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116 papers 25 to 100 followers
Victor De la Puente-Diaz de Leon, Valente de Jesus Jaramillo-Rocha, Jean-Louis Teboul, Sofia Garcia-Miranda, Bernardo A Martinez-Guerra, Guillermo Dominguez-Cherit
BACKGROUND: Arterial blood pressure is the most common variable used to assess the response to a fluid challenge in routine clinical practice. The aim of this study was to evaluate the accuracy of the change in the radial artery pulse pressure (rPP) to detect the change in cardiac output after a fluid challenge in patients with septic shock. METHODS: Prospective observational study including 35 patients with septic shock in which rPP and cardiac output were measured before and after a fluid challenge with 400 mL of crystalloid solution...
January 1, 2017: Journal of Intensive Care Medicine
Jozef Kesecioglu, Philippe Eggimann
No abstract text is available yet for this article.
August 2016: Intensive Care Medicine
Nicholas D Caputo, Marc Kanter, Robert Fraser, Ronald Simon
BACKGROUND: Biomarkers such as serum lactate, anion gap (AG), and base excess (BE) have been shown to be of use in determining shock in patients with seemingly normal vital signs. We seek to determine if these biomarkers can be used interchangeably in patients with trauma in the emergency setting based on their test characteristics and correlation to each other. METHODS: A prospective observational cohort study was undertaken at an urban level 1 trauma center. Baseline vital signs, point-of-care BE, AG, and serum lactate were recorded in all patients who presented for trauma...
September 2015: American Journal of Emergency Medicine
Daniel Aronovich, Maykel Trotter, Cynthia Rivera, Michael Dalley, David Farcy, Michel Betancourt, Lydia Howard, Sharon Licciardi, Luigi Cubeddu, Robert Goldszer
INTRODUCTION: There has been an increase in patients having serum lactate drawn in emergency situations. The objective of this study was to determine whether or not it was necessary to obtain a lactate level in patients with a normal serum bicarbonate level and anion gap. METHODS: This is a retrospective chart review evaluation of 304 patients who had serum lactate and electrolytes measured in an emergency setting in one academic medical center. RESULTS: In 66 patients who had elevated serum lactate (>2...
May 2015: Western Journal of Emergency Medicine
Zhengrong Guan, Justin P VanBeusecum, Edward W Inscho
Endothelin (ET) is one of the most potent renal vasoconstrictors. Endothelin plays an essential role in the regulation of renal blood flow, glomerular filtration, sodium and water transport, and acid-base balance. ET-1, ET-2, and ET-3 are the three distinct endothelin isoforms comprising the endothelin family. ET-1 is the major physiologically relevant peptide and exerts its biological activity through two G-protein-coupled receptors: ET(A) and ET(B). Both ET(A) and ET(B) are expressed by the renal vasculature...
March 2015: Seminars in Nephrology
Sonia Sharma, Ankur Gupta, Sanjiv Saxena
Renal tubular acidosis (RTA) is essentially characterized by normal anion gap and hyperchloremic metabolic acidosis. It is important to understand that despite knowing the disease for 60-70 years, complexities in the laboratory tests and their interpretation still make clinicians cautious to diagnose and label types of tubular disorder. Hence, we are writing this mini-review to emphasize on the step wise approach to RTA with some understanding on its basic etiopathogenesis. This will definitely help to have an accurate interpretation of urine and blood reports in correlation with the clinical condition...
August 2015: Clinical and Experimental Nephrology
M Adeva-Andany, M López-Ojén, R Funcasta-Calderón, E Ameneiros-Rodríguez, C Donapetry-García, M Vila-Altesor, J Rodríguez-Seijas
Metabolic pathways involved in lactate metabolism are important to understand the physiological response to exercise and the pathogenesis of prevalent diseases such as diabetes and cancer. Monocarboxylate transporters are being investigated as potential targets for diagnosis and therapy of these and other disorders. Glucose and alanine produce pyruvate which is reduced to lactate by lactate dehydrogenase in the cytoplasm without oxygen consumption. Lactate removal takes place via its oxidation to pyruvate by lactate dehydrogenase...
July 2014: Mitochondrion
Daniel O Thomas-Rueddel, Bernhard Poidinger, Manfred Weiss, Friedhelm Bach, Karin Dey, Helene Häberle, Udo Kaisers, Hendrik Rüddel, Dirk Schädler, Christian Scheer, Torsten Schreiber, Tobias Schürholz, Philipp Simon, Armin Sommerer, Daniel Schwarzkopf, Andreas Weyland, Gabriele Wöbker, Konrad Reinhart, Frank Bloos
PURPOSE: Current guidelines and most trials do not consider elevated lactate (Lac) serum concentrations when grading sepsis severity. We therefore assessed the association of different types of circulatory dysfunction regarding presence of hyperlactatemia and need for vasopressor support with clinical presentation and outcome of sepsis. METHODS: In a secondary analysis of a prospective observational multicenter cohort study, 988 patients with severe sepsis were investigated regarding vasopressor support, Lac levels, and outcome...
