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https://www.readbyqxmd.com/read/28213648/-state-of-the-art-in-fluid-and-volume-therapy-a%C3%A2-user-friendly-staged-concept
#1
M Rehm, N Hulde, T Kammerer, A S Meidert, K Hofmann-Kiefer
Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperative fluid losses should be discriminated from volume losses (surgical blood loss or interstitial volume losses containing protein)...
February 17, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28212163/multiple-organ-dysfunction-in-children-mechanically-ventilated-for-acute-respiratory-failure
#2
Scott L Weiss, Lisa A Asaro, Heidi R Flori, Geoffrey L Allen, David Wypij, Martha A Q Curley
OBJECTIVES: The impact of extrapulmonary organ dysfunction, independent from sepsis and lung injury severity, on outcomes in pediatric acute respiratory failure is unclear. We sought to determine the frequency, timing, and risk factors for extrapulmonary organ dysfunction and the independent association of multiple organ dysfunction syndrome with outcomes in pediatric acute respiratory failure. DESIGN: Secondary observational analysis of the Randomized Evaluation of Sedation Titration for Respiratory Failure cluster-randomized prospective clinical trial conducted between 2009 and 2013...
February 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28210072/the-parenteral-vitamin-c-improves-sepsis-and-sepsis-induced-multiple-organ-dysfunction-syndrome-via-preventing-cellular-immunosuppression
#3
Yu-Lei Gao, Bin Lu, Jian-Hua Zhai, Yan-Cun Liu, Hai-Xia Qi, Ying Yao, Yan-Fen Chai, Song-Tao Shou
Cellular immunosuppression appears to be involved in sepsis and sepsis-induced multiple organ dysfunction syndrome (MODS). Recent evidence showed that parenteral vitamin C (Vit C) had the ability to attenuate sepsis and sepsis-induced MODS. Herein, we investigated the impact of parenteral Vit C on cellular immunosuppression and the therapeutic value in sepsis. Using cecal ligation and puncture (CLP), sepsis was induced in WT and Gulo(-/-) mice followed with 200 mg/Kg parenteral Vit C administration. The immunologic functions of CD4(+)CD25(+) regulatory T cells (Tregs) and CD4(+)CD25(-) T cells, as well as the organ functions, were determined...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28209998/cervical-pessary-for-prevention-of-preterm-birth-a-meta-analysis
#4
Xin-Hang Jin, Dan Li, Li-Li Huang
To investigate the efficacy of cervical pessary placement in preventing preterm birth and perinatal morbidity and mortality in asymptomatic women with a singleton pregnancy and a short cervix, we searched literature in relevant databases. The meta-analysis of the 3 included trials (1412 women) showed cervical pessary placement did not reduce the risk of spontaneous preterm birth <34 weeks in these women (risk ratio (RR), 0.71; 95% confidence interval (CI), 0.21-2.43, P = 0.59; I(2) = 90%). The sensitivity analyses by excluding one trial at one time showed the same results...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28209134/first-clinical-experience-in-14-patients-treated-with-advos-a-study-on-feasibility-safety-and-efficacy-of-a-new-type-of-albumin-dialysis
#5
Wolfgang Huber, Benedikt Henschel, Roland Schmid, Ahmed Al-Chalabi
BACKGROUND: Liver failure (LF) is associated with prolonged hospital stay, increased cost and substantial mortality. Due to the limited number of donor organs, extracorporeal liver support is suggested as an appealing concept to "bridge to transplant" or to avoid transplant in case of recovery. ADVanced Organ Support (ADVOS) is a new type of albumin dialysis, that provides rapid regeneration of toxin-binding albumin by two purification circuits altering the binding capacities of albumin by biochemical (changing of pH) and physical (changing of temperature) modulation of the dialysate...
