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hypotension resuscitation

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https://www.readbyqxmd.com/read/28529913/critical-care-management-and-intensive-care-unit-outcomes-following-cytoreductive-surgery-with-hyperthermic-intraperitoneal-chemotherapy
#1
Sumit Kapoor, Adel Bassily-Marcus, Rafael Alba Yunen, Parissa Tabrizian, Sabrine Semoin, Joseph Blankush, Daniel Labow, John Oropello, Anthony Manasia, Roopa Kohli-Seth
AIM: To study the early postoperative intensive care unit (ICU) management and complications in the first 2 wk of patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: Our study is a retrospective, observational study performed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who underwent CRS and HIPEC between January 1, 2007 and December 31, 2012 and admitted to ICU postoperatively were studied...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28529306/normalization-of-diffuse-st-depression-with-avr-elevation-after-rehydration-in-a-patient-with-severe-aortic-stenosis
#2
Sachin R Patel, Vikas J Patel, Brittany Clark, George Rust
BACKGROUND Isolated ST elevation in lead aVR in combination with global ST depression with normalization after rehydration is a unique electrocardiographic pattern that is associated with a broad range of diagnoses. Its association with left main coronary artery disease and other acute coronary syndromes suggest the need for early and aggressive cardiac evaluation. CASE REPORT A 53-year-old man presented with altered mental status and loss of consciousness. He was unresponsive, hypotensive, tachycardiac, and diaphoretic...
May 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28509668/norepinephrine-in-septic-shock-when-and-how-much
#3
Olfa Hamzaoui, Thomas W L Scheeren, Jean-Louis Teboul
PURPOSE OF REVIEW: Norepinephrine is the first-line agent recommended during resuscitation of septic shock to correct hypotension because of depressed vascular tone. Important clinical issues are the best timing to start norepinephrine, the optimal blood pressure target, and the best therapeutic options to face refractory hypotension of when high doses of norepinephrine are required to reach the target. RECENT FINDINGS: Recent literature has reported benefits of early administration of norepinephrine because of the following reasons: profound and durable hypotension is an independent factor of increased mortality, early administration of norepinephrine increases cardiac output, improves microcirculation and avoid fluid overload...
May 13, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28500653/blood-transfusion-in-the-surgical-treatment-of-adolescent-idiopathic-scoliosis-a-single-center-experience-of-patient-blood-management-in-210-cases
#4
Søren Ohrt-Nissen, Naeem Bukhari, Casper Dragsted, Martin Gehrchen, Pär I Johansson, Jesper Dirks, Jakob Stensballe, Benny Dahl
BACKGROUND: The surgical treatment of adolescent idiopathic scoliosis can be associated with substantial blood loss, requiring allogeneic red blood cell (RBC) transfusion. This study describes the use of RBC and the effect of a standardized perioperative patient blood management program. STUDY DESIGN AND METHODS: Patients treated with posterior instrumented fusion were consecutively enrolled over a 6-year period. Patient blood management strategies were implemented in 2011, including prophylactic tranexamic acid, intraoperative permissive hypotension, restrictive fluid therapy (including avoidance of synthetic colloids), restrictive RBC trigger according to institutional standardized protocol, the use of cell savage, and goal-directed therapy according to thrombelastography...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28492403/pediatric-in-hospital-acute-respiratory-compromise-a-report-from-the-american-heart-association-s-get-with-the-guidelines-resuscitation-registry
#5
Lars W Andersen, Mikael Vognsen, Alexis Topjian, Linda Brown, Robert A Berg, Vinay M Nadkarni, Hans Kirkegaard, Michael W Donnino
OBJECTIVES: The main objectives of this study were to describe in-hospital acute respiratory compromise among children (< 18 yr old), and its association with cardiac arrest and in-hospital mortality. DESIGN: Observational study using prospectively collected data. SETTING: U.S. hospitals reporting data to the "Get With The Guidelines-Resuscitation" registry. PATIENTS: Pediatric patients (< 18 yr old) with acute respiratory compromise...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28489728/novel-adjunct-drugs-reverse-endothelial-glycocalyx-damage-after-hemorrhagic-shock-in-rats
#6
Ivo P Torres Filho, Luciana N Torres, Christi Salgado, Michael A Dubick
INTRODUCTION: There is interest in the small-volume therapeutic use of adjunct drugs for treating hemorrhagic shock (HS). However, critical information is only partially available on mechanisms of action of promising compounds such as adenosine-lidocaine-Magnesium (ALM), beta-hydroxybutyrate plus melatonin (BHB/M), and poloxamer 188 (P-188). Therefore, we tested the hypothesis that these adjuncts would reverse HS-induced damage to microvascular endothelial glycocalyx and hemodynamics...
