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[PMID]:29185590
[Au] Autor:Biagini S; Dale CS; Real JM; Moreira ES; Carvalho CRR; Schettino GPP; Wendel S; Azevedo LCP
[Ad] Endereço:Instituto de Ensino e Pesquisa, Hospital Sírio-Libanês, São Paulo, SP, Brasil.
[Ti] Título:Short-term effects of stored homologous red blood cell transfusion on cardiorespiratory function and inflammation: an experimental study in a hypovolemia model.
[So] Source:Braz J Med Biol Res;51(1):e6258, 2017 Nov 17.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:The pathophysiological mechanisms associated with the effects of red blood cell (RBC) transfusion on cardiopulmonary function and inflammation are unclear. We developed an experimental model of homologous 14-days stored RBC transfusion in hypovolemic swine to evaluate the short-term effects of transfusion on cardiopulmonary system and inflammation. Sixteen healthy male anesthetized swine (68±3.3 kg) were submitted to controlled hemorrhage (25% of blood volume). Two units of non-filtered RBC from each animal were stored under blood bank conditions for 14 days. After 30 min of hypovolemia, the control group (n=8) received an infusion of lactated Ringer's solution (three times the removed volume). The transfusion group (n=8) received two units of homologous 14-days stored RBC and lactated Ringer's solution in a volume that was three times the difference between blood removed and blood transfusion infused. Both groups were followed up for 6 h after resuscitation with collection of hemodynamic and respiratory data. Cytokines and RNA expression were measured in plasma and lung tissue. Stored RBC transfusion significantly increased mixed oxygen venous saturation and arterial oxygen content. Transfusion was not associated with alterations on pulmonary function. Pulmonary concentrations of cytokines were not different between groups. Gene expression for lung cytokines demonstrated a 2-fold increase in mRNA level for inducible nitric oxide synthase and a 0.5-fold decrease in mRNA content for IL-21 in the transfused group. Thus, stored homologous RBC transfusion in a hypovolemia model improved cardiovascular parameters but did not induce significant effects on microcirculation, pulmonary inflammation and respiratory function up to 6 h after transfusion.
[Mh] Termos MeSH primário: Preservação de Sangue/métodos
Fenômenos Fisiológicos Cardiovasculares
Transfusão de Eritrócitos/métodos
Hipovolemia/terapia
Pneumonia/fisiopatologia
Fenômenos Fisiológicos Respiratórios
[Mh] Termos MeSH secundário: Animais
Preservação de Sangue/efeitos adversos
Citocinas/sangue
Modelos Animais de Doenças
Ensaio de Imunoadsorção Enzimática
Transfusão de Eritrócitos/efeitos adversos
Hemodinâmica
Masculino
Oxigênio/metabolismo
Reprodutibilidade dos Testes
Ressuscitação/métodos
Suínos
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cytokines); S88TT14065 (Oxygen)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171219
[Lr] Data última revisão:
171219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171130
[St] Status:MEDLINE


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[PMID]:28818141
[Au] Autor:Zhang Q; Evans JM; Stenger MB; Moore FB; Knapp CF
[Ti] Título:Autonomic Cardiovascular Responses to Orthostatic Stress After a Short Artificial Gravity Exposure.
[So] Source:Aerosp Med Hum Perform;88(9):827-833, 2017 Sep 01.
[Is] ISSN:2375-6314
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Intermittent artificial gravity (AG) training over days and weeks has been shown to improve the human orthostatic tolerance limit (OTL) and improve cardiovascular regulation in response to orthostatic stress. Effects of a single AG exposure are currently unknown. METHODS: We tested cardiovascular responses to orthostatic stress in 16 hypovolemic subjects (9 men and 7 women), once following a single, short (∼90 min) bout of AG and once following a similar period of head-down bed rest (HDBR). Hypovolemia was produced by intravenous furosemide infusion (20 mg) and orthostatic stress was produced by combined 70° head-up tilt (HUT) and progressively increasing lower body negative pressure until symptoms of presyncope developed. To assess reflex-induced changes in cardiovascular regulation, heart rate and blood pressure variability were analyzed by spectral analysis and baroreflex activity was evaluated by transfer function analysis. RESULTS: Compared to HDBR, a short AG exposure increased men's low frequency (0.04-0.15 Hz) power of systolic blood pressure (SBPLF), but did not change women's SBPLF responses to orthostatic stress. In response to 70° HUT, compared to supine, low frequency phase delay (PhaseLF) between systolic blood pressure and RR intervals increased by ∼20% following HDBR, but did not change following AG, reflecting improved baroreflex activity at a milder level of orthostatic stress after AG. CONCLUSIONS: These results indicate that a short bout of AG increased both sympathetic and baroreflex responsiveness to orthostatic stress in hypovolemia-induced, cardiovascular-deconditioned men and women, which may contribute to the AG-induced improvement of OTL shown in our previous reports.Zhang Q, Evans JM, Stenger MB, Moore FB, Knapp CF. Autonomic cardiovascular responses to orthostatic stress after a short artificial gravity exposure. Aerosp Med Hum Perform. 2017; 88(9):827-833.
[Mh] Termos MeSH primário: Sistema Nervoso Autônomo/fisiologia
Descondicionamento Cardiovascular/fisiologia
Gravidade Alterada
Decúbito Inclinado com Rebaixamento da Cabeça/fisiologia
[Mh] Termos MeSH secundário: Adulto
Barorreflexo/fisiologia
Repouso em Cama
Pressão Sanguínea/fisiologia
Feminino
Frequência Cardíaca/fisiologia
Hemodinâmica/fisiologia
Seres Humanos
Hipovolemia/fisiopatologia
Pressão Negativa da Região Corporal Inferior
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM; S
[Da] Data de entrada para processamento:170819
[St] Status:MEDLINE
[do] DOI:10.3357/AMHP.4811.2017


