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https://www.readbyqxmd.com/read/27025948/siadh-differential-diagnosis-and-clinical-management
#1
Alessandro Peri, Christian Grohé, Rossana Berardi, Isabelle Runkle
Despite the widespread prevalence of hyponatremia and its deleterious effects on patients, it is often overlooked and consequently undertreated. This set of four cases provides practical advice on how to identify, diagnose, and treat patients with syndrome of inappropriate antidiuretic hormone (SIADH). The first steps that a physician should take when diagnosing a patient with hyponatremia are to assess the severity of neurological symptoms, and check the patient's volemic status in order to determine whether emergency treatment with hypertonic saline is indicated...
March 30, 2016: Endocrine
https://www.readbyqxmd.com/read/27025140/-volemic-status-and-the-phasic-approach-to-the-treatment-of-critical-states-new-opportunites-and-prospects
#2
REVIEW
V V Kuz'kov, E V Fot, A A Smjotkin, K M Lebedinskij, M Yu Kirov
Current guidelines suggest that an early and aggressive fluid therapy is the best rescue approach to restore and preserve cardiac index, organ function and decrease the risk of multiple organ failure in shock of various origin. However, escala- tion of fluid resuscitation is a double-edged sword often associated with reperfusion, glicocalyx injury, capillary leakage, delayed weight gain and heperhydration. The body of evidences demons trates that an excessive fluid load in ICUpatient with global increased permeability syndrome, and, particularly, in ARDS and acute kidney injury can be devastating, particularly when guided with central venous pressure...
November 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/26596026/-goal-target-infusion-therapy-based-on-noninvasive-hemodynamic-monitoring-escoo
#3
P A Volkov, S A Sevalkin, B T Churadze, Yu T Volkova, V A Gur'yanov
We described our experience in using the new noninvasive hemodynamic monitoring (esCCO), which allowed recording most important parameters of heart capacity. Infusion therapy during laparoscopic operations might be based on dynamic of systolic blood volume. This functional approach can be used for evaluation of heart reaction on bolus fluid load, to optimike volemic status in situations associated with dynamical blood circulation changes. We compared intraoperative infused fluid volumes, calculated by traditional approach and by target approach...
July 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/26431247/association-of-postoperative-furosemide-use-with-a-reduced-blood-transfusion-rate-in-sagittal-craniosynostosis-surgery
#4
Adil Harroud, Alexander G Weil, Jean Turgeon, Claude Mercier, Louis Crevier
OBJECT A major challenge in sagittal craniosynostosis surgery is the high transfusion rate (50%-100%) related to blood loss in small pediatric patients. Several approaches have been proposed to prevent packed red blood cell (PRBC) transfusion, including endoscopic surgery, erythropoietin ortranexamic acid administration, and preoperative hemodilution. The authors hypothesized that a significant proportion of postoperative anemia observed in pediatric patients is actually dilutional. Consequently, since 2005, at CHU Sainte-Justine, furosemide has been administered to correct the volemic status and prevent PRBC transfusion...
January 2016: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/26395001/influence-of-tidal-volume-on-pulse-pressure-variation-and-stroke-volume-variation-during-experimental-intra-abdominal-hypertension
#5
F Díaz, B Erranz, A Donoso, T Salomon, Pablo Cruces
BACKGROUND: Pulse pressure variation (PPV) and stroke volume variation (SVV) are frequently used to assess fluid responsiveness in critically ill patients on mechanical ventilation (MV). There are many factors, in addition to preload that influence the magnitude of these cyclic variations. We sought to investigate the effect of tidal volume (V(T)) on PPV and SVV, and prediction of fluid responsiveness in a model of intra-abdominal hypertension (IAH). METHODS: Twelve anesthetized and mechanically ventilated piglets on continuous pulse contour cardiac output monitoring...
