed with ICUAW using either clinical or electrophysiological criteria were selected...
May 29, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29803894/impact-of-selective-serotonin-reuptake-inhibitors-ssris-during-pregnancy-and-lactation-a-focus-on-short-and-long-term-vascular-effects
#7
REVIEW
S Zullino, T Simoncini
SSRIs are the first choice for the treatment of mood disorders during pregnancy and lactation. Despite the known side effects, the benefits/risks balance suggests their use. Hypertensive disorders of pregnancy (HDP) and Intrauterine growth restriction (IUGR) are the main vascular effects of these drugs, with mechanisms that involves endothelial dysfunction in feto-placental system. These data are supported by animal models, even if preliminary findings are not yet adequately supported by molecular and clinical data...
May 24, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29766322/microdaimon-study-microcirculatory-daily-monitoring-in-critically-ill-patients-a-prospective-observational-study
#8
Claudia Scorcella, Elisa Damiani, Roberta Domizi, Silvia Pierantozzi, Stefania Tondi, Andrea Carsetti, Silvia Ciucani, Valentina Monaldi, Mara Rogani, Benedetto Marini, Erica Adrario, Rocco Romano, Can Ince, E Christiaan Boerma, Abele Donati
BACKGROUND: Until now, the prognostic value of microcirculatory alterations in critically ill patients has been mainly evaluated in highly selected subgroups. Aim of this study is to monitor the microcirculation daily in mixed group of Intensive Care Unit (ICU)-patients and to establish the association between (the evolution of) microcirculatory alterations and outcome. METHODS: This is a prospective longitudinal observational single-centre study in adult patients admitted to a 12-bed ICU in an Italian teaching hospital...
May 15, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29739621/the-incidence-and-outcome-of-hyperlactatemia-in-patients-admitted-to-the-intensive-care-unit-after-elective-surgery
#9
Tatsuhiko Abe, Shigehiko Uchino, Yusuke Sasabuchi, Masanori Takinami
BACKGROUND: Although hyperlactatemia is often developed in critically ill patients, it is unclear whether hyperlactatemia is associated with poor prognosis for surgical ICU (SICU) patients. METHODS: We performed a retrospective analysis in an academic hospital in Tokyo. The maximum lactate was defined as the highest value within the SICU stay. The primary outcome was the composite outcome of in-hospital mortality, re-admission to the SICU or admission to the general ICU and emergency reoperation...
April 23, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29732655/external-validation-and-improvement-of-life-score-as-a-prediction-tool-in-critically-ill-cirrhosis-patients
#10
Shuangzhe Yao, Xihui Jiang, Chao Sun, Zhongqing Zheng, Bangmao Wang, Tao Wang
PURPOSE: The LiFe (liver, injury, failure, evaluation) score, calculated according to arterial lactate, total bilirubin, and INR, is a novel score for risk prediction in ICU patients with cirrhosis. The present study aimed to externally validate and optimize the LiFe score for predicting outcomes in critically ill cirrhosis patients. METHODS: The study employed the single-center database Medical Information Mart for Intensive Care-III (MIMIC-III) for analysis. A total of 536 critically ill cirrhosis patients from the MIMIC-III database were analyzed...
May 7, 2018: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/29729532/how-do-we-diagnose-and-treat-epilepsy-with-myoclonic-atonic-seizures-doose-syndrome-results-of-the-pediatric-epilepsy-research-consortium-survey
#11
Katherine Nickels, Ronald Thibert, Stephanie Rau, Scott Demarest, Elaine Wirrell, Eric H Kossoff, Charuta Joshi, Srishti Nangia, Renee Shellhaas
OBJECTIVE: To obtain and assess opinions on EMAS diagnostic criteria, recommended investigations, and therapeutic options, from a large group of physicians who care for children with EMAS. METHODS: The EMAS focus group of PERC created a survey to assess the opinions of pediatric neurologists who care for children with EMAS regarding diagnosis and treatment of this condition, which was sent to members of PERC, AES, and CNS. A Likert scale was used to assess the respondents' opinions on the importance of diagnostic and exclusion criteria (five point scale), investigations (four point scale), and treatment (six point scale) of EMAS...
August 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29720475/comparison-of-qsofa-with-current-emergency-department-tools-for-screening-of-patients-with-sepsis-for-critical-illness
#12
Robert M Rodriguez, John C Greenwood, Thomas J Nuckton, Bryan Darger, Frances S Shofer, Dawn Troeger, Soo Y Jung, Kelly G Speich, Joel Valencia, J Hope Kilgannon, Danny Fernandez, Brigitte M Baumann
OBJECTIVE: We sought to compare the quick sequential organ failure assessment (qSOFA) to systemic inflammatory response syndrome (SIRS), severe sepsis criteria and lactate levels for their ability to identify ED patients with sepsis with critical illness. METHODS: We conducted this multicenter retrospective cohort study at five US hospitals, enrolling all adult patients admitted to these hospitals from their EDs with infectious disease-related illnesses from 1 January 2016 to 30 April 2016...
June 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29695298/pyruvate-is-a-prospective-alkalizer-to-correct-hypoxic-lactic-acidosis
#13
REVIEW
Ying Wang, Ya Huang, Jing Yang, Fang-Qiang Zhou, Lian Zhao, Hong Zhou
Type A lactic acidosis resulted from hypoxic mitochondrial dysfunction is an independent predictor of mortality for critically ill patients. However, current therapeutic agents are still in shortage and can even be harmful. This paper reviewed data regarding lactic acidosis treatment and recommended that pyruvate might be a potential alkalizer to correct type A lactic acidosis in future clinical practice. Pyruvate is a key energy metabolic substrate and a pyruvate dehydrogenase (PDH) activator with several unique beneficial biological properties, including anti-oxidant and anti-inflammatory effects and the ability to activate the hypoxia-inducible factor-1 (HIF-1α) - erythropoietin (EPO) signal pathway...
