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Lactate and hypotension

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https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#1
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27861290/pathophysiological-trends-during-withdrawal-of-life-support-implications-for-organ-donation-after-circulatory-death
#2
Arjun Iyer, Hong Chee Chew, Ling Gao, Jeanette Villanueva, Mark Hicks, Aoife Doyle, Gayathri Kumarasinghe, Andrew Jabbour, Paul Cassius Jansz, Michael P Feneley, Richard P Harvey, Robert M Graham, Kumud K Dhital, Peter S Macdonald
BACKGROUND: Donation after circulatory death (DCD) provides an alternative pathway to deceased organ transplantation. Although clinical DCD lung, liver, and kidney transplantation are well established, transplantation of hearts retrieved from DCD donors has reached clinical translation only recently. Progress has been limited by concern regarding the viability of DCD hearts. The aim of this study was to document the pathophysiological changes that occur in the heart and circulation during withdrawal of life (WLS) support...
December 2016: Transplantation
https://www.readbyqxmd.com/read/27820776/muscle-oxygenation-as-an-early-predictor-of-shock-severity-in-trauma-patients
#3
Lorilee S L Arakaki, Eileen M Bulger, Wayne A Ciesielski, David J Carlbom, Dana M Fisk, Kellie J Sheehan, Karin M Asplund, Kenneth A Schenkman
INTRODUCTION: We evaluated the potential utility of a new prototype noninvasive muscle oxygenation (MOx) measurement for the identification of shock severity in a population of patients admitted to the trauma resuscitation rooms of a Level I regional trauma center. The goal of this project was to correlate MOx with shock severity as defined by standard measures of shock: systolic blood pressure, heart rate, and lactate. METHODS: Optical spectra were collected from subjects by placement of a custom-designed optical probe over the first dorsal interosseous muscles on the back of the hand...
November 3, 2016: Shock
https://www.readbyqxmd.com/read/27774825/optimum-treatment-of-vasopressor-dependent-distributive-shock
#4
Jean-Louis Vincent, Marc Leone
Distributive shock is associated with decreased systemic vascular resistance and altered oxygen extraction. Septic shock is the most frequent form of distributive shock. In shock states, duration of hypotension is associated with poor outcomes. The speed at which treatment to restore adequate perfusion pressure is initiated is, therefore, important to improve survival. Areas covered: This review presents an overview of the literature related to the management of vasopressor-dependent distributive shock, and in particular the relationship between arterial pressure and organ perfusion and function...
November 7, 2016: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/27753637/acute-toxicity-of-vildagliptin-differences-in-sensitivity-between-cynomolgus-monkeys-of-asian-or-mauritian-origin
#5
Peter Hoffmann, Lori Martin, Michael Keselica, Diane Gunson, Elizabeth Skuba, Dan Lapadula, Michael Hayes, Phil Bentley, Steve Busch
This article describes acute toxicity data in cynomolgus monkeys following oral treatment with vildagliptin, a dipeptidyl peptidase-4 inhibitor. Acute toxicity symptoms in cynomolgus monkeys include edema formation of the extremities, tails, and face associated with skeletal muscle necrosis, and elevations of lactate dehydrogenase, creatine kinase, alanine transaminase, and aspartate aminotransferase activities in the serum; hypothermia; hypotension; tachycardia; moribundity; and death in a few isolated instances...
October 17, 2016: Toxicologic Pathology
https://www.readbyqxmd.com/read/27750254/temporal-profile-of-circulating-micrornas-after-global-hypoxia-ischemia-in-newborn-piglets
#6
Håvard Tetlie Garberg, Marianne U Huun, Lars O Baumbusch, Monica Åsegg-Atneosen, Rønnaug Solberg, Ola Didrik Saugstad
BACKGROUND: There is a lack of reliable biomarkers that can identify and grade acute hypoxic-ischemic encephalopathy in newborns. MicroRNAs (miRNA) are short, non-coding strands of RNA that are released into the circulation in response to tissue stress and injury. Some miRNAs are highly tissue specific and thus may potentially be non-invasive biomarkers of neonatal hypoxic-ischemic brain injury. OBJECTIVE: The aim of this study was to characterize the temporal expression of selected circulating miRNAs in a clinically relevant piglet model of neonatal hypoxia-ischemia (HI)...