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[PMID]:28806046
[Au] Autor:Braun MM; Mahowald M
[Ad] Endereço:Madigan Army Medical Center Family Medicine Residency, 9040 Jackson Ave, Tacoma, WA 98431.
[Ti] Título:Electrolytes: Sodium Disorders.
[So] Source:FP Essent;459:11-20, 2017 Aug.
[Is] ISSN:2159-3000
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sodium disorders (ie, hyponatremia, hypernatremia) are common electrolyte disturbances in clinical medicine and are associated with increased rates of morbidity and mortality. Etiologies of hyponatremia are classified into four categories. The first is pseudohyponatremia, in which the sodium level is low due to hyperproteinemia, hyperlipidemia, or hyperglycemia. The other three categories are based on overall patient fluid status and include hypovolemic (commonly due to fluid loss), hypervolemic (commonly due to fluid retention from heart failure, cirrhosis, or renal failure), and euvolemic (most often because of syndrome of inappropriate secretion of antidiuretic hormone). Hypovolemic hyponatremia is managed by rehydration with isotonic saline. Hypervolemic hyponatremia is managed by addressing the underlying cause. Euvolemic hyponatremia is managed by restricting free water intake, addressing the underlying cause, and occasionally with drugs (eg, vasopressin receptor antagonists). Patients with severe or acutely symptomatic hyponatremia (eg, altered mental status, seizures), including those with acute symptomatic exercise-induced hyponatremia, require urgent treatment. This should consist of hypertonic saline administration along with monitoring of sodium levels to avoid overly rapid correction. Hypernatremia most often occurs because of water loss or inadequate water intake. Depending on severity, management involves oral or intravenous hypotonic fluids and addressing the underlying cause.
[Mh] Termos MeSH primário: Antagonistas de Receptores de Hormônios Antidiuréticos/uso terapêutico
Hidratação
Hipernatremia/terapia
Hiponatremia/terapia
Solução Salina Hipertônica/uso terapêutico
Cloreto de Sódio/uso terapêutico
[Mh] Termos MeSH secundário: Exercício
Insuficiência Cardíaca/complicações
Seres Humanos
Hipernatremia/etiologia
Hiponatremia/etiologia
Hipovolemia/complicações
Síndrome de Secreção Inadequada de HAD/complicações
Soluções Isotônicas/uso terapêutico
Cirrose Hepática/complicações
Insuficiência Renal/complicações
Desequilíbrio Hidroeletrolítico/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antidiuretic Hormone Receptor Antagonists); 0 (Isotonic Solutions); 0 (Saline Solution, Hypertonic); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE


  4 / 1316 MEDLINE  
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[PMID]:28802376
[Au] Autor:Tracy LF; Gomez G; Overton LJ; McClain WG
[Ad] Endereço:University of North Carolina, Department of Otolaryngology/Head and Neck Surgery, 101 Manning Drive, Chapel Hill, NC 27599, USA. Electronic address: LFTracy@Harvard.mgh.edu.
[Ti] Título:Hypovolemic shock after labial and lingual frenulectomy: A report of two cases.
[So] Source:Int J Pediatr Otorhinolaryngol;100:223-224, 2017 Sep.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:Lingual and labial frenulectomy are commonly performed as an outpatient procedure, either in an office setting or under general anesthesia. Frenulectomy is generally regarded by both otolaryngologists and dentists as a straightforward and low-risk procedure with limited evidence-based indications and similarly few contraindications. We describe two cases of hypovolemic shock occurring after outpatient frenulectomy requiring emergent interventions of cardiopulmonary resuscitation and blood transfusion. These rare, but life-threatening outcomes warrant recognition as potential complications for the presumed benign labial and lingual frenulectomy. We additionally briefly review indications for upper labial and lingual frenulectomy.
[Mh] Termos MeSH primário: Anquiloglossia/cirurgia
Hipovolemia/etiologia
Freio Lingual/cirurgia
Choque/etiologia
Língua/cirurgia
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Seres Humanos
Lactente
Masculino
Pacientes Ambulatoriais
Estudos Retrospectivos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170814
[St] Status:MEDLINE


