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https://www.readbyqxmd.com/read/28158232/the-effects-of-hospice-shared-care-for-gastric-cancer-patients
#1
Kun-Siang Huang, Shih-Ho Wang, Seng-Kee Chuah, Kun-Ming Rau, Yu-Hung Lin, Meng-Che Hsieh, Li-Hsueh Shih, Yen-Hao Chen
BACKGROUND: Hospice care has been proved to result in changes to the medical behaviors of terminally ill patients. The aim of this study was to evaluate the effects and medical behavior changes of hospice-shared care intervention among terminally ill gastric cancer patients. METHODS: A total of 174 patients who died of gastric cancer between 2012 and 2014 were identified. These patients were divided into two groups: a hospice-shared care group (n = 93) and a control group (n = 81)...
2017: PloS One
https://www.readbyqxmd.com/read/28149031/thoughts-on-the-current-management-of-acute-aluminum-phosphide-toxicity-and-proposals-for-therapy-an-evidence-based-review
#2
REVIEW
Maryam Vasheghani Farahani, Davood Soroosh, Sayed Mahdi Marashi
The majority of aluminum phosphide (ALP) toxicity cases are suicidal attempts. Despite advances in critical care medicine, the mortality rate of ALP remains very high. Unfortunately, knowledge on the toxicokinetics of ALP is very low. An obsolete idea was proposed that inhibition of complex IV of cytochrome C oxidase is responsible for multiorgan dysfunction. However, based on human studies, this effect might be insignificant. Thus, a novel idea proposes that the main mechanism might be vascular wall integrity disruption...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28140442/the-effects-of-sternal-intraosseous-and-intravenous-administration-of-amiodarone-in-a-hypovolemic-swine-cardiac-arrest-model
#3
Samuel Smith, Bradley Borgkvist, Teara Kist, Jason Annelin, Don Johnson, Robert Long
OBJECTIVE: This study compared the effects of amiodarone via sternal intraosseous (SIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility. SUBJECTS: Yorkshire-cross swine (n = 28)...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140441/effects-of-humerus-intraosseous-versus-intravenous-amiodarone-administration-in-a-hypovolemic-porcine-model
#4
Cpt Monica M Holloway, Cpt Shannan L Jurina, Cpt Joshua D Orszag, Lt George R Bragdon, Lt Rustin D Green, Jose C Garcia-Blanco, Brian E Benham, Ltc Timothy S Adams, Don Johnson
OBJECTIVE: To compare the effects of amiodarone administration by humerus intraosseous (HIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to maximum concentration (Tmax), maximum plasma drug concentration (Cmax), time to ROSC, and mean concentrations over time in a hypovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility. SUBJECTS: Yorkshire-cross swine (n = 28)...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140440/the-effects-of-tibial-intraosseous-versus-intravenous-amiodarone-administration-in-a-hypovolemic-cardiac-arrest-procine-model
#5
Kathryn Hampton, Eric Wang, Jerome Ivan Argame, Tom Bateman, William Craig, Don Johnson
OBJECTIVE: This study compared the effects of amiodarone via tibial intraosseous (TIO) and intravenous (IV) routes on return of spontaneous circulation (ROSC), time to ROSC, maximum drug concentration (Cmax), time to maximum concentration (Tmax), and mean concentrations over time in a hypovolemic cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility. SUBJECTS: Yorkshire-cross swine (n = 28)...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140439/effects-of-tibial-and-humerus-intraosseous-administration-of-epinephrine-in-a-cardiac-arrest-swine-model
#6
Ltc Denise Beaumont, Asal Baragchizadeh, Charles Johnson, Don Johnson
OBJECTIVE: Compare maximum concentration (Cmax), time to maximum concentration (Tmax), mean serum concentration of epinephrine, return of spontaneous circulation (ROSC), time to ROSC, and odds of survival relative to epinephrine administration by humerus intraosseous (HIO), tibial intraosseous (TIO), and intravenous (IV) routes in a swine cardiac arrest model. DESIGN: Prospective, between subjects, randomized experimental design. SETTING: TriService Research Facility...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28140438/the-comparison-of-humeral-intraosseous-and-intravenous-administration-of-vasopressin-on-return-of-spontaneous-circulation-and-pharmacokinetics-in-a-hypovolemic-cardiac-arrest-swine-model
#7
Mark H Wimmer, Kenneth Heffner, Michael Smithers, Richard Culley, Jennifer Coyner, Michael Loughren, Don Johnson
INTRODUCTION: The American Heart Association (AHA) recommends intravenous (IV) or intraosseous (IO) vasopressin in Advanced Cardiac Life Support (ACLS). Obtaining IV access in hypovolemic cardiac arrest patients can be difficult, and IO access is often obtained in these life threatening situations. No studies have been conducted to determine the effects of humeral IO (HIO) access with vasopressin in the return of spontaneous circulation (ROSC). Our study compared the kinetics of vasopressin and ROSC with HIO with IV access in the hypovolemic swine model...