October 18, 2016: Neonatology
https://www.readbyqxmd.com/read/27749345/agreement-of-bioreactance-cardiac-output-monitoring-with-thermodilution-during-hemorrhagic-shock-and-resuscitation-in-adult-swine
#7
David A Berlin, Harrison Peprah-Mensah, Seth Manoach, Paul M Heerdt
OBJECTIVE: The study tests the hypothesis that noninvasive cardiac output monitoring based upon bioreactance (Cheetah Medical, Portland, OR) has acceptable agreement with intermittent bolus thermodilution over a wide range of cardiac output in an adult porcine model of hemorrhagic shock and resuscitation. DESIGN: Prospective laboratory animal investigation. SETTING: Preclinical university laboratory. SUBJECTS: Eight ~ 50 kg Yorkshire swine with a femoral artery catheter for blood pressure measurement and a pulmonary artery catheter for bolus thermodilution...
October 3, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27747715/coma-after-quetiapine-fumarate-intentional-overdose-in-a-71-year-old-man-a-case-report
#8
S Gibiino, A Trappoli, B Balzarro, A R Atti, D De Ronchi
A 71-year-old man developed coma with severe respiratory failure, hypotension, and tachycardia induced by the intentional ingestion of quetiapine fumarate extended release (XR) 20 g. At the time, he had been treated for bipolar depression with venlafaxine 75 mg/day, lamotrigine 100 mg/day, pregabalin 75 mg/day, and quetiapine XR 400 mg/day for approximately 1 year. Comorbidities were hypertension treated with metoprolol, diabetes mellitus type 2 treated with metformin, and benign prostatic hyperplasia treated with silodosin...
December 2015: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/27746565/evaluation-of-antihypotensive-techniques-for-cesarean-section-under-spinal-anesthesia-rapid-crystalloid-hydration-versus-intravenous-ephedrine
#9
Kalpana Rajendra Kulkarni, Amruta Girish Naik, Sunetra Girish Deshpande
BACKGROUND: Spinal anesthesia is a preferred technique over general anesthesia for cesarean delivery. It avoids maternal airway related complications, aspiration and neonatal depression. However hypotension following spinal anesthesia can lead to decrease in uterine blood flow and neonatal hypoxia. AIMS: We aimed to evaluate the efficacy of 15 mL.kg- 1of crystalloid preloading versus prophylactic intravenous bolus of 10 mg ephedrine as an antihypotensive measure for cesarean section...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27730689/measurement-of-haemolysis-markers-following-transfusion-of-uncrossmatched-low-titer-group-o-whole-blood-in-civilian-trauma-patients-initial-experience-at-a-level-1-trauma-centre
#10
J N Seheult, D J Triulzi, L H Alarcon, J L Sperry, A Murdock, M H Yazer
BACKGROUND/OBJECTIVES: The safety of administering uncrossmatched, group O, cold-stored, whole blood (cWB) during civilian trauma resuscitation was evaluated. METHODS/MATERIALS: Male trauma patients with haemorrhage-induced hypotension who received leuko-reduced uncrossmatched group O+, low titer (<50) anti-A and -B, platelet-replete cWB during initial resuscitation were included. The biochemical markers of haemolysis (lactate dehydrogenase, total bilirubin, haptoglobin, creatinine, serum potassium) were measured on the day of cWB receipt (day 0), and over the next 2 days, reports of transfusion reactions and total blood product administration in first 24 h of admission were recorded...
