collection
https://read.qxmd.com/read/25698681/do-not-drown-the-patient-appropriate-fluid-management-in-critical-illness
#21
JOURNAL ARTICLE
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
https://read.qxmd.com/read/25702758/sodium-balance-not-fluid-balance-is-associated-with-respiratory-dysfunction-in-mechanically-ventilated-patients-a-prospective-multicentre-study
#22
MULTICENTER STUDY
Shailesh Bihari, Sandra L Peake, Shivesh Prakash, Manoj Saxena, Victoria Campbell, Andrew Bersten
BACKGROUND: Large positive sodium balances, independent of fluid balance, may lead to expanded extracellular fluid volumes and adverse clinical outcomes in the critically ill, including impaired oxygenation. OBJECTIVES: To estimate sodium and fluid balances in critically ill patients needing invasive mechanical ventilation (MV) for more than 48 hours and to evaluate the relationship between fluid balance, sodium balance and respiratory function (PaO2/FiO2 ratio and length of MV)...
March 2015: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://read.qxmd.com/read/25679107/early-peripheral-perfusion-guided-fluid-therapy-in-patients-with-septic-shock
#23
RANDOMIZED CONTROLLED TRIAL
Michel E van Genderen, Noel Engels, Ralf J P van der Valk, Alexandre Lima, Eva Klijn, Jan Bakker, Jasper van Bommel
No abstract text is available yet for this article.
February 15, 2015: American Journal of Respiratory and Critical Care Medicine
https://read.qxmd.com/read/25669592/a-systematic-review-of-extravasation-and-local-tissue-injury-from-administration-of-vasopressors-through-peripheral-intravenous-catheters-and-central-venous-catheters
#24
REVIEW
Osama M Loubani, Robert S Green
PURPOSE: The aim of this study was to collect and describe all published reports of local tissue injury or extravasation from vasopressor administration via either peripheral intravenous (IV) or central venous catheter. METHODS: A systematic search of Medline, Embase, and Cochrane databases was performed from inception through January 2014 for reports of adults who received vasopressor intravenously via peripheral IV or central venous catheter for a therapeutic purpose...
June 2015: Journal of Critical Care
https://read.qxmd.com/read/25629597/fluid-resuscitation-should-respect-the-endothelial-glycocalyx-layer
#25
COMMENT
Bertrand Guidet, Hafid Ait-Oufella
Endothelial glycocalyx degradation induced by fluid overload adds to the concern of a detrimental effect of uncontrolled fluid resuscitation and the risk of unnecessary fluid infusion. As a consequence, the use of new tools for monitoring response to fluids appears promising. From that perspective, the monitoring of plasma concentration of glycocalyx degradation markers could be useful.
December 23, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/25537574/correlation-of-lactate-albumin-ratio-level-to-organ-failure-and-mortality-in-severe-sepsis-and-septic-shock
#26
JOURNAL ARTICLE
Biao Wang, Gang Chen, Yifei Cao, Jiping Xue, Jia Li, Yunfu Wu
BACKGROUND: This study examines the clinical utility of the increased lactate/albumin ratio as an indicator of multiple-organ dysfunction syndrome (MODS) and mortality in severe sepsis and septic shock. METHODS: We designed a prospective cohort study in an intensive care unit, and 54 patients with severe sepsis or septic shock were included. Data were used to determine a relationship between lactate/albumin ratio and the development of MODS and mortality. These associations were determined by the Mann-Whitney test, multiple logistic regression, plotting the receiver operating characteristic curve and Spearman test...
April 2015: Journal of Critical Care
https://read.qxmd.com/read/25546532/novel-approaches-to-minimize-ventilator-induced-lung-injury
#27
REVIEW
Pierpaolo Terragni, Vito Marco Ranieri, Luca Brazzi
PURPOSE OF REVIEW: To discuss the mechanisms of ventilator-induced lung injury and the pro and cons of the different approaches proposed by literature to minimize its impact in patients with acute respiratory distress syndrome. RECENT FINDINGS: Mechanical ventilation is indispensable to manage respiratory failure. The evolution of knowledge of the physiological principles and of the clinical implementation of mechanical ventilation is characterized by the shift of interest from its capability to restore 'normal gas exchange' to its capability of causing further lung damage and multisystem organ failure...
February 2015: Current Opinion in Critical Care
https://read.qxmd.com/read/25565318/crystalloids-versus-colloids-exploring-differences-in-fluid-requirements-by-systematic-review-and-meta-regression
#28
REVIEW
Diego Orbegozo Cortés, Teresa Gamarano Barros, Hassane Njimi, Jean-Louis Vincent
BACKGROUND: Positive fluid balance has been associated with worse outcomes, and knowledge of differences in the amounts of different types of fluid needed to achieve the same end points may have important clinical implications. Large molecules persist longer in the blood vessels than smaller molecules, such that less IV colloid may be needed to achieve similar hemodynamic end points compared with crystalloid. Recent clinical data have, however, challenged this physiological concept, with investigators reporting lower-than-expected crystalloid/colloid ratios in various populations...