October 2016: American Journal of Disaster Medicine
https://www.readbyqxmd.com/read/28073769/aldosterone-does-not-predict-cardiovascular-events-following-acute-coronary-syndrome-in-patients-initially-without-heart-failure
#8
Reynaria Pitts, Elise Gunzburger, Christie M Ballantyne, Philip J Barter, David Kallend, Lawrence A Leiter, Eran Leitersdorf, Stephen J Nicholls, Prediman K Shah, Jean-Claude Tardif, Anders G Olsson, John J V McMurray, John Kittelson, Gregory G Schwartz
BACKGROUND: Aldosterone may have adverse effects in the myocardium and vasculature. Treatment with an aldosterone antagonist reduces cardiovascular risk in patients with acute myocardial infarction complicated by heart failure (HF) and left ventricular systolic dysfunction. However, most patients with acute coronary syndrome do not have advanced HF. Among such patients, it is unknown whether aldosterone predicts cardiovascular risk. METHODS AND RESULTS: To address this question, we examined data from the dal-OUTCOMES trial that compared the cholesteryl ester transfer protein inhibitor dalcetrapib with placebo, beginning 4 to 12 weeks after an index acute coronary syndrome...
January 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28072500/ultrasound-guided-intracardiac-xenotransfusion-of-canine-packed-red-blood-cells-and-epinephrine-to-the-left-ventricle-of-a-severely-anemic-cat-during-cardiopulmonary-resuscitation
#9
Liron Oron, Yaron Bruchim, Sigal Klainbart, Efrat Kelmer
OBJECTIVE: To describe the use of an ultrasound-guided intracardiac xenotransfusion of canine packed red blood cells (pRBC) to the left ventricle of a severely anemic cat during cardiopulmonary resuscitation (CPR). CASE SUMMARY: An 8-year-old previously healthy neutered female cat was presented with severe weakness after she had disappeared for 1 month. On presentation, the cat was in hypovolemic shock, laterally recumbent, and severely anemic with massive flea infestation...
January 10, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28062336/comparative-safety-of-morphine-delivered-via-intravenous-route-versus-patient-controlled-analgesia-device-for-pediatric-inpatients
#10
Jennifer Faerber, Wenjun Zhong, Dingwei Dai, Avi Baehr, Lynne G Maxwell, F Wickham Kraemer, Chris Feudtner
BACKGROUND: Although patient-controlled analgesia (PCA) is an effective pain control modality, there is a lack of large studies on PCA safety in pediatric patients. This study compared the delivery of morphine either via intravenous route (morphine IV) or via PCA device (morphine PCA) on risk of cardiopulmonary resuscitation (CPR) and mechanical ventilation (MV) using a large administrative database. METHODS: We assembled a retrospective cohort of pediatric inpatients between 5 and 21 years old in 42 children's hospitals between 2007 and 2011 from the Pediatric Health Information System...
January 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28055027/interdisciplinary-onsite-team-based-simulation-training-in-the-neonatal-intensive-care-unit-a-pilot-report
#11
D J W Reed, R L Hermelin, C S Kennedy, J Sharma
OBJECTIVE: Simulation training improves individual clinician confidence, performance and self-efficacy in resuscitation and procedural training experiences. The reality of resuscitation experiences in the neonatal intensive care unit (NICU) is that they are team-accomplished events. However, limited data exist on team-based simulation training (TBST) in the NICU. We report the experience of TBST over a 4-year period. STUDY DESIGN: This is a retrospective report of 65 TBST events in a 71-bed Level IV NICU at a regional subspecialty children's hospital...
January 5, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28050441/blunt-cardiac-rupture-a-diagnostic-challenge
#12
Suraj Pinni, Vineet Kumar, Satish Balkrishna Dharap
Blunt Cardiac Rupture (BCR) is a life threatening injury. Majority of patients do not reach the hospital and in those who reach the emergency department, timely diagnosis and treatment is a challenge. The case is about a patient with multiple blunt injuries who presented in shock. Cardiac tamponade was suspected on clinical grounds and on evidence of mediastinal widening on radiograph. In the absence of songography, the diagnosis was confirmed by subxiphoid pericardial window. Emergency thoracotomy revealed a right atrial appendage rupture which was surgically corrected...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28032304/l-carnitine-reduces-susceptibility-to-bupivacaine-induced-cardiotoxicity-an-experimental-study-in-rats
#13
Gail K Wong, Carolyne Pehora, Mark W Crawford
BACKGROUND: The primary aim of this study was to evaluate the effect of acute administration of L-carnitine 100 mg·kg(-1) iv on susceptibility to bupivacaine-induced cardiotoxicity in rats. METHODS: In the first of two experiments, L-carnitine 100 mg·kg(-1) iv (n = 10) or saline iv (n = 10) was administered to anesthetized and mechanically ventilated Sprague-Dawley rats following which an infusion of bupivacaine 2.0 mg·kg(-1)·min(-1) iv was given until asystole occurred...