October 12, 2016: Transfusion Medicine
https://www.readbyqxmd.com/read/27712890/acute-gastrointestinal-compromise-in-neonates-with-congenital-diaphragmatic-hernia-prior-to-repair
#11
Catherine Fox, Michael Stewart, Sebastian K King, Neil Patel
BACKGROUND: Congenital diaphragmatic hernia (CDH) affects 1 in 3000 live births. Modern management strategies include delayed repair of the diaphragm to permit pre-operative optimization of cardiorespiratory status. We describe a cohort of neonates in whom early emergency operative intervention was required for potentially fatal intestinal compromise. METHODS: A retrospective review was performed of all neonatal CDH patients managed at a tertiary center in an 8-year period (2005-2012)...
September 15, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27661862/ombitasvir-paritaprevir-ritonavir-dasabuvir-viekira-pak-induced-lactic-acidosis
#12
Catherine L Oberg, Robert J Hiensch, Hooman D Poor
OBJECTIVE: To report a case series of three patients with hepatitis C virus infection who all presented with severe type B lactic acidosis shortly after starting treatment with ombitasvir-paritaprevir-ritonavir-dasabuvir. DESIGN: Case series. SETTING: ICU. PATIENTS: Three patients, all who had HCV cirrhosis with mild hepatic impairment (Child-Pugh A) and had started taking ombitasvir-paritaprevir-ritonavir-dasabuvir within the preceding 2 weeks, presented with similar nonspecific symptoms of lethargy, fatigue, and nausea...
September 22, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27642568/comparing-the-hemodynamic-effects-of-spinal-anesthesia-in-preeclamptic-and-healthy-parturients-during-cesarean-section
#13
Mahshid Nikooseresht, Mohamad Ali Seif Rabiei, Pooran Hajian, Razieh Dastaran, Nasim Alipour
BACKGROUND: Despite controversies about the safest anesthetic technique for cesarean delivery in severely preeclamptic women, there is evidence that supports the use of spinal anesthesia in this group of patients. OBJECTIVES: This prospective randomized clinical trial was designed to determine the hemodynamic effects of low-dose spinal bupivacaine and the incidence of spinal anesthesia-associated hypotension in severely preeclamptic and healthy parturients undergoing cesarean sections...
June 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27625478/phenylephrine-infusion-for-spinal-induced-hypotension-in-elective-cesarean-delivery-does-preload-make-a-difference
#14
Brandi A Bottiger, Dmitri S Bezinover, Berend Mets, Priti G Dalal, Jansie Prozesky, Serdar Ural, Sonia Vaida
BACKGROUND AND AIMS: Patients undergoing elective cesarean delivery (CD) have a high-risk of spinal-induced hypotension (SIH). We hypothesized that a colloid preload would further reduce SIH when compared with a crystalloid preload. MATERIAL AND METHODS: Eighty-two healthy parturients undergoing elective CD were included in the study. Patients were randomly assigned to two groups (41 patients in each group) to receive either Lactated Ringer's solution (1500 ml) or hydroxyethyl starch (6% in normal saline, 500 ml) 30 min prior to placement of spinal anesthesia...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27596079/-relationship-between-changes-of-increased-amylase-or-lipase-levels-and-pancreas-injury-in-critically-ill-children
#15
(no author information available yet)
OBJECTIVE: To observe the occurrence rate of elevated serum amylase and lipase in critically ill children, to explore the relationship between elevated pancreatic enzymes and pancreatic injury, and the effect of elevated pancreatic enzymes on state of illness and the prognosis. METHOD: The data of cases treated in pediatric intensive care unit(ICU) of 17 children's hospitals were collected prospectively from January 2012 to March 2014 according to the inclusion and exclusion criteria...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27588932/intravenous-oxytocin-use-to-decrease-blood-loss-during-scheduled-cesarean-delivery-a-randomized-double-blinded-controlled-trial-oxytrial
#16
Labib M Ghulmiyyah, Ihab M Usta, Ghina Ghazeeri, Nael Taher, Gael Abu-Ghannam, Hani Tamim, Anwar H Nassar
Objective The objective of this study was to determine the optimal dose of intravenous oxytocin administered during cesarean delivery (CD) to decrease the amount of blood loss. Methods Out of a total of 226 women presenting for CD, 189 patients were randomized into three groups by a computer-generated random number sequence table. Low-risk women with singleton term pregnancies undergoing scheduled CD were assigned to receive 20, 30, or 40 units (U) of oxytocin diluted in 500 mL of lactated Ringer solution intraoperatively...