February 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28207795/organ-dysfunction-during-continuous-veno-venous-high-cut-off-hemodialysis-in-patients-with-septic-acute-kidney-injury-a-prospective-observational-study
#6
Gianluca Villa, Cosimo Chelazzi, Elena Morettini, Lucia Zamidei, Serafina Valente, A Lucia Caldini, Giovanni Zagli, A Raffaele De Gaudio, Stefano Romagnoli
BACKGROUND: Continuous veno-venous hemodialysis with high cut-off membranes (HCO-CVVHD) removes inflammatory mediators involved in organ dysfunction during sepsis. The aim of the present study was to assess the variations in SOFA score and identify early predictors of short-term mortality in a cohort of patients with septic shock, treated with HCO-CVVHD for acute kidney injury (AKI). METHODS: An observational prospective multicenter cohort study was conducted in four mixed medical-surgical ICUs...
2017: PloS One
https://www.readbyqxmd.com/read/28207570/international-survey-of-critically-ill-children-with-acute-neurologic-insults-the-prevalence-of-acute-critical-neurological-disease-in-children-a-global-epidemiological-assessment-study
#7
Ericka L Fink, Patrick M Kochanek, Robert C Tasker, John Beca, Michael J Bell, Robert S B Clark, Jamie Hutchison, Monica S Vavilala, Anthony Fabio, Derek C Angus, R Scott Watson
OBJECTIVE: The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. DESIGN: Prospective study. SETTING: Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). PATIENTS: Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass...
February 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28207287/thiamine-as-a-renal-protective-agent-in-septic-shock-a-secondary-analysis-of-a-randomized-double-blind-placebo-controlled-trial
#8
Ari Moskowitz, Lars W Andersen, Michael N Cocchi, Mathias Karlsson, Parth V Patel, Michael W Donnino
RATIONALE: Acute kidney injury (AKI) is common in patients with sepsis and has been associated with high mortality rates. The provision of thiamine to septic patients may reduce the incidence and severity of sepsis-related AKI and thereby prevent renal failure requiring renal replacement therapy (RRT). OBJECTIVES: To test the hypothesis that thiamine supplementation mitigates kidney injury in septic shock. METHODS: This was a secondary analysis of a single-center, randomized, double-blind trial comparing thiamine to placebo in patients with septic shock...
February 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28207269/a-biocompatible-injectable-hydrogel-with-potent-wound-healing-and-antibacterial-properties
#9
Jiaul Hoque, Relekar G Prakash, Krishnamoorthy Paramanandham, Bibek R Shome, Jayanta Haldar
Two component injectable hydrogels that cross-link in-situ have been used as non-invasive wound-filling devices, i.e., sealants. These materials carry a variety of functions at the wound sites such as seal leaks, cease unwanted bleeding, bind tissues together, and assist in wound healing process. However, commonly used sealants typically lack antibacterial properties. Since bacterial infection at the wound site is very common, bioadhesive materials with intrinsic antibacterial properties are urgently required...
February 16, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28205051/impact-of-preoperative-steroid-or-immunosuppressant-use-on-short-term-outcomes-following-colectomy-in-crohn-s-disease-patients
#10
N Valizadeh, A C A Murray, K Suradkar, A Al-Mazrou, R P Kiran
BACKGROUND: Evaluating the impact of steroid or immunosuppressants (SI) therapy prior to colectomy in Crohn's disease (CD) patients on postoperative septic and colectomy-specific outcomes using the American College of Surgeons (ACS)-National Surgical Quality Improvement Program (NSQIP)-targeted colectomy database. METHODS: All CD patients undergoing colectomy were retrieved from the 2012-2013 NSQIP-targeted database. Thirty-day postoperative outcomes were compared for patients who were on steroids or immunosuppressants (SI) within the 30 days prior to colectomy to the others using univariable and multivariable analyses...