April 26, 2018: Military Medical Research
https://www.readbyqxmd.com/read/29688088/constant-light-during-lactation-programs-circadian-and-metabolic-systems
#14
Palma-Gómez Madahi, Osnaya Ivan, Balderas Adriana, Ortega Diana, Escobar Carolina
Exposure to light at night is a disruptive condition for the adult circadian system, leading to arrhythmicity in nocturnal rodents. Circadian disruption is a risk factor for developing physiological and behavioral alterations, including weight gain and metabolic disease. During early stages of development, the circadian system undergoes a critical period of adjustment, and it is especially vulnerable to altered lighting conditions that may program its function, leading to long-term effects. We hypothesized that during lactation a disrupted light-dark cycle due to light at night may disrupt the circadian system and in the long term induce metabolic disorders...
April 24, 2018: Chronobiology International
https://www.readbyqxmd.com/read/29679531/the-association-of-early-postoperative-lactate-levels-with-morbidity-after-elective-major-abdominal-surgery
#15
Jelena Veličković, Ivan Palibrk, Biljana Miličić, Dejan Veličković, Bojan Jovanović, Goran Rakić, Milorad Petrović, Vesna Bumbaširević
Lactate levels are widely used as an indicator of outcome in critically ill patients. We investigated the prognostic value of postoperative lactate levels for postoperative complications (POC), mortality and length of hospital stay after elective major abdominal surgery. A total of 195 patients were prospectively evaluated. Lactate levels were assessed on admission to the intensive care unit (ICU) [L0], 4 hours (L4), 12 hours (L12), and 24 hours (L24) after the operation. Demographic and perioperative clinical data were collected...
April 21, 2018: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/29675709/acid-base-status-and-its-clinical-implications-in-critically-ill-patients-with-cirrhosis-acute-on-chronic-liver-failure-and-without-liver-disease
#16
Andreas Drolz, Thomas Horvatits, Kevin Roedl, Karoline Rutter, Richard Brunner, Christian Zauner, Peter Schellongowski, Gottfried Heinz, Georg-Christian Funk, Michael Trauner, Bruno Schneeweiss, Valentin Fuhrmann
BACKGROUND: Acid-base disturbances are frequently observed in critically ill patients at the intensive care unit. To our knowledge, the acid-base profile of patients with acute-on-chronic liver failure (ACLF) has not been evaluated and compared to critically ill patients without acute or chronic liver disease. RESULTS: One hundred and seventy-eight critically ill patients with liver cirrhosis were compared to 178 matched controls in this post hoc analysis of prospectively collected data...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29577222/-establishment-of-comprehensive-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients
#17
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the comprehensive prediction model of acute gastrointestinal injury (AGI) grades of critically ill patients. METHODS: From April 2015 to November 2015, the binary channel gastrointestinal sounds (GIS) monitor system which has been developed and verified by the research group was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of Chinese PLA General Hospital. Also, the AGI grades (Grande I(-IIII(, the higher the level, the heavier the gastrointestinal dysfunction) were evaluated...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29576361/can-energy-intake-alter-clinical-and-hospital-outcomes-in-picu
#18
Bodil M K Larsen, Megan R Beggs, Amanda Y Leong, Sung Hyun Kang, Rabin Persad, Gonzalo Garcia Guerra
BACKGROUND & AIMS: Energy is essential for the treatment and recovery of children admitted to Pediatric Intensive Care Units (PICU). There are significant immediate and long-term health consequences of both under- and over-feeding in this population. Energy requirements of critically ill children vary depending on age, nutritional status, sepsis, fever, pharmacotherapy, and duration and stage of critical illness. This study aimed to determine the incidence of over- and under-feeding and to compare hospital outcomes between these feeding categories...
April 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29562917/the-use-of-mid-regional-proadrenomedullin-to-identify-disease-severity-and-treatment-response-to-sepsis-a-secondary-analysis-of-a-large-randomised-controlled-trial
#19
Gunnar Elke, Frank Bloos, Darius Cameron Wilson, Frank Martin Brunkhorst, Josef Briegel, Konrad Reinhart, Markus Loeffler, Stefan Kluge, Axel Nierhaus, Ulrich Jaschinski, Onnen Moerer, Andreas Weyland, Patrick Meybohm
BACKGROUND: This study assessed the ability of mid-regional proadrenomedullin (MR-proADM) in comparison to conventional biomarkers (procalcitonin (PCT), lactate, C-reactive protein) and clinical scores to identify disease severity in patients with sepsis. METHODS: This is a secondary analysis of a randomised controlled trial in patients with severe sepsis or septic shock across 33 German intensive care units. The association between biomarkers and clinical scores with mortality was assessed by Cox regression analysis, area under the receiver operating characteristic and Kaplan-Meier curves...
March 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29549960/analytical-considerations-and-general-diagnostic-and-therapeutic-ramifications-of-milk-hormones-during-lactation
#20
REVIEW
Carol L Wagner, John E Baatz, Danforth Newton, Bruce W Hollis
In this review, we will discuss the changes that occur in the mammary gland from pregnancy to lactation and the issues surrounding the analysis of circulating and milk hormones during the stages of lactogenesis. There is a cascade of events that must occur to achieve milk synthesis, milk ejection, and successful transfer to the breastfeeding infant. The adequacy and success of this process is no small measure and the assessment of milk production, the hormones involved in this process and the ability to properly diagnose conditions and causes of low milk supply are critical for the health and well-being of the mother-infant breastfeeding dyad...
January 2018: Best Practice & Research. Clinical Endocrinology & Metabolism
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