September 2, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27548501/protective-effects-of-kolaviron-and-gallic-acid-against-cobalt-chloride-induced-cardiorenal-dysfunction-via-suppression-of-oxidative-stress-and-activation-of-the-erk-signaling-pathway
#17
Akinleye Stephen Akinrinde, Olutayo Omobowale, Ademola Oyagbemi, Ebunoluwa Asenuga, Temitayo Ajibade
Cobalt (Co) toxicity is a potential public health problem due to recent renewed use of Co in orthopedic implants, dietary supplements, and blood doping in athletes and horses. We investigated the protective roles of kolaviron (KV), a bi-flavonoid of Garcinia kola, and gallic acid (GA) on cobalt chloride (CoCl2)-induced cardiorenal damage in rats. CoCl2 caused significant increases (p < 0.05) in serum creatine kinase-myocardial band (CK-MB), lactate dehydrogenase (LDH), aspartate transaminase (AST), xanthine oxidase (XO), urea, creatinine, malondialdehyde, H2O2, nitric oxide, as well as C-reactive protein expression, along with significant (p < 0...
July 5, 2016: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/27547885/characteristics-treatment-and-outcomes-for-all-emergency-department-patients-fulfilling-criteria-for-septic-shock-a-prospective-observational-study
#18
Julian M Williams, Jaimi H Greenslade, Chelsea A Dymond, Kevin Chu, Anthony F T Brown, Jeffrey Lipman
OBJECTIVE: Most published data on emergency department (ED) patients with septic shock have been generated from studies examining the effect of early protocolized resuscitation in selected cohorts. Consequently, these data do not generally represent patients falling outside trial inclusion criteria or judged unsuitable for aggressive treatment. Our aim was to determine the characteristics, treatment and outcomes for all ED patients fulfilling the criteria for septic shock. METHODS: Septic shock patients were identified from a prospective database of consecutive ED patients admitted with infection...
August 19, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/27506331/the-impact-of-delayed-biliary-decompression-and-anti-microbial-therapy-in-260-patients-with-cholangitis-associated-septic-shock
#19
C J Karvellas, J G Abraldes, S Zepeda-Gomez, D C Moffat, Y Mirzanejad, G Vazquez-Grande, E K Esfahani, A Kumar
BACKGROUND: Cholangitis-associated septic shock carries significant mortality. There is uncertainty regarding the most appropriate time to achieve biliary decompression. AIM: To determine whether the timing of biliary decompression and anti-microbial therapy affect the survival in cholangitis patients with septic shock. METHODS: Nested retrospective cohort study of all cholangitis-associated septic shock patients (hypotension requiring vasopressors) from an international, multi-centre database between 1996 and 2011...
October 2016: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27484695/targeted-tissue-perfusion-versus-macrocirculation-guided-standard-care-in-patients-with-septic-shock-tartare-2s-study-protocol-and-statistical-analysis-plan-for-a-randomized-controlled-trial
#20
Ville Pettilä, Tobias Merz, Erika Wilkman, Anders Perner, Sari Karlsson, Theis Lange, Johanna Hästbacka, Peter Buhl Hjortrup, Anne Kuitunen, Stephan M Jakob, Jukka Takala
BACKGROUND: Septic shock has a 90-day mortality risk of up to 50 %. The hemodynamic targets, including mean arterial pressure (MAP) are not based on robust clinical data. Both severe hypotension and high doses of vasopressors may be harmful. Hence, re-evaluation of hemodynamic targets in septic shock is relevant. METHODS/DESIGN: The targeted tissue perfusion versus macrocirculation-guided standard care in patients with septic shock (TARTARE-2S) trial is a prospective, two-parallel-group, randomized, open-label, multicenter trial with assessor-blinded outcome evaluation...
August 2, 2016: Trials
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