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Iv resuscitation

Piroze M Davierwala, Sergey Leontyev, Alexander Verevkin, Ardawan J Rastan, Matthias Mohr, Farhad Bakhtiary, Martin Misfeld, Friedrich W Mohr
BACKGROUND: Cardiogenic shock after acute myocardial infarction is an indication for emergent coronary artery bypass grafting in patients not amenable to percutaneous coronary intervention. Our study aimed to evaluate and identify risk factors for early and long-term outcomes in such patients. METHODS: A total of 508 patients who underwent coronary artery bypass grafting for cardiogenic shock complicating acute myocardial infarction between January 2000 and June 2014 were divided into 3 time cohorts: 2000 to 2004 (n=204), 2005 to 2009 (n=166), and 2010 to 2014 (n=138)...
October 25, 2016: Circulation
Nehemiah T Liu, José Salinas, Craig A Fenrich, Maria L Serio-Melvin, George C Kramer, Ian R Driscoll, Martin A Schreiber, Leopoldo C Cancio, Kevin K Chung
INTRODUCTION: The depth of burn has been an important factor often overlooked when estimating the total resuscitation fluid needed for early burn care. The goal of this study was to determine the degree to which full-thickness (FT) involvement affected overall 24-hour burn resuscitation volumes. METHODS: We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, with significant burns that required resuscitation using our computerized decision support system for burn fluid resuscitation...
November 2016: Journal of Trauma and Acute Care Surgery
Brian Clemency, Colleen Clemency Cordes, Heather A Lindstrom, Jeanne M Basior, Deborah P Waldrop
OBJECTIVES: What patients intend when they make health care choices and whether they understand the meaning of orders for life-sustaining treatment forms is not well understood. The purpose of this study was to analyze the directives from a sample of emergency department (ED) patients' MOLST forms. PROCEDURES: MOLST forms that accompanied 100 patients who were transported to an ED were collected and their contents analyzed. Data categories included age, gender, if the patient completed the form for themselves, medical orders for life-sustaining treatment including intubation, ventilation, artificial nutrition, artificial fluids or other treatment, and wishes for future hospitalization or transfer...
September 27, 2016: Journal of the American Medical Directors Association
Kokui Elikplim Pomevor, Augustine Adomah-Afari
Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers' perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana...
October 10, 2016: International Journal of Health Care Quality Assurance
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
Matthew Keane
Multiple organ failure is a significant complication in traumatic injury, and can be exacerbated by a failure to adequately monitor and control trauma patients' core body temperature in emergency departments (EDs). Nearly half of trauma patients are hypothermic on arrival at emergency departments, often due to factors beyond the control of emergency service responders and during on-scene resuscitation attempts. This article examines the physiology of the 'triad of death' -hypothermia, metabolic acidosis and coagulopathy - to highlight the importance of monitoring and maintaining normothermia, or normal body temperature, which is between 36°C and 37...
September 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Rebecca D Powell, Donna A Goodenow, Hannah V Mixer, Iain H Mckillop, Susan L Evans
BACKGROUND: Hemorrhagic shock and reperfusion (HSR) injury leads to a cascade of reactive oxygen species (ROS) production and mitochondrial dysfunction, which results in energy failure, cell death and multiple organ dysfunction. Cytochrome c (cyt c) is the final electron carrier in the mitochondrial electron transport chain providing the electrochemical force for ATP production. We sought to determine whether exogenous cyt c administration would improve parameters of organ dysfunction and/or mitochondrial stability in a rat model of HSR...
September 3, 2016: Journal of Trauma and Acute Care Surgery
Michael Peck, James Jeng, Amr Moghazy
Intravenous (IV) cannulation and sterile IV salt solutions may not be options in resource-limited settings (RLSs). This article presents recipes for fluid resuscitation in the aftermath of burns occurring in RLSs. Burns of 20% total body surface area (TBSA) can be resuscitated, and burns up to 40% TBSA can most likely be resuscitated, using oral resuscitation solutions (ORSs) with salt supplementation. Without IV therapy, fluid resuscitation for larger burns may only be possible with ORSs. Published global experience is limited, and the magnitude of burn injuries that successfully respond to World Health Organization ORSs is not well-described...
