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Lactate and hypotension

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https://www.readbyqxmd.com/read/29344029/primary-adrenal-lymphoma-presenting-with-adrenal-failure-a-case-report-and-review-of-the-literature
#1
Fariba Karimi
Introduction: Primary adrenal lymphoma is rare, with a few cases reported in the literature. Most often it manifests as bilateral adrenal lesions and adrenal insufficiency is a common complication. Case Presentation: A 53-year-old male was referred with abdominal discomfort and darkening of the skin since 1 month prior to admission. His workups detected large bilateral adrenal masses. The patient was admitted due to hypotension, and was diagnosed with adrenal insufficiency...
October 2017: International Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29319732/a-fatal-and-metabolic-experimental-hemorrhagic-shock-in-immature-swine
#2
Simone Alves Dos Santos Ferreira, Ana Cristina de Moraes, Renato Giuseppe Giovanni Terzi, Evandro Luis Assis Ferreira, William Adalberto Silva, Marcos Mello Moreira
PURPOSE: To use blood lactate (BL) as an end-point metabolic marker for the begin resuscitation of volume replacement in experimental hemorrhagic shock. METHODS: Group I (n=7) was not bled (Control). Animals in Group II (n=7) were bled to a MAP of 30mmHg in thirty minutes. Hemodynamic and metabolic data were recorded at Baseline, at 30, 60 and 120 minutes after Baseline. The animals were intubated in spontaneous breathing (FIO2=0.21) with halothane. RESULTS: Group I all survived...
December 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29310559/arrhythmias-in-children-in-early-postoperative-period-after-cardiac-surgery
#3
Manoj Kumar Sahu, Anupam Das, Bharat Siddharth, Sachin Talwar, Sarvesh Pal Singh, Atul Abraham, Arin Choudhury
BACKGROUND: Postoperative arrhythmias are a known complication after cardiac surgical repairs for congenital heart disease. METHODS: Data were reviewed pertaining to incidence, diagnosis, potential risk factors, and management of postoperative arrhythmias in 369 consecutive patients under 18 years of age, undergoing elective open heart surgery. All children were admitted to the intensive care unit and continuous electrocardiographic monitoring was performed. Patient factors such as Aristotle Basic Complexity Score, total surgical duration, hypotension, tachycardia, serum lactate level, and inotropic score were analyzed...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29306875/serum-lactate-cut-offs-as-a-risk-stratification-tool-for-in-hospital-adverse-outcomes-in-emergency-department-patients-screened-for-suspected-sepsis
#4
Amith L Shetty, Kelly Thompson, Karen Byth, Petra Macaskill, Malcolm Green, Mary Fullick, Harvey Lander, Jonathan Iredell
OBJECTIVES: We investigated specific lactate thresholds for adverse outcomes in patients presenting to emergency departments (EDs) with suspected sepsis identified based on the performance of a sepsis screening algorithm. DESIGN AND SETTING: A standardised sepsis bundle was implemented across public hospitals in New South Wales, Australia, as a quality improvement initiative. A register of all adult ED presentations (≥18 years) meeting predefined criteria for sepsis was created, using a combination of data linkage and direct reporting from 97 participating sites...
January 5, 2018: BMJ Open
https://www.readbyqxmd.com/read/29298189/delay-within-the-3-hour-surviving-sepsis-campaign-guideline-on-mortality-for-patients-with-severe-sepsis-and-septic-shock
#5
Lisiane Pruinelli, Bonnie L Westra, Pranjul Yadav, Alexander Hoff, Michael Steinbach, Vipin Kumar, Connie W Delaney, Gyorgy Simon
OBJECTIVES: To specify when delays of specific 3-hour bundle Surviving Sepsis Campaign guideline recommendations applied to severe sepsis or septic shock become harmful and impact mortality. DESIGN: Retrospective cohort study. SETTING: One health system composed of six hospitals and 45 clinics in a Midwest state from January 01, 2011, to July 31, 2015. PATIENTS: All adult patients hospitalized with billing diagnosis of severe sepsis or septic shock...