May 9, 2017: Shock
https://www.readbyqxmd.com/read/28481669/prehospital-fluid-administration-in-trauma-patients-a-survey-of-state-protocols
#7
Sahil Dadoo, Joseph M Grover, Lukas G Keil, Kay S Hwang, Jane H Brice, Timothy F Platts-Mills
OBJECTIVE: The optimal resuscitation approach during the initial treatment of hypotensive trauma patients remains unknown, but some clinical trials have observed a survival benefit from restricting fluid administration prior to definitive hemorrhage control. We sought to characterize emergency medical services (EMS) protocols for the administration of intravenous fluids in this setting. METHODS: Publicly accessible statewide EMS protocols for the treatment of hypotensive trauma patients were included and characterized by: 1) goal of fluid administration, 2) dosing strategy, 3) maximum dose, 4) type of fluid, and 5) specific protocols for head trauma, if present...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28462900/hyperdehydroepiandrosterone-in-neonates-with-hypoxic-ischemic-encephalopathy-and-circulatory-collapse
#8
Abdelmoneim Khashana, Engy Ahmed
BACKGROUND: Circulatory collapse is a very common complication of the critical illnesses in neonates including neonates with hypoxic ischemic encephalopathy; it can be the end result and cause of death of several conditions. Often, despite treatment with fluid resuscitation and vasopressor agents, circulatory collapse persist, and blood pressure can remain critically low, compromising adequate blood flow to vital organs and brain. Low blood pressure has been associated with increased mortality...
April 12, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28458893/successful-treatment-of-thyroid-storm-presenting-as-recurrent-cardiac-arrest-and-subsequent-multiorgan-failure-by-continuous-renal-replacement-therapy
#9
Han Soo Park, Su Kyoung Kwon, Ye Na Kim
SUMMARY: Thyroid storm is a rare and potentially life-threatening medical emergency. We experienced a case of thyroid storm associated with sepsis caused by pneumonia, which had a catastrophic course including recurrent cardiac arrest and subsequent multiple organ failure (MOF). A 22-year-old female patient with a 10-year history of Graves' disease was transferred to our emergency department (ED). She had a cardiac arrest at her home and a second cardiac arrest at the ED. Her heart recovered after 20 min of cardiac resuscitation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28452887/multicenter-retrospective-study-of-non-compressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#10
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
OBJECTIVE: Rational development of technology for rapid control of non-compressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) versus open (OPEN) management. METHODS: Retrospective study of adult trauma patients with NCTH admitted to 4 urban level 1 trauma centers in the Houston and San Antonio metropolitan areas in 2008-2012...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452884/the-effect-of-reboa-partial-aortic-occlusion-and-aggressive-blood-transfusion-on-traumatic-brain-injury-in-a-swine-polytrauma-model
#11
M Austin Johnson, Timothy K Williams, Sarah-Ashley E Ferencz, Anders J Davidson, Rachel M Russo, William T O'Brien, Joseph M Galante, J Kevin Grayson, Lucas P Neff
OBJECTIVES: Despite clinical reports of poor outcomes, the degree to which REBOA exacerbates traumatic brain injury (TBI) is not known. We hypothesized that combined effects of increased proximal mean arterial pressure (pMAP), carotid blood flow (Qcarotid), and intracranial pressure (ICP) from REBOA would lead to TBI progression compared to partial aortic occlusion (PAO) or no intervention. METHODS: 21 swine underwent a standardized TBI via computer Controlled cortical impact followed by 25% total blood volume rapid hemorrhage...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28452098/impact-of-bradycardia-or-asystole-on-neonatal-cardiopulmonary-resuscitation-at-birth
#12
Vasantha H S Kumar, Annie Skrobacz, Changxing Ma
BACKGROUND: Fetal hypoxia from intrapartum events can lead to absent heart rate (HR) or bradycardia (BC) at birth requiring aggressive neonatal resuscitation. Neonatal resuscitation guidelines do not differentiate infants with bradycardia (HR<100/min) from absent HR at birth. As HR is the primary determinant of resuscitation, we hypothesize that infants with no HR at 1 minute would require more extensive resuscitation with worse clinical outcomes compared to infants with bradycardia at 1minute...
April 28, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28450776/brainstem-anesthesia-after-retrobulbar-block-a-case-report-and-review-of-literature
#13
Kumale Tolesa, Girum W Gebreal
BACKGROUND: Retro-bulbar anesthesia is one of the most common regional blocks used for intraocular surgeries. Complications associated with regional blocks may be limited to the eye or may be systemic. CASE REPORT: After a retro-bulbar block for glaucoma surgery, a 60-year-old man developed loss of consciousness, apnea with hypotension and bradycardia-features of brainstem anesthesia. We present the clinical features, treatment and comments on how to prevent the problem as well as a review of the literature on reported cases...