April 2015: Journal of Critical Care
Pablo Tapia, Dagoberto Soto, Alejandro Bruhn, Leyla Alegría, Nicolás Jarufe, Cecilia Luengo, Eduardo Kattan, Tomás Regueira, Arturo Meissner, Rodrigo Menchaca, María Ignacia Vives, Nicolas Echeverría, Gustavo Ospina-Tascón, Jan Bakker, Glenn Hernández
INTRODUCTION: Although the prognostic value of persistent hyperlactatemia in septic shock is unequivocal, its physiological determinants are controversial. Particularly, the role of impaired hepatic clearance has been underestimated and is only considered relevant in patients with liver ischemia or cirrhosis. Our objectives were to establish whether endotoxemia impairs whole body net lactate clearance, and to explore a potential role for total liver hypoperfusion during the early phase of septic shock...
April 22, 2015: Critical Care: the Official Journal of the Critical Care Forum
Willem Schurmans, Wim Lemahieu, Eric Frans
No abstract text is available yet for this article.
June 2014: Clinical Kidney Journal
Jeffrey A Kraut, Ira Kurtz
Acute non-anion gap metabolic acidosis, also termed hyperchloremic acidosis, is frequently detected in seriously ill patients. The most common mechanisms leading to this acid-base disorder include loss of large quantities of base secondary to diarrhea and administration of large quantities of chloride-containing solutions in the treatment of hypovolemia and various shock states. The resultant acidic milieu can cause cellular dysfunction and contribute to poor clinical outcomes. The associated change in the chloride concentration in the distal tubule lumen might also play a role in reducing the glomerular filtration rate...
February 2015: Clinical Kidney Journal
Richard Brunner, Andreas Drolz, Thomas-Matthias Scherzer, Katharina Staufer, Valentin Fuhrmann, Christian Zauner, Ulrike Holzinger, Bruno Schneeweiß
INTRODUCTION: Hyperchloremic acidosis is frequent in critically ill patients. Renal tubular acidosis (RTA) may contribute to acidemia in the state of hyperchloremic acidosis, but the prevalence of RTA has never been studied in critically ill patients. Therefore, we aimed to investigate the prevalence, type, and possible risk factors of RTA in critically ill patients using a physical-chemical approach. METHODS: This prospective, observational trial was conducted in a medical ICU of a university hospital...
April 6, 2015: Critical Care: the Official Journal of the Critical Care Forum
Clark G Owyang, Kaushal H Shah
No abstract text is available yet for this article.
November 2015: Annals of Emergency Medicine
Wei Li, Jun Xu, Dingyu Tan, Xuezhong Yu
OBJECTIVE: To evaluate the efficacy of hypertonic saline (HS) treatment in cardiopulmonary resuscitation (CPR) in animal models of cardiac arrest (CA). METHODS: PubMed and EMBASE data were retrieved from January 1st, 1966 to September 30th, 2014, and Wanfang data and CNKI were searched from January 1st, 1990 to September 30th, 2014 for randomized controlled trials (RCTs) regarding CPR intervention of CA animal models with HS. HS was intravenously infused at the initiation of CPR in HS group, without limiting its dosage or concentration...
March 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Harry W Daniell
No abstract text is available yet for this article.
March 2015: Intensive Care Medicine
B J Piper, P W Harrigan
We describe the protocolised use of 23.4% hypertonic saline solution (HTS) for intracranial hypertension in the context of traumatic brain injury in the paediatric population. This study represents the largest published data on the use of 23.4% HTS in the paediatric population. In this retrospective cohort, we focus on the efficacy, biochemical and metabolic consequences of 23.4% HTS administration in a Level 1 paediatric trauma centre. Mortality in the first seven days was 6% (2/32) with a mean intensive care unit length-of-stay of ten days (range 2 to 25, standard deviation [SD] 6)...
March 2015: Anaesthesia and Intensive Care
D A Scott, R Slater, M Duffy
No abstract text is available yet for this article.
March 2015: Anaesthesia and Intensive Care
Vikhyat S Bebarta, Normalynn Garrett, Susan Boudreau, Maria Castaneda
OBJECTIVES: The objective was to compare systolic blood pressure (sBP) over time in swine that have had 30% of their blood volume removed (Class III shock) and treated with intravenous (IV) whole blood or IV hydroxocobalamin, compared to nontreated control animals. METHODS: Thirty swine (45 to 55 kg) were anesthetized, intubated, and instrumented with continuous femoral and pulmonary artery pressure monitoring. Animals were hemorrhaged a total of 20 mL/kg over a 20-minute period...
March 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Sharukh Lokhandwala, Ari Moskowitz, Rebecca Lawniczak, Tyler Giberson, Michael N Cocchi, Michael W Donnino
PURPOSE: Occult hypoperfusion is associated with increased mortality in patients with sepsis. We sought to determine the practice patterns and outcomes of patients with sepsis-related occult hypoperfusion and introduce a potential method for risk stratification. MATERIALS AND METHODS: Single-center retrospective study of normotensive patients presenting to an urban tertiary care emergency department with lactate greater than or equal to 4 mmol/L and suspected infection...
June 2015: Journal of Critical Care
Kees H Polderman, Joseph Varon
Administering intravenous fluids to support the circulation in critically ill patients has been a mainstay of emergency medicine and critical care for decades, especially (but not exclusively) in patients with distributive or hypovolemic shock. However, in recent years, this automatic use of large fluid volumes is beginning to be questioned. Analysis from several large trials in severe sepsis and/or acute respiratory distress syndrome have shown independent links between volumes of fluid administered and outcome; conservative fluid strategies have also been associated with lower mortality in trauma patients...
March 2015: American Journal of Emergency Medicine
2015-03-05 05:30:56
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