2015: BMC Anesthesiology
https://www.readbyqxmd.com/read/26093720/correlation-of-the-volume-control-parameters-with-health-related-quality-of-life-in-renal-transplant-patients
#6
H Colak, I Sert, C Ekmekcı, C Tugmen, Y Kurtulmus, S Kursat, H Töz
INTRODUCTION: Transplantation is the most effective treatment strategy for end-stage renal failure. We aimed to investigate the correlation of volume control parameters with health-related quality of life (HRQoL) in renal transplantation patients during the pre- and post-transplantation periods. MATERIAL AND METHODS: Seventy-seven patients who underwent renal transplantation from deceased donors between January 2011 and January 2013 were included in the study. The biochemical markers, complete blood count, and creatinine levels were measured during pretransplantation and at post-transplantation month 6...
June 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/25618821/correlation-of-volume-control-parameters-with-health-related-quality-of-life-in-renal-transplant-patients
#7
H Colak, I Sert, C Ekmekci, C Tugmen, Y Kurtulmus, S Kursat, H Töz
BACKGROUND: Transplantation is the most effective treatment strategy for end-stage renal failure. We aimed to investigate the correlation of volume control parameters with health-related quality of life (HRQoL) in renal transplant patients in the pre- and post-transplant periods. METHODS: Seventy-seven patients who underwent renal transplantation from deceased donors between January 2011 and January 2013 were included in the study. The biochemical markers, complete blood count, and creatinine levels were measured during the pre-transplant and at post-transplant 6th month...
January 21, 2015: Transplantation Proceedings
https://www.readbyqxmd.com/read/24926312/can-nephrologists-use-ultrasound-to-evaluate-the-inferior-vena-cava-a-cross-sectional-study-of-the-agreement-between-a-nephrologist-and-a-cardiologist
#8
José Muniz Pazeli, Daniel Fagundes Vidigal, Tarcísio Cestari Grossi, Natália Maria Silva Fernandes, Fernando Colugnati, Rogério Baumgratz de Paula, Hélady Sanders-Pinheiro
BACKGROUND/AIMS: The costs and the need for a specialist impair the implementation of ultrasonography for evaluating the inferior vena cava (IVC) to assess the volemic status in hemodialysis patients. We investigated whether a nephrologist with limited ultrasound training can accurately assess the IVC in patients undergoing hemodialysis. METHODS: A cardiologist and a nephrologist consecutively measured the indexed IVC expiratory diameter (VCDi) and the IVC collapsibility index (IVCCI) of 52 patients during hemodialysis sessions...
January 2014: Nephron Extra
https://www.readbyqxmd.com/read/24652158/clinical-evaluation-of-hyponatremia-and-hypovolemia-in-critically-ill-adult-neurologic-patients-contribution-of-the-use-of-cumulative-balance-of-sodium
#9
Paolo Gritti, Luigi Andrea Lanterna, Lidia Rotasperti, Matteo Filippini, Simone Cazzaniga, Carlo Brembilla, Tatyana Sarnecki, Ferdinando Luca Lorini
PURPOSE: Knowledge of the cumulative balance of sodium (CBS) is important for the diagnosis of salt disorders and water homeostasis and has the potential to predict hypovolemic status in acute neurological patients. However, an extensive application of the use of CBS is still lacking in the intensive care setting, where salt and water homeostasis represents a priority. METHODS: Records of consecutive series of acute neurological patients admitted to a neurointensive care unit over a 6-month period were retrospectively reviewed...
October 2014: Journal of Anesthesia
https://www.readbyqxmd.com/read/24549516/non-invasive-evaluation-of-cardiac-hemodynamics-in-end-stage-renal-disease-esrd
#10
Alberto Milan, Eleonora Avenatti, Erika Della Valle, Ambra Fabbri, Agnese Ravera, Marco Pozzato, Giovanni Ferrari, Francesco Quarello, Franco Aprà, Franco Veglio
OBJECTIVE: Volume overload is typical of haemodialysis patients; correct volume status evaluation is crucial in achieving blood pressure homeostasis, hypertension management and good treatment planning. This study evaluates the effect of acute volume depletion on ultrasonographic parameters and suggests two of them as able to predict patients volume overload. PATIENTS AND INTERVENTION: 27 patients with end stage renal disease treated with haemodialysis underwent a complete echocardiographic exam before, after 90 min and at the end of the dialysis...