January 2, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29290743/use-of-vasopressin-in-neonatal-intensive-care-unit-patients-with-hypotension
#6
Mengwei Ni, Jeffrey R Kaiser, Brady S Moffett, Christopher J Rhee, Jennifer Placencia, Kimberly L Dinh, Joseph L Hagan, Danielle R Rios
OBJECTIVE: To evaluate the safety and efficacy of vasopressin for the treatment of hypotension in patients admitted to neonatal intensive care units (NICUs). METHODS: Vasopressin use in 69 infants admitted to our NICU between 2011 and 2014 was examined. Data evaluated included demographics; serum creatinine, sodium, and lactate concentrations; urine output; and systolic, diastolic, and mean blood pressures (BPs). Parameters prior to vasopressin use were compared to those at maximum dose...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29287672/-impact-of-hypotension-and-global-hypoperfusion-in-postoperative-delirium-a-pilot-study-in-older-adults-undergoing-open-colon-surgery
#7
Eduardo Tobar, Mario A Abedrapo, Jaime A Godoy, Jose L Llanos, Mauricio J Díaz, Rodrigo Azolas, Gunther R Bocic, Jaime A Escobar, Rodrigo A Cornejo, Carlos M Romero
BACKGROUND: Post-operative delirium is a serious complication in patients undergoing major abdominal surgery. It remains unclear whether peri-operative hemodynamic and perfusion variables affect the risk for postoperative delirium. The objective of this pilot study was to evaluate the association between perfusion and hemodynamics peri-operative with the appearance of post-operative delirium. METHODS: Prospective cohort study of adults 60 years or older undergoing elective open colon surgery...
December 26, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29245260/risk-factors-for-death-in-children-with-critical-and-severe-hand-foot-and-mouth-disease-in-chongqing-china-an-observational-study
#8
Gaihuan Zheng, Jiaoyang Cao, Jie Yu, Zhenzhen Zhang, Quanbo Liu, Junhua Chen
Hand-foot-and-mouth disease (HFMD) is a common childhood infection that may lead to serious complications and even death. Globally, epidemics of HFMD are increasing each year, especially in China. This study aimed to identify risk factors for death in children with critical and severe HFMD in Chongqing, China.We performed an observational study involving patients with critical and severe HFMD admitted to the Children's Hospital of Chongqing Medical University from January 2009 to December 2016. Overall, 179 patients aged 2 months to 16 years, were included; 127 died (non-survival group) and 52 survived (survival group); the case-fatality rate was 70...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29227201/early-rescue-from-acute-severe-clostridium-difficile-a-novel-treatment-strategy
#9
Biniam Kidane, Kalvin Lung, Greig McCreery, Chadia El-Khatib, Michael C Ott, Roberto Hernandez-Alejandro, Chris Vinden, Daryl Gray, Neil G Parry, Kenneth A Leslie, Tina S Mele
BACKGROUND: Severe Clostridium difficile infections (CDI) can lead to significant impediments to effective treatment. We developed a novel treatment protocol utilizing bedside gastrointestinal lavage (GIL) for the management of patients with severe, complicated CDI. We describe the development and early outcomes of non-operative bedside GIL in hospitalized patients with severe, complicated CDI following the Idea, Development, Exploration, Assessment, Long Term Study (IDEAL) framework at the Idea stage...
December 11, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29206763/association-of-clinical-hypoperfusion-variables-with-lactate-clearance-and-hospital-mortality
#10
Jessica Londoño, César Niño, James Díaz, Carlos Morales, Jimmy León, Elisa Bernal, Cesar Vargas, Leonardo Mejía, Carolina Hincapié, Johana Ascuntar, Alba León, Fabián Jaimes
BACKGROUND: lactate has shown utility in assessing the prognosis of patients admitted to the hospital with confirmed or suspected shock. Some findings of the physical examination might replace it as screening tool. We asked to determine the correlation and association between clinical perfusion parameters and lactate at the time of admission; the correlation between the change in clinical parameters and lactate clearance after 6 and 24 hours of resuscitation and; the association between clinical parameters, lactate and mortality...