February 2015: Anesthesia and Analgesia
https://read.qxmd.com/read/25517063/-history-of-the-renin-angiotensin-system-great-men-a-great-finding
#29
JOURNAL ARTICLE
Pablo Nicolás Cherne, Pablo Young
The discovery of the renin-angiotensin-aldosterone system (RAS) was one of the important findings in physiology. Two research groups, in both North and South America, independently discovered that renin released a novel vasopressor agent. The Argentine group named it hypertensin, and called hypertensinogen to its plasma protein substrate. The group from the United States named it angiotonin. In 1958, Braun Menendez and Irvine Page suggested that the peptide's name should be angiotensin. Development of angiotensin converting enzyme (ACE) inhibitors proved that the RAS is effective in controlling hypertension and heart failure, and in preventing vascular injury in chronic diseases...
September 2014: Revista Médica de Chile
https://read.qxmd.com/read/25515081/renal-acid-base-regulation-new-insights-from-animal-models
#30
REVIEW
Dominique Eladari, Yusuke Kumai
Because majority of biological processes are dependent on pH, maintaining systemic acid-base balance is critical. The kidney contributes to systemic acid-base regulation, by reabsorbing HCO3 (-) (both filtered by glomeruli and generated within a nephron) and acidifying urine. Abnormalities in those processes will eventually lead to a disruption in systemic acid-base balance and provoke metabolic acid-base disorders. Research over the past 30 years advanced our understanding on cellular and molecular mechanisms responsible for those processes...
August 2015: Pflügers Archiv: European Journal of Physiology
https://read.qxmd.com/read/25494270/lactic-acidosis
#31
REVIEW
Jeffrey A Kraut, Nicolaos E Madias
New England Journal of Medicine, Volume 371, Issue 24, Page 2309-2319, December 2014.
December 11, 2014: New England Journal of Medicine
https://read.qxmd.com/read/25492894/renal-fanconi-syndrome-taking-a-proximal-look-at-the-nephron
#32
REVIEW
Enriko D Klootwijk, Markus Reichold, Robert J Unwin, Robert Kleta, Richard Warth, Detlef Bockenhauer
Renal Fanconi syndrome (RFS) refers to the generalized dysfunction of the proximal tubule (PT) (Kleta R. Fanconi or not Fanconi? Lowe syndrome revisited. Clin J Am Soc Nephrol 2008; 3: 1244-1245). In its isolated form, RFS only affects the PT, but not the other nephron segments. The study of isolated RFS can thus provide specific insights into the function of the PT. In a recent paper, Klootwijk et al. investigated one such form of isolated RFS and revealed the underlying molecular basis (Klootwijk ED, Reichold M, Helip-Wooley A et al...
September 2015: Nephrology, Dialysis, Transplantation
https://read.qxmd.com/read/25472864/140-mmol-l-of-sodium-versus-77-mmol-l-of-sodium-in-maintenance-intravenous-fluid-therapy-for-children-in-hospital-pims-a-randomised-controlled-double-blind-trial
#33
RANDOMIZED CONTROLLED TRIAL
Sarah McNab, Trevor Duke, Mike South, Franz E Babl, Katherine J Lee, Sarah J Arnup, Simon Young, Hannah Turner, Andrew Davidson
BACKGROUND: Use of hypotonic intravenous fluid to maintain hydration in children in hospital has been associated with hyponatraemia, leading to neurological morbidity and mortality. We aimed to assess whether use of fluid solutions with a higher sodium concentration reduced the risk of hyponatraemia compared with use of hypotonic solutions. METHODS: We did a randomised controlled double-blind trial of children admitted to The Royal Children's Hospital (Melbourne, VIC, Australia) who needed intravenous maintenance hydration for 6 h or longer...
March 28, 2015: Lancet
https://read.qxmd.com/read/25476454/an-in-vitro-evaluation-of-infusion-methods-using-a-syringe-pump-to-improve-noradrenaline-administration
#34
JOURNAL ARTICLE
S Genay, B Décaudin, S Scoccia, C Barthélémy, B Debaene, G Lebuffe, P Odou
BACKGROUND: International guidelines recommend noradrenaline (NA) as the vasopressor of choice to treat septic shock. The aim of this study was to determine the best way to infuse patients with NA. METHODS: The in vitro study was designed to measure NA concentration at the end of each studied assembly line. Three infusion systems used the double pump method and three single pumps, which differed as regards NA concentrations (0,2 - 0,5 - 1 mg/h), dead space volume of the devices and the use of saline...
February 2015: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/25472570/the-association-between-hyperoxia-and-patient-outcomes-after-cardiac-arrest-analysis-of-a-high-resolution-database
#35
JOURNAL ARTICLE
Jonathan Elmer, Michael Scutella, Raghevesh Pullalarevu, Bo Wang, Nishit Vaghasia, Stephen Trzeciak, Bedda L Rosario-Rivera, Francis X Guyette, Jon C Rittenberger, Cameron Dezfulian
PURPOSE: Previous observational studies have inconsistently associated early hyperoxia with worse outcomes after cardiac arrest, and have methodological limitations. We tested this association using a high-resolution database controlling for multiple disease-specific markers of severity of illness and care processes. METHODS: This was a retrospective analysis of a single-center, prospective registry of consecutive cardiac arrest patients. We included patients who survived and were mechanically ventilated ≥24 h after arrest...