March 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28030495/resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients-in-youth
#14
Tatsuya Norii, Shin Miyata, Yusuke Terasaka, Sundeep Guliani, Stephen W Lu, Cameron Crandall
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) has received increasing attention for critically uncontrolled hemorrhagic shock. However, the efficacy of REBOA in patients in youth is unknown. OBJECTIVES: The aim of this study was to evaluate the mortality and characteristics of patients of age ≤ 18 years with severe traumatic injury who received REBOA. METHODS: We retrospectively analyzed observational cohort data from the Japan Trauma Data Bank (JTDB) from 2004 to 2015...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28007621/instability-of-willingness-to-accept-life-sustaining-treatments-of-patients-with-advanced-chronic-organ-failure-during-one-year
#15
Carmen H M Houben, Martijn A Spruit, Jos M G A Schols, Emiel F M Wouters, Daisy J A Janssen
BACKGROUND: For optimal end-of-life decision-making, it is important to understand the stability of patients' treatment preferences. The aim of this article is to examine stability of willingness to accept life-sustaining treatments during one-year follow-up in Dutch patients with advanced chronic organ failure. In addition, we want to explore the association between willingness to accept high-burden treatment and preferences for cardiopulmonary resuscitation (CPR) and mechanical ventilation (MV)...
December 19, 2016: Chest
https://www.readbyqxmd.com/read/27998615/analysis-of-intraosseous-blood-samples-using-an-epoc-point-of-care-analyzer-during-resuscitation
#16
Crystal Ives Tallman, Michael Darracq, Megann Young
BACKGROUND: In the early phases of resuscitation in a critically ill patient, especially those in cardiac arrest, intravenous (IV) access can be difficult to obtain. Intraosseous (IO) access is often used in these critical situations to allow medication administration. When no IV access is available, it is difficult to obtain blood for point of care analysis, yet this information can be crucial in directing the resuscitation. We hypothesized that IO samples may be used with a point of care device to obtain useful information when seconds really do matter...
December 12, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27993546/post-resuscitation-management-of-cardiac-arrest-patients-in-the-critical-care-environment-a-retrospective-audit-of-compliance-with-evidence-based-guidelines
#17
REVIEW
A Milonas, A Hutchinson, D Charlesworth, A Doric, J Green, J Considine
BACKGROUND: There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. OBJECTIVES: The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation...
December 16, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27941593/low-dose-sodium-nitrite-fluid-resuscitation-prevents-lethality-from-crush-syndrome-by-improving-nitric-oxide-consumption-and-preventing-myoglobin-cytotoxicity-in-kidney-in-a-rat-model
#18
Isamu Murata, Yumi Miyake, Naomi Takahashi, Ryuta Suzuki, Takayuki Fujiwara, Yuji Sato, Yutaka Inoe, Jun Kobayashi, Ikuo Kanamoto
OBJECTIVE: Crush syndrome (CS) is a serious medical condition characterized by muscle cell damage resulting from pressure. CS has a high mortality, even when patients receive fluid therapy. We examined whether administration of NaNO2-containing fluid can improve survival in a rat model of CS. DESIGN: The CS model was generated by subjecting anesthetized rats to bilateral hind limb compression with a rubber tourniquet for 5 h. Rats were then randomly divided into six groups: (i) sham; (ii) CS with no treatment; (iii) CS with normal saline treatment; (iv) CS with normal saline + 25 mEq/L bicarbonate treatment; and (v and vi) CS with normal saline + 200 or 500 μmol/kg NaNO2...
December 9, 2016: Shock
https://www.readbyqxmd.com/read/27918869/paramedic-initiated-cms-sepsis-core-measure-bundle-prior-to-hospital-arrival-a-stepwise-approach
#19
Jason G Walchok, Ronald G Pirrallo, Douglas Furmanek, Martin Lutz, Colt Shope, Brandi Giles, Greta Gue, Aaron Dix
BACKGROUND: To improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) implemented core measures that outline the initial treatment of the septic patient. These measures include initial blood culture collection prior to antibiotics, adequate intravenous fluid resuscitation, and early administration of broad spectrum antibiotics. We sought to determine if Paramedics can initiate the CMS sepsis core measure bundle in the prehospital field reliably. METHODS: This is a retrospective, case series from a 3rd service EMS system model in Greenville, South Carolina between November 17, 2014 and February 20, 2016...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27918639/evaluation-of-an-outpatient-protocol-in-the-treatment-of-canine-parvoviral-enteritis
#20
Emilee C Venn, Karolina Preisner, Pedro L Boscan, David C Twedt, Lauren A Sullivan
OBJECTIVE: To compare 2 treatment protocols (standard in-hospital versus modified outpatient) in affecting the duration of treatment or survival of dogs with parvoviral enteritis. DESIGN: Prospective, randomized study. SETTING: University teaching hospital. ANIMALS: Client-owned dogs with naturally acquired parvovirus were randomized to receive either an inpatient (n = 20) or outpatient (n = 20) treatment protocol. INTERVENTIONS: Both groups received intravenous (IV) fluid resuscitation and correction of hypoglycemia at hospital admission...
January 2017: Journal of Veterinary Emergency and Critical Care
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