December 4, 2017: Shock
https://www.readbyqxmd.com/read/29193548/rephill-protocol-for-a-randomised-controlled-trial-of-pre-hospital-blood-product-resuscitation-for-trauma
#11
I M Smith, N Crombie, J R Bishop, A McLaughlin, D N Naumann, M Herbert, J M Hancox, G Slinn, N Ives, M Grant, G D Perkins, H Doughty, M J Midwinter
OBJECTIVES: To describe the 'Resuscitation with Pre-HospItaL bLood products' trial (RePHILL) - a multi-centre randomised controlled trial of pre-hospital blood product (PHBP) administration vs standard care for traumatic haemorrhage. BACKGROUND: PHBP are increasingly used for pre-hospital trauma resuscitation despite a lack of robust evidence demonstrating superiority over crystalloids. Provision of PHBP carries additional logistical and regulatory implications, and requires a sustainable supply of universal blood components...
November 28, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/29188497/bexarotene-a-selective-rxr%C3%AE-agonist-reverses-hypotension-associated-with-inflammation-and-tissue-injury-in-a-rat-model-of-septic-shock
#12
Bahar Tunctan, Sefika P Kucukkavruk, Meryem Temiz-Resitoglu, Demet S Guden, Ayse N Sari, Seyhan Sahan-Firat
Peroxisome proliferator-activated receptors (PPARs) are nuclear receptors that can activate or inhibit the expression of many target genes by forming a heterodimer complex with the retinoid X receptor (RXR). The aim of this study was to investigate effects of bexarotene, a selective RXRα agonist, on the changes in renal, cardiac, hepatic, and pulmonary expression/activity of inducible nitric oxide synthase (iNOS) and cytochrome P450 (CYP) 4F6 in relation to PPARα/β/γ-RXRα heterodimer formation in a rat model of septic shock...
November 29, 2017: Inflammation
https://www.readbyqxmd.com/read/29183276/the-effectiveness-of-prehospital-hypertonic-saline-for-hypotensive-trauma-patients-a-systematic-review-and-meta-analysis
#13
I E Blanchard, A Ahmad, K L Tang, P E Ronksley, D Lorenzetti, G Lazarenko, E S Lang, C J Doig, H T Stelfox
BACKGROUND: The optimal prehospital fluid for the treatment of hypotension is unknown. Hypertonic fluids may increase circulatory volume and mute the pro-inflammatory response of the body to injury and illness. The purpose of this systematic review is to determine whether in patients presenting with hypotension in the prehospital setting (population), the administration of hypertonic saline (intervention), compared to an isotonic fluid (control), improves survival to hospital discharge (outcome)...
November 28, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29179767/rhabdomyolysis-lactic-acidosis-and-multiple-organ-failure-during-telbivudine-treatment-for-hepatitis-b-a-case-report-and-review-of-the-literature
#14
Jinxin Zheng, Minggui Deng, Xiaoliang Qiu, Zhong Chen, Duoyun Li, Xiangbin Deng, Qiwen Deng, Zhijian Yu
BACKGROUND: Telbivudine can cause severe side effects, including myositis, neuritis, rhabdomyolysis, and lactic acidosis. However, reported cases of telbivudine leading to multiple organ failure are rare. Here, we report a case of telbivudine-induced severe polymyositis, lactic acidosis, and multiple organ failure. CASE PRESENTATION: A 30-year-old Chinese man with hepatitis B virus infection received antiviral treatment with 600 mg of telbivudine daily for more than 11 months...