February 15, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28203580/unusual-presentation-of-diffuse-large-b-cell-lymphoma-with-splenic-infarcts
#11
Vivek Kumar, Parita Soni, Vishangi Dave, Jonathan Harris
A 67-year-old man presented with a 3-day history of abdominal pain, fever, and significant weight loss over 2 months. Physical examination revealed left upper quadrant tenderness, hepatomegaly, splenomegaly, and bilateral pitting edema but peripheral lymphadenopathy was absent. Laboratory tests showed anemia, thrombocytopenia, elevated prothrombin time (PT), partial thromboplastin time (PTT), and increased lactate dehydrogenase (LDH). PTT was corrected completely in mixing study. Further workup for the cause of coagulopathy revealed decreased levels of all clotting factors except factor VIII and increase fibrinogen levels, which ruled out disseminated intravascular coagulation (DIC)...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28203255/the-influencing-factors-on-procalcitonin-values-in-newborns-with-noninfectious-conditions-during-the-first-week-of-life
#12
Jueseong Lee, Yong Hyeon Bang, Eun Hee Lee, Byung Min Choi, Young Sook Hong
PURPOSE: Although procalcitonin (PCT) level is useful for the diagnosis of neonatal sepsis, PCT reliability is inconsistent because of the varied conditions encountered in neonatal intensive care units. This study aimed to investigate PCT levels and factors influencing increased PCT levelin newborns without bacterial infection during the first week of life. METHODS: In newborns hospitalized between March 2013 and October 2015, PCT levels were measured on the first, third, and seventh days after birth...
January 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28202703/investigations-in-gabaa-receptor-antibody-associated-encephalitis
#13
Marianna Spatola, Mar Petit-Pedrol, Mateus Mistieri Simabukuro, Thaís Armangue, Fernanda J Castro, Maria I Barcelo Artigues, Maria R Julià Benique, Leslie Benson, Mark Gorman, Ana Felipe, Ruben L Caparó Oblitas, Myrna R Rosenfeld, Francesc Graus, Josep Dalmau
OBJECTIVE: To report the clinical features, comorbidities, receptor subunit targets, and outcome in patients with anti-GABAA receptor (GABAAR) encephalitis. METHODS: Clinical study of 26 patients, including 17 new (April 2013-January 2016) and 9 previously reported patients. Antibodies to α1, β3, and γ2 subunits of the GABAAR were determined using reported techniques. RESULTS: Patients' median age was 40.5 years (interquartile range 48...
February 15, 2017: Neurology
https://www.readbyqxmd.com/read/28202686/simvastatin-pre-treatment-improves-survival-and-mitochondrial-function-in-a-three-day-fluid-resuscitated-rat-model-of-sepsis
#14
Jerome Morel, Iain Hargreaves, David Brealey, Viruna Neergheen, Janne T Backman, Sandro Lindig, Marcus Bläss, Michael Bauer, Daniel F McAuley, Mervyn Singer
Statins may offer protective effects in sepsis through anti-inflammatory, mitochondrial protection and other actions. We thus evaluated the effects of simvastatin on survival, organ and mitochondrial function, tissue and plasma ubiquinone levels and liver transcriptomics in a 3-day rat model of sepsis. Comparisons of rat plasma simvastatin and ubiquinone levels were made against levels sampled in blood from patients with acute lung injury (ALI) enrolled into a trial of statin therapy. Animals received simvastatin by gavage either pre- or post-induction of faecal peritonitis...
February 15, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28202189/does-the-presence-of-a-urinary-catheter-predict-severe-sepsis-in-a-bacteraemic-cohort
#15
M Melzer, C Welch
BACKGROUND: Sepsis is a major cause of mortality with an estimated 37,000 deaths in the UK each year. This study aimed to determine host factors that can predict severe sepsis in a bacteraemic cohort. METHODS: From December 2012 to November 2013, demographic, clinical and microbiological data were collected on consecutive patients with bacteraemia at a London teaching hospital. These data were used to categorize patients as having severe or non-severe sepsis. Multi-variate logistic regression was used to determine the association between host factors and severe sepsis...
January 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28199348/presentation-management-and-outcomes-of-sepsis-in-adults-and-children-admitted-to-a-rural-ugandan-hospital-a-prospective-observational-cohort-study
#16
Kristina E Rudd, Leonard K Tutaryebwa, T Eoin West
OBJECTIVES: Limited data are available on sepsis in low-resource settings, particularly outside of urban referral centers. We conducted a prospective observational single-center cohort study in May 2013 to assess the presentation, management and outcomes of adult and pediatric patients admitted with sepsis to a community hospital in rural Uganda. METHODS: We consecutively screened all patients admitted to medical wards who met sepsis criteria. We evaluated eligible patients within 24 hours of presentation and 24-48 hours after admission, and followed them until hospital discharge...