October 2016: Critical Care Clinics
Charles D Deakin, Jie Yang, Robert Nguyen, Jiawen Zhu, Stephen J Brett, Jerry P Nolan, Gavin D Perkins, David G Pogson, Sam Parnia
BACKGROUND: Epinephrine has been presumed to improve cerebral oxygen delivery during cardiopulmonary resuscitation (CPR), but animal and registry studies suggest that epinephrine-induced capillary vasoconstriction may decrease cerebral capillary blood flow and worsen neurological outcome. The effect of epinephrine on cerebral oxygenation (rSO2) during CPR has not been documented in the clinical setting. METHODS: rSO2 was measured continuously using cerebral oximetry in patients with in-hospital cardiac arrest...
August 31, 2016: Resuscitation
Wail N Khraise, Mohammed Z Allouh, Mohammad Y Hiasat, Raed S Said
BACKGROUND Intraoperative pulmonary embolism (PE) is a rare life-threatening complication in patients undergoing surgical intervention. Generally, cancer patients have a higher risk for developing this complication. Unfortunately, there is no standard procedure for its management. CASE REPORT We report the case of a 39-year-old woman with high-grade glioma in the right frontal lobe who was admitted to the surgical theater for craniotomy and excision of the tumor. During the general anesthesia procedure and just before inserting the central venous line, her end-tidal CO2 and O2 saturation dropped sharply...
2016: American Journal of Case Reports
Dimitrios Konstantelos, Jürgen Dinger, Sascha Ifflaender, Mario Rüdiger
BACKGROUND: Over the past years, research on neonatal resuscitation has focused on single interventions. The present study was performed to analyze the process quality of delivery room management of preterm infants born by c-section in our institution. METHODS: We performed a cross-sectional study of videos of preterm infants born by c-section. Videos were analyzed according to time point, duration and number of performed medical interventions. The study period occurred between January 2012 and December 2013...
2016: BMC Pregnancy and Childbirth
Sarah Manspeaker, Kelley Henderson, Dru Riddle
BACKGROUND: Exertional rhabdomyolysis (ER) is the breakdown of skeletal muscle tissue following intense physical activity that results in impairment of the cell membrane, which allows intracellular contents to be released into the bloodstream. Signs and symptoms include myalgia, myoglobinuria and increased creatine kinase (CK) levels. Athletes are vulnerable to this condition due to their increased level of physical activity. The severity and effects of this condition vary between individuals; however, all athletes are at risk of significant muscle damage, renal failure and perhaps death if not recognized and treated quickly...
June 2016: JBI Database of Systematic Reviews and Implementation Reports
Philippe Haouzi, Nicole Tubbs, Matthew D Rannals, Annick Judenherc-Haouzi, Larry A Cabell, Joe A McDonough, Takashi Sonobe
Our objective was to determine how circulatory failure develops following systemic administration of potassium cyanide (KCN). We used a non-inhaled modality of intoxication, wherein the change in breathing pattern would not influence the diffusion of CN into the blood, akin to the effects of ingesting toxic levels of CN. In a group of 300-400 g rats, CN-induced coma (CN IP, 7 mg/kg) produced a central apnea within 2-3 minutes along with a potent and prolonged gasping pattern leading to auto-resuscitation in 38% of the animals...
August 10, 2016: Shock
Anna Sina P Meyer, Sisse R Ostrowski, Jesper Kjaergaard, Pär I Johansson, Christian Hassager
BACKGROUND: Morbidity and mortality following initial survival of cardiac arrest remain high despite great efforts to improve resuscitation techniques and post-resuscitation care, in part due to the ischemia-reperfusion injury secondary to the restoration of the blood circulation. Patients resuscitated from cardiac arrest display evidence of endothelial injury and coagulopathy (hypocoagulability, hyperfibrinolysis), which in associated with poor outcome. Recent randomized controlled trials have revealed that treatment with infusion of prostacyclin reduces endothelial damage after major surgery and AMI...