November 2016: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28448605/vasopressor-use-following-traumatic-injury-a-single-center-retrospective-study
#14
Mathieu Hylands, Marie-Pier Godbout, Sandeep K Mayer, William D Fraser, Alain Vanasse, Marc-André Leclair, Alexis F Turgeon, François Lauzier, Emmanuel Charbonney, Vincent Trottier, Tarek S Razek, André Roy, Frédérick D'Aragon, Emilie Belley-Côté, Andrew G Day, Soazig Le Guillan, Robert Sabbagh, François Lamontagne
OBJECTIVES: Vasopressors are not recommended by current trauma guidelines, but recent reports indicate that they are commonly used. We aimed to describe the early hemodynamic management of trauma patients outside densely populated urban centers. METHODS: We conducted a single-center retrospective cohort study in a Canadian regional trauma center. All adult patients treated for traumatic injury in 2013 who died within 24 hours of admission or were transferred to the intensive care unit were included...
2017: PloS One
https://www.readbyqxmd.com/read/28447933/acute-decompensated-heart-failure-new-strategies-for-improving-outcomes
#15
Emily Singer Fisher, Boyd Burns
Acute decompensated heart failure is a common emergency department presentation with significant associated morbidity and mortality. Heart failure accounts for more than 1 million hospitalizations annually, with a steadily increasing incidence as our population ages. This issue reviews recent literature regarding appropriate management of emergency department presentations of acute decompensated heart failure, with special attention to newer medication options. Emergency department management and appropriate interventions are discussed, along with critical decision-making points in resuscitation for both hypertensive and hypotensive patients...
May 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28439845/a-systematic-review-of-the-clinical-presentation-diagnosis-and-treatment-of-small-bowel-obstruction
#16
REVIEW
Srinivas R Rami Reddy, Mitchell S Cappell
PURPOSE OF REVIEW: This study aimed to systematically review small bowel obstruction (SBO), focusing on recent changes in diagnosis/therapy. RECENT FINDINGS: SBO incidence is about 350,000/annum in the USA. Etiologies include adhesions (65%), hernias (10%), neoplasms (5%), Crohn's disease (5%), and other (15%). Bowel dilatation occurs proximal to obstruction primarily from swallowed air and secondarily from intraluminal fluid accumulation. Dilatation increases mural tension, decreases mucosal perfusion, causes bacterial proliferation, and decreases mural tensile strength that increases bowel perforation risks...
June 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28435902/emergency-medical-service-personnel-need-to-improve-knowledge-and-attitude-regarding-prehospital-sepsis-care
#17
Joongmin Park, Sung Yeon Hwang, Tae Gun Shin, Ik Joon Jo, Hee Yoon, Tae Rim Lee, Won Chul Cha, Min Seob Sim
OBJECTIVE: We aimed to evaluate the knowledge and attitudes of emergency medical service (EMS) personnel pertaining to sepsis. We also compared EMS personnel's knowledge of sepsis and their intention to engage in prehospital sepsis management. METHODS: The survey was conducted during education conferences for EMS personnel in December 2013 and January 2015 in Seoul, Korea. The questionnaire composed of 10 questions relevant to sepsis, was distributed on-scene, and was retrieved by investigators after the conference...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#18
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28414664/gonococcal-endocarditis-the-gift-that-stops-giving-an-uncommon-presentation-of-a-common-disease
#19
G Olayemi, M Oferczak, A Elagizi, I El-Abbassi, M Eschete, J Crowe
INTRODUCTION: Gonorrhea is the 2nd most common sexually transmitted disease in the US with 800,000 cases of gonorrhea each year. Disseminated gonorrhea infection occurs in 0.5 percent - 3 percent of these patients and is more frequent in woman younger than 40 years of age. CASE: A 36 year old woman with a history of polysubstance abuse presented with 10 day history of feeling generally unwell. At presentation, vitals were remarkable for tachycardia and hypotension...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412053/-the-prognostic-value-of-cerebral-oxygen-saturation-measurement-for-assessing-prognosis-after-cardiopulmonary-resuscitation
#20
Mehmet Turan Inal, Dilek Memiş, Ilker Yıldırım, Hüseyin Uğur, Aysegul Erkaymaz, F Nesrin Turan
BACKGROUND: Despite new improvements on cardiopulmonary resuscitation (CPR), brain damage is very often after resuscitation. OBJECTIVE: To assess the prognostic value of cerebral oxygen saturation measurement (rSO2) for assessing prognosis on patients after cardiopulmonary resuscitation. DESIGN: Retrospective analysis. MEASUREMENTS AND RESULTS: We analyzed 25 post-CPR patients (12 female and 13 male). All the patients were cooled to a target temperature of 33-34°C...
April 12, 2017: Revista Brasileira de Anestesiologia
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