December 2014: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/22418601/impact-of-intra-abdominal-pressure-on-retrohepatic-vena-cava-shape-and-flow-in-mechanically-ventilated-pigs
#11
Karim Bendjelid, Jean-Paul Viale, Serge Duperret, Joëlle Colling, Vincent Piriou, Paolo Merlani, Didier Jacques
Conflicting results have been found regarding correlations between right atrial pressure (RAP) and inferior vena cava (IVC) diameter in mechanically ventilated patients. This finding could be related to an increase in intra-abdominal pressure (IAP). This study was designed to clarify whether variations in IVC flow rate caused by positive pressure ventilation are associated with changes in the retrohepatic IVC cross-section (ΔIVC) during major changes in volume status and IAP. Nine pigs were anesthetized, mechanically ventilated and equipped...
April 2012: Physiological Measurement
https://www.readbyqxmd.com/read/22166718/utility-of-measurements-of-abdominal-perfusion-pressure-as-a-measure-of-isovolemic-status-and-intestinal-perfusion-in-patients-with-ruptured-aortic-aneurysm
#12
Krzysztof Bieda, Fryderyk Pukacki, Maciej Zieliński, Paweł Sobczyński, Grzegorz Oszkinis, Roma Hartman-Sobczyńska, Wacław Majewski
UNLABELLED: Ruptured abdominal aorta aneurysm of ten results in intraabdominal hypertension (IAH). When IAH exceeds 20 mm Hg, intestinal ischemia can result that is a common cause of severe postoperative complications, including death. THE AIM OF THE STUDY: was to evaluate utility of measurement of abdominal perfusion pressure (APP) to estimate intestinal perfusion and isovolemic status in patients undergoing surgical treatment for ruptured abdominal aorta aneurysm...
August 2011: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/21851025/-clinical-effectiveness-of-the-infusion-therapy-under-control-of-the-transesophageal-dopplerography-in-acute-period-of-severe-combined-trauma
#13
RANDOMIZED CONTROLLED TRIAL
K E Vil'chinskiĭ, A I Gutnikov, L A Davydova, S V Tsarenko, E A Evdokimov
In 72 patients with combined trauma the impact of volume and consistence of infusion therapy on severity of the disease, frequency and severity of infectious complications, duration of MV and ICU stay was assessed. The patients were divided into 2 groups depending on the volemic status control method and infusion algorithm. The main group (35 patients) was controlled by transesophageal dopplerography Cardio Q apparatus ("Deltex Medical", GB) and the infusion therapy was carried out under the control of stroke volume and Ftc...
May 2011: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/21830048/evaluation-of-mean-systemic-filling-pressure-from-pulse-contour-cardiac-output-and-central-venous-pressure
#14
Jacinta J Maas, Bart F Geerts, Jos R C Jansen
OBJECTIVE: The volemic status of a patient can be determined by measuring mean systemic filling pressure (Pmsf). Pmsf is obtained from the venous return curve, i.e. the relationship between central venous pressure (Pcv) and blood flow. We evaluated the feasibility and precision of Pmsf measurement. METHODS: In ten piglets we constructed venous return curves using seven 12 s inspiratory holds transiently increasing Pcv to seven different steady state levels and monitored the resultant blood flow, by pulse contour (COpc) and by flow probes around the pulmonary artery (COr) and aorta (COl)...
June 2011: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/20546573/hypervolemia-induces-and-potentiates-lung-damage-after-recruitment-maneuver-in-a-model-of-sepsis-induced-acute-lung-injury
#15
Pedro L Silva, Fernanda F Cruz, Livia C Fujisaki, Gisele P Oliveira, Cynthia S Samary, Debora S Ornellas, Tatiana Maron-Gutierrez, Nazareth N Rocha, Regina Goldenberg, Cristiane S N B Garcia, Marcelo M Morales, Vera L Capelozzi, Marcelo Gama de Abreu, Paolo Pelosi, Patricia R M Rocco
INTRODUCTION: Recruitment maneuvers (RMs) seem to be more effective in extrapulmonary acute lung injury (ALI), caused mainly by sepsis, than in pulmonary ALI. Nevertheless, the maintenance of adequate volemic status is particularly challenging in sepsis. Since the interaction between volemic status and RMs is not well established, we investigated the effects of RMs on lung and distal organs in the presence of hypovolemia, normovolemia, and hypervolemia in a model of extrapulmonary lung injury induced by sepsis...