November 27, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29123903/early-evaluation-of-severity-in-patients-with-severe-sepsis-a-comparison-with-septic-shock-subgroup-analysis-of-the-japanese-association-for-acute-medicine-sepsis-registry-jaam-sr
#15
Takehiko Tarui, Yoshihiro Yamaguchi, Koichiro Suzuki, Ryosuke Tsuruta, Hiroto Ikeda, Hiroshi Ogura, Shigeki Kushimoto, Joji Kotani, Shin-Ichiro Shiraishi, Yasushi Suzuki, Kiyotsugu Takuma, Naoshi Takeyama, Seitaro Fujishima, Toshihiko Mayumi, Yasuo Miki, Norio Yamashita, Naoki Aikawa, Satoshi Gando
Aim: The purpose of this subgroup analysis of a Japanese multicenter registry, the Japanese Association for Acute Medicine Sepsis Registry Advanced (JAAM-SR-Advanced), was to identify early outcome indicators for severe sepsis that are useful and more objective than "septic shock." Methods: Among 624 patients with severe sepsis registered in JAAM-SR-Advanced, 554 with valid serum lactate data were retrospectively studied. Hypotension before and after fluid resuscitation and the highest lactate values over the initial 24 h were compared for their ability to predict in-hospital mortality...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#16
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29077159/inflammatory-factor-in-donor-liver-and-its-effect-on-recipient-myocardial-injury-after-liver-transplantation
#17
J-B Chen, G-Y Chen, S-D Wei, J-J Sun, G-B Liu, Z-T Xie, G-F Tang
OBJECTIVE: To study the inflammatory factors in donor livers and its effect on recipient myocardial injury after liver transplantation recipients. PATIENTS AND METHODS: Eighteen patients who underwent orthotopic liver transplantations between January 2014 and December 2015 in our hospital were selected. A portion of the hepatic venous blood of donor's livers was preserved in heparinized tubes after partial resection. The concentrations of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), cardiac troponin I (cTnI), creatine kinase isoenzyme (CK-MB), and the activity of lactate dehydrogenase (LDH) in serum were measured...
October 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29040243/toxic-shock-syndrome-still-a-timely-diagnosis
#18
Kira L Gossack-Keenan, April J Kam
BACKGROUND: Toxic shock syndrome (TSS) is an acute, severe, toxin-mediated disease, characterized by fever, hypotension, and multiorgan system involvement. Toxic shock syndrome has made headlines because of its high associated morbidity and mortality rate in previously healthy young females. Incidence peaked in the early 1980s owing to increased usage of ultra-absorbent tampons. After improved patient education and tampon labeling, the incidence of menstrual TSS has declined. CASE: A previously healthy 14-year-old girl presented to an urgent care center with a 2-day history of fever, erythematous maculopapular rash, vomiting, diarrhea, and malaise...
October 16, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29026888/korean-shock-society-septic-shock-registry-a-preliminary-report
#19
Tae Gun Shin, Sung Yeon Hwang, Gu Hyun Kang, Won Young Kim, Seung Mok Ryoo, Kyuseok Kim, You Hwan Jo, Sung Phil Chung, Young Seon Joo, Jin Ho Beom, Sung-Hyuk Choi, Young Hoon Yoon, Woon Yong Kwon, Tae Ho Lim, Kap Su Han, Han Sung Choi, Gil Joon Suh
OBJECTIVE: To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED). METHODS: This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included...
September 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28915221/metformin-exerts-beneficial-effects-in-hemorrhagic-shock-in-an-ampk%C3%AE-1-independent-manner
#20
Paul Kim, Giovanna Piraino, Michael O'Connor, Paul W Hake, Vivian Wolfe, Patrick Lahni, Basilia Zingarelli
Despite therapeutic advances in hemorrhagic shock, mortality from multiple organ failure remains high. AMP-activated protein kinase (AMPK) is involved in cellular energy homeostasis. Two catalytic subunits, α1 and α2, have been identified, with α1 subunit largely expressed in major organs. Here, we hypothesized that genetic deficiency of AMPKα1 worsens hemorrhage-induced multiple organ failure. We also investigated whether treatment with metformin, a clinically used drug for metabolic homeostasis, affords beneficial effects...
September 14, 2017: Shock
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