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By Juan Carlos Luis Navarro Anesthesiologist in Virgen del Rocio University Hospital.
https://www.readbyqxmd.com/read/27007094/clinical-practice-guideline-management-of-acute-pancreatitis
#1
REVIEW
Joshua A Greenberg, Jonathan Hsu, Mohammad Bawazeer, John Marshall, Jan O Friedrich, Avery Nathens, Natalie Coburn, Gary R May, Emily Pearsall, Robin S McLeod
There has been an increase in the incidence of acute pancreatitis reported worldwide. Despite improvements in access to care, imaging and interventional techniques, acute pancreatitis continues to be associated with significant morbidity and mortality. Despite the availability of clinical practice guidelines for the management of acute pancreatitis, recent studies auditing the clinical management of the condition have shown important areas of noncompliance with evidence-based recommendations. This underscores the importance of creating understandable and implementable recommendations for the diagnosis and management of acute pancreatitis...
April 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/26679628/clinical-practice-guideline-for-the-management-of-candidiasis-2016-update-by-the-infectious-diseases-society-of-america
#2
Peter G Pappas, Carol A Kauffman, David R Andes, Cornelius J Clancy, Kieren A Marr, Luis Ostrosky-Zeichner, Annette C Reboli, Mindy G Schuster, Jose A Vazquez, Thomas J Walsh, Theoklis E Zaoutis, Jack D Sobel
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.
February 15, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/26620145/peri-operative-fluid-management-to-enhance-recovery
#3
REVIEW
R Gupta, T J Gan
'Enhanced recovery after surgery' protocols implement a series of peri-operative interventions intended to improve recovery after major operations, one aspect of which is fluid management. The pre-operative goal is to prepare a hydrated, euvolaemic patient by avoiding routine mechanical bowel preparation and by encouraging patients to drink clear liquids up to two hours before induction of anaesthesia. The intra-operative goal is to achieve a 'zero' fluid balance at the end of uncomplicated surgery: goal-directed fluid therapy is recommended for poorly prepared or sick patients or those undergoing more complex surgery...
January 2016: Anaesthesia
https://www.readbyqxmd.com/read/26510669/clinical-study-to-evaluate-the-role-of-preoperative-dexmedetomidine-in-attenuation-of-hemodynamic-response-to-direct-laryngoscopy-and-tracheal-intubation
#4
Kamlesh Kumari, Satinder Gombar, Dheeraj Kapoor, Harpreet Singh Sandhu
OBJECTIVES: Dexmedetomidine, an α2 agonist, has been evaluated for its hypnotic, analgesic, and anxiolytic properties in the intraoperative period and critical care setting. However, data on the effect of dexmedetomidine on attenuation of pressor response to direct laryngoscopy and tracheal intubation are limited. We studied the effect of a single preinduction intravenous dose of dexmedetomidine of 0.5 μg/kg on hemodynamic responses to tracheal intubation, and dose requirements of anesthetics for induction and their adverse effects...
December 2015: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
https://www.readbyqxmd.com/read/26316210/early-goal-directed-resuscitation-of-patients-with-septic-shock-current-evidence-and-future-directions
#5
REVIEW
Ravi G Gupta, Sarah M Hartigan, Markos G Kashiouris, Curtis N Sessler, Gonzalo M L Bearman
Severe sepsis and septic shock are among the leading causes of mortality in the intensive care unit. Over a decade ago, early goal-directed therapy (EGDT) emerged as a novel approach for reducing sepsis mortality and was incorporated into guidelines published by the international Surviving Sepsis Campaign. In addition to requiring early detection of sepsis and prompt initiation of antibiotics, the EGDT protocol requires invasive patient monitoring to guide resuscitation with intravenous fluids, vasopressors, red cell transfusions, and inotropes...
August 28, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26284722/septic-shock-advances-in-diagnosis-and-treatment
#6
REVIEW
Christopher W Seymour, Matthew R Rosengart
IMPORTANCE: Septic shock is a clinical emergency that occurs in more than 230,000 US patients each year. OBSERVATIONS AND ADVANCES: In the setting of suspected or documented infection, septic shock is typically defined in a clinical setting by low systolic (≤90 mm Hg) or mean arterial blood pressure (≤65 mm Hg) accompanied by signs of hypoperfusion (eg, oliguria, hyperlactemia, poor peripheral perfusion, or altered mental status). Focused ultrasonography is recommended for the prompt recognition of complicating physiology (eg, hypovolemia or cardiogenic shock), while invasive hemodynamic monitoring is recommended only for select patients...
August 18, 2015: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/26237037/vasopressors-for-the-treatment-of-septic-shock-systematic-review-and-meta-analysis
#7
REVIEW
Tomer Avni, Adi Lador, Shaul Lev, Leonard Leibovici, Mical Paul, Alon Grossman
OBJECTIVE: International guidelines recommend dopamine or norepinephrine as first-line vasopressor agents in septic shock. Phenylephrine, epinephrine, vasopressin and terlipressin are considered second-line agents. Our objective was to assess the evidence for the efficiency and safety of all vasopressors in septic shock. METHODS: Systematic review and meta-analysis. We searched electronic database of MEDLINE, CENTRAL, LILACS and conference proceedings up to June 2014...
2015: PloS One
https://www.readbyqxmd.com/read/22436955/dexmedetomidine-vs-midazolam-or-propofol-for-sedation-during-prolonged-mechanical-ventilation-two-randomized-controlled-trials
#8
RANDOMIZED CONTROLLED TRIAL
Stephan M Jakob, Esko Ruokonen, R Michael Grounds, Toni Sarapohja, Chris Garratt, Stuart J Pocock, J Raymond Bratty, Jukka Takala
CONTEXT: Long-term sedation with midazolam or propofol in intensive care units (ICUs) has serious adverse effects. Dexmedetomidine, an α(2)-agonist available for ICU sedation, may reduce the duration of mechanical ventilation and enhance patient comfort. OBJECTIVE: To determine the efficacy of dexmedetomidine vs midazolam or propofol (preferred usual care) in maintaining sedation; reducing duration of mechanical ventilation; and improving patients' interaction with nursing care...
March 21, 2012: JAMA: the Journal of the American Medical Association
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