2016: Trials
Anna Jarosz, Tomasz Darocha, Sylweriusz Kosiński, Robert Gałązkowski, Piotr Mazur, Jacek Piątek, Janusz Konstanty-Kalandyk, Hubert Hymczak, Rafał Drwiła
We sought to organize a functional system of recognition and advanced treatment of hypothermic patients with extracorporeal rewarming as a treatment option. All patients with suspected hypothermia are consulted with the Hypothermia Coordinator (HC), whose role is to provide expertise on hypothermia recognition and treatment to all rescue and medical services. Patients with Swiss Staging System of Hypothermia (HT) class III and IV are subjected to extracorporeal rewarming. Patients with class I and II are managed in local hospitals, after the hypothermia coordinator provides instructions...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Mohamad J Alshikho, Joud M Talas, Salem I Noureldine, Saf Zazou, Aladdin Addas, Haitham Kurabi, Mahmoud Nasser
BACKGROUND Intestinal lymphangiectasia (IL) is a rare disease characterized by a dilatation of the intestinal lymphatics and loss of lymph fluid into the gastrointestinal tract leading to hypoproteinemia, edema, lymphocytopenia, hypogammaglobinemia, and immunological abnormalities. Iron, calcium, and other serum components (e.g., lipids, fat soluble vitamins) may also be depleted. A literature search revealed more than 200 reported cases of IL. Herein, we report our observations of a patient diagnosed with IL; we also present our conclusion for our review of the published literature...
2016: American Journal of Case Reports
Raquel Poyatos-León, Gema Sanabria-Martínez, Jorge Cañete García-Prieto, Celia Álvarez-Bueno, Diana P Pozuelo-Carrascosa, Iván Cavero-Redondo, Antonio García-Hermoso, Sagrario Gómez-Cantarino, Miriam Garrido-Miguel, Vicente Martínez-Vizcaíno
BACKGROUND: In recent years, the influence of physical exercise on pregnancy outcomes has been widely debated. Despite the numerous studies addressing the relationship between maternal physical activity and pregnancy outcomes, the evidence for consistent and significant impact of regular exercise during pregnancy on fetal growth remains lacking. The aims of this study were, first, to assess the level of physical activity performed throughout the pregnancy by objective (accelerometer) and self-reported (questionnaire) measurements, and, second, to ascertain pre-pregnancy physical activity levels, to estimate the relationship between levels of physical activity and some pregnancy and neonatal outcomes...
2016: BMC Public Health
Nehemiah T Liu, José Salinas, Craig A Fenrich, Maria L Serio-Melvin, George C Kramer, Ian R Driscoll, Martin A Schreiber, Leopoldo C Cancio, Kevin K Chung
INTRODUCTION: The depth of burn has been an important factor often overlooked when estimating the total resuscitation fluid needed for early burn care. The goal of this study was to determine the degree to which full thickness (FT) involvement impacted overall 24-hour burn resuscitation volumes. METHODS: We performed a retrospective review of patients admitted to our burn intensive care unit from December 2007 to April 2013, with significant burns who required resuscitation using our computerized decision support system for burn fluid resuscitation...
July 6, 2016: Journal of Trauma and Acute Care Surgery
Paul A Tripi, Susan Thomas, Anna Clebone, Mark M Goldfinger, Joseph D Tobias
BACKGROUND: Anesthesia providers frequently rely upon in-situ peripheral intravenous catheters (IVs) during the perioperative care of pediatric patients. IV dysfunction can result in complications including inability to administer medications for resuscitation, extravasation of tissue-toxic medications, and incomplete induction of anesthesia. This study was performed to prospectively assess the frequency of IV dysfunction in children presenting for anesthesia care. METHODS: A survey of IV patency and integrity was completed in patients less than 18 years of age arriving at the preoperative holding area for anesthesia evaluation...
February 2016: Middle East Journal of Anesthesiology
Jessica L Weaver, Paul J Matheson, Ryan T Hurt, Cynthia D Downard, Craig J McClain, R Neal Garrison, Jason W Smith
BACKGROUND: MicroRNAs (miRNAs) are small segments of noncoding RNA that regulate gene expression and protein function, and therefore are key regulators of cellular processes including those of the inflammatory cascade after hemorrhagic shock (HS). We have previously shown that direct peritoneal resuscitation (DPR), as an adjunct to traditional IV fluid resuscitation, improves visceral blood flow and reduces pro-inflammatory cytokines released during HS. The effects of DPR on hepatic miRNA (miR) expression patterns after resuscitated HS are not known...
July 2016: Journal of the American College of Surgeons
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