2017: PloS One
https://www.readbyqxmd.com/read/28198754/relationship-between-adverse-tracheal-intubation-associated-events-and-picu-outcomes
#17
Margaret M Parker, Gabrielle Nuthall, Calvin Brown, Katherine Biagas, Natalie Napolitano, Lee A Polikoff, Dennis Simon, Michael Miksa, Eleanor Gradidge, Jan Hau Lee, Ashwin S Krishna, David Tellez, Geoffrey L Bird, Kyle J Rehder, David A Turner, Michelle Adu-Darko, Sholeen T Nett, Ashley T Derbyshire, Keith Meyer, John Giuliano, Erin B Owen, Janice E Sullivan, Keiko Tarquinio, Pradip Kamat, Ronald C Sanders, Matthew Pinto, G Kris Bysani, Guillaume Emeriaud, Yuki Nagai, Melissa A McCarthy, Karen H Walson, Paula Vanderford, Anthony Lee, Jesse Bain, Peter Skippen, Ryan Breuer, Sarah Tallent, Vinay Nadkarni, Akira Nishisaki
OBJECTIVE: Tracheal intubation in PICUs is a common procedure often associated with adverse events. The aim of this study is to evaluate the association between immediate events such as tracheal intubation associated events or desaturation and ICU outcomes: length of stay, duration of mechanical ventilation, and mortality. STUDY DESIGN: Prospective cohort study with 35 PICUs using a multicenter tracheal intubation quality improvement database (National Emergency Airway Registry for Children: NEAR4KIDS) from January 2013 to June 2015...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28197792/laparoscopic-lavage-versus-surgical-resection-for-acute-diverticulitis-with-generalised-peritonitis-a-systematic-review-and-meta-analysis
#18
REVIEW
R Cirocchi, S Di Saverio, D G Weber, R Taboła, I Abraha, J Randolph, A Arezzo, G A Binda
This systematic review and meta-analysis investigates current evidence on the therapeutic role of laparoscopic lavage in the management of diverticular peritonitis. A systematic review of the literature was performed on PubMed until June 2016, according to preferred reporting items for systematic reviews and meta-analyses guidelines. All randomised controlled trials comparing laparoscopic lavage with surgical resection, irrespective of anastomosis or stoma formation, were analysed. After assessment of titles and full text, 3 randomised trials fulfilled the inclusion criteria...
February 15, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28197048/hypernatremia-in-the-neonate-neonatal-hypernatremia-and-hypernatremic-dehydration-in-neonates-receiving-exclusive-breastfeeding
#19
Nilofer Salim Mujawar, Archana Nirmal Jaiswal
AIMS AND OBJECTIVES: Evaluation of neonatal hypernatremia and hypernatremic dehydration in neonates receiving exclusive breastfeeding. INTRODUCTION: Neonatal hypernatremia is a serious condition in the newborn period. We present infants with hypernatremic dehydration due to breast milk (BM) hypernatremia. Hypernatremic dehydration in breast-fed newborns is usually secondary to insufficient lactation. We present the neonatal hypernatremia and hypernatremic dehydration encountered between January and December, 2012, its causes and treatment...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28196938/risk-of-acute-stroke-after-hospitalization-for-sepsis-a-case-crossover-study
#20
Amelia K Boehme, Purnima Ranawat, Jorge Luna, Hooman Kamel, Mitchell S V Elkind
BACKGROUND AND PURPOSE: Infections have been found to increase the risk of stroke over the short term. We hypothesized that stroke risk would be highest shortly after a sepsis hospitalization, but that the risk would decrease, yet remain up to 1 year after sepsis. METHODS: This case-crossover analysis utilized data obtained from the California State Inpatient Database of the Healthcare Cost and Utilization Project. All stroke admissions were included. Exposure was defined as hospitalization for sepsis or septicemia 180, 90, 30, or 15 days before stroke (risk period) or similar time intervals exactly 1 or 2 years before stroke (control period)...
February 14, 2017: Stroke; a Journal of Cerebral Circulation
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