January 2015: Intensive Care Medicine
https://read.qxmd.com/read/25474535/randomized-placebo-controlled-trial-of-acetaminophen-for-the-reduction-of-oxidative-injury-in-severe-sepsis-the-acetaminophen-for-the-reduction-of-oxidative-injury-in-severe-sepsis-trial
#36
RANDOMIZED CONTROLLED TRIAL
David R Janz, Julie A Bastarache, Todd W Rice, Gordon R Bernard, Melissa A Warren, Nancy Wickersham, Gillian Sills, John A Oates, L Jackson Roberts, Lorraine B Ware
OBJECTIVES: This trial evaluated the efficacy of acetaminophen in reducing oxidative injury, as measured by plasma F2-isoprostanes, in adult patients with severe sepsis and detectable plasma cell-free hemoglobin. DESIGN: Single-center, randomized, double-blind, placebo-controlled phase II trial. SETTING: Medical ICU in a tertiary, academic medical center. PATIENTS: Critically ill patients 18 years old or older with severe sepsis and detectable plasma cell-free hemoglobin...
March 2015: Critical Care Medicine
https://read.qxmd.com/read/25479113/lactate-measurements-in-sepsis-induced-tissue-hypoperfusion-results-from-the-surviving-sepsis-campaign-database
#37
MULTICENTER STUDY
Brian Casserly, Gary S Phillips, Christa Schorr, R Phillip Dellinger, Sean R Townsend, Tiffany M Osborn, Konrad Reinhart, Narendran Selvakumar, Mitchell M Levy
OBJECTIVE: The Surviving Sepsis Campaign guidelines recommend obtaining a serum lactate measurement within 6 hours of presentation for all patients with suspected severe sepsis or septic shock. A lactate greater than 4 mmol/L qualifies for administration of early quantitative resuscitation therapy. We evaluated lactate elevation (with special attention to values > 4 mmol/L) and presence or absence of hypotension as a marker of clinical outcome. DESIGN AND SETTING: The Surviving Sepsis Campaign developed a database to assess the overall effect of the sepsis bundles as a performance improvement tool for clinical practice and patient outcome...
March 2015: Critical Care Medicine
https://read.qxmd.com/read/25475099/jugular-vein-distensibility-predicts-fluid-responsiveness-in-septic-patients
#38
JOURNAL ARTICLE
Fabio Guarracino, Baldassarre Ferro, Francesco Forfori, Pietro Bertini, Luana Magliacano, Michael R Pinsky
INTRODUCTION: The purpose of the study was to verify the efficacy of using internal jugular vein (IJV) size and distensibility as a reliable index of fluid responsiveness in mechanically ventilated patients with sepsis. METHODS: Hemodynamic data of mechanically ventilated patients with sepsis were collected through a radial arterial indwelling catheter connected to continuous hemodynamic monitoring system (Most Care®, Vytech Health, Padova, Italy), including cardiac index (CI) (L/min/M(2)), heart rate (beats/min), mean arterial pressure (MAP) (mmHg), central venous pressure (CVP) (mmHg) and arterial pulse pressure variation (PPV), coupled with ultrasound evaluation of IJV distensibility (%), defined as a ratio of the difference between IJV maximal antero-posterior diameter during inspiration and minimum expiratory diameter to minimum expiratory diameter x100...
December 5, 2014: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/25483379/fluid-balance-in-sepsis-and-septic-shock-as-a-determining-factor-of-mortality
#39
JOURNAL ARTICLE
Josep-Maria Sirvent, Cristina Ferri, Anna Baró, Cristina Murcia, Carolina Lorencio
OBJECTIVE: The objective was to assess whether fluid balance had a determinant impact on mortality rate in a cohort of critically ill patients with severe sepsis or septic shock. DESIGN: A prospective and observational study was carried out on an inception cohort. SETTING: The setting was an intensive care unit of a university hospital. PATIENTS: Patients admitted consecutively in the intensive care unit who were diagnosed with severe sepsis or septic shock were included...
February 2015: American Journal of Emergency Medicine
https://read.qxmd.com/read/25435477/minimally-invasive-monitoring
#40
REVIEW
Xavier Monnet, Jean-Louis Teboul
Although use of the classic pulmonary artery catheter has declined, several techniques have emerged to estimate cardiac output. Arterial pressure waveform analysis computes cardiac output from the arterial pressure curve. The method of estimating cardiac output for these devices depends on whether they need to be calibrated by an independent measure of cardiac output. Some newer devices have been developed to estimate cardiac output from an arterial curve obtained noninvasively with photoplethysmography, allowing a noninvasive beat-by-beat estimation of cardiac output...
January 2015: Critical Care Clinics
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