2010: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/20524336/-diagnostics-of-volemic-disorders-in-cardiosurgical-patients-modern-state-of-the-problem
#16
REVIEW
I A Tolstova, B A Aksel'rod, A G Iavorovskiĭ
Volemic disorders are widely encountered in anesthesiology and intensive therapy. Lower cardiac output caused by inadequate preload leads to tissue hypoperfusion, increased frequency of perioperative complications and higher death rates. The objective diagnosis of the volemic status remains a challenge since before as all the indices characterizing the preload, which are currently used in clinical practice, enable the true preload to be estimated only to a certain extent. The paper considers the currently available diagnostic studies for volemic disorders in cardiosurgical patients, their merits, demerits, and possible limitations of their use...
March 2010: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/20395651/a-piezo-film-based-measurement-system-for-global-haemodynamic-assessment
#17
Fabrizio Clemente, Pasquale Arpaia, Pasquale Cimmino
A non-invasive piezo-film-based measurement method for haemodynamic assessment is proposed. The design of a system, able to reconstruct the blood pressure waveform online by dealing with problems arising from the piezo-film capacitive nature in the targeted frequency range (from quasi-dc up to 12 Hz), is illustrated. The system is based on a commercial piezo-film placed easily on the radial artery with a special brace without any discomfort for the patient. The analogical conditioning circuit and digital signal processing are continuously tuned with the signal from the sensor to reconstruct the blood pressure signal online...
May 2010: Physiological Measurement
https://www.readbyqxmd.com/read/20108541/the-importance-of-residual-renal-function-in-chronic-dialysed-patients
#18
REVIEW
Daniela Rădulescu, Dumitru Ferechide
In the last decade, many researches have reached to the conclusion that preservation of residual renal function (RRF) is important after initiating dialysis, as well as in the predialysis period. RRF has been proven to contribue to the quality of life of dialysis patients. Longer preservation of RRF provides a better small and middle molecule removal, improved volemic status and arterial pressure control, diminished risk of vascular and valvular calcification due to better phosphate removal. Deterioration of RRF results in worsening of anemia, inflammation and malnutrition...
April 2009: Journal of Medicine and Life
https://www.readbyqxmd.com/read/20099648/-impact-of-preoperative-levosimendan-therapy-on-the-volemic-status-and-vascular-tone-of-patients-with-chronic-heart-failure-during-anesthesia
#19
B A Aksel'rod, I A Tolstova, N A Trekova, P E Kolpakov, M A Babaev, I E Belianko
The impact of preoperative levosimendan therapy on the volemic status and vascular tone was studied in patients with chronic heart failure (CHF) during anesthesia and the ways of correcting the occurring changes were defined. The study included 21 patients with CHF in the presence of dilated cardiomyopathy, who underwent mitral valve replacement and tricuspid valvoplasty. Group 1 patients (n = 11) were given levosimendan (Simdax) in a dose of 0.05-0.1 mg/kg x min 2 days prior to surgery; Group 2 (n = 10) was control...
November 2009: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/19938714/-effect-of-volemic-status-on-brain-oxygenation-and-metabolism-in-patients-with-intracranial-hemorrhages
#20
S S Petrikov, Iu V Titova, Kh T Guseĭnova, A A Solodov, V V Krylov
The paper analyzes the impact of the volemic status and its correction on systemic hemodynamic parameters (transpulmonary thermodilution PiCCO plus technique), the value of intracranial pressure and the biochemical composition of brain interstitial fluid (tissue microdialysis) in the affected and conditionally intact hemisphere in 8 patients with intracranial hemorrhages and a reduced awakening level up to 4-8 scores by the Glasgow coma scale. It has been shown that in patients with significant metabolic disturbance in the involved hemisphere, hypovolemia correction using hydroxyethyl starch 130/0...
September 2009: Anesteziologiia i Reanimatologiia
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