  5 / 1316 MEDLINE  
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[PMID]:28778291
[Au] Autor:Kennedy BB; McMurtry Baird S
[Ad] Endereço:Vanderbilt University School of Nursing, 204 Godchaux Hall, 461 21st Avenue South, Nashville, TN 37240, USA. Electronic address: betsy.kennedy@vanderbilt.edu.
[Ti] Título:Collaborative Strategies for Management of Obstetric Hemorrhage.
[So] Source:Crit Care Nurs Clin North Am;29(3):315-330, 2017 Sep.
[Is] ISSN:1558-3481
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Obstetric hemorrhage is a significant cause of perinatal morbidity and mortality that requires prompt recognition and collaborative intervention to prevent poor outcomes. Medical and surgical management goals include controlling bleeding, supporting tissue oxygenation and perfusion, and monitoring for coagulopathies and complications.
[Mh] Termos MeSH primário: Mortalidade Materna
Complicações do Trabalho de Parto/terapia
Hemorragia Uterina/terapia
[Mh] Termos MeSH secundário: Enfermagem de Cuidados Críticos
Feminino
Seres Humanos
Hipovolemia
Complicações do Trabalho de Parto/sangue
Gravidez
Fatores de Risco
Hemorragia Uterina/epidemiologia
Hemorragia Uterina/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170806
[St] Status:MEDLINE


  6 / 1316 MEDLINE  
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[PMID]:28719636
[Au] Autor:Alshahrani S; Rapoport RM; Zahedi K; Jiang M; Nieman M; Barone S; Meredith AL; Lorenz JN; Rubinstein J; Soleimani M
[Ad] Endereço:Department of Pharmacology and Cell Biophysics, University of Cincinnati, College of Medicine, Cincinnati, OH, United States of America.
[Ti] Título:The non-diuretic hypotensive effects of thiazides are enhanced during volume depletion states.
[So] Source:PLoS One;12(7):e0181376, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Thiazide derivatives including Hydrochlorothiazide (HCTZ) represent the most common treatment of mild to moderate hypertension. Thiazides initially enhance diuresis via inhibition of the kidney Na+-Cl- Cotransporter (NCC). However, chronic volume depletion and diuresis are minimal while lowered blood pressure (BP) is maintained on thiazides. Thus, a vasodilator action of thiazides is proposed, likely via Ca2+-activated K+ (BK) channels in vascular smooth muscles. This study ascertains the role of volume depletion induced by salt restriction or salt wasting in NCC KO mice on the non-diuretic hypotensive action of HCTZ. HCTZ (20mg/kg s.c.) lowered BP in 1) NCC KO on a salt restricted diet but not with normal diet; 2) in volume depleted but not in volume resuscitated pendrin/NCC dKO mice; the BP reduction occurs without any enhancement in salt excretion or reduction in cardiac output. HCTZ still lowered BP following treatment of NCC KO on salt restricted diet with paxilline (8 mg/kg, i.p.), a BK channel blocker, and in BK KO and BK/NCC dKO mice on salt restricted diet. In aortic rings from NCC KO mice on normal and low salt diet, HCTZ did not alter and minimally decreased maximal phenylephrine contraction, respectively, while contractile sensitivity remained unchanged. These results demonstrate 1) the non-diuretic hypotensive effects of thiazides are augmented with volume depletion and 2) that the BP reduction is likely the result of HCTZ inhibition of vasoconstriction through a pathway dependent on factors present in vivo, is unrelated to BK channel activation, and involves processes associated with intravascular volume depletion.
[Mh] Termos MeSH primário: Anti-Hipertensivos/farmacologia
Hidroclorotiazida/farmacologia
Hipovolemia/fisiopatologia
[Mh] Termos MeSH secundário: Antagonistas de Receptores de Angiotensina/farmacologia
Animais
Pressão Sanguínea/efeitos dos fármacos
Débito Cardíaco/efeitos dos fármacos
Dieta Hipossódica
Hipovolemia/metabolismo
Canais de Potássio Ativados por Cálcio de Condutância Alta/metabolismo
Camundongos
Receptores de Angiotensina/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Angiotensin Receptor Antagonists); 0 (Antihypertensive Agents); 0 (Large-Conductance Calcium-Activated Potassium Channels); 0 (Receptors, Angiotensin); 0J48LPH2TH (Hydrochlorothiazide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0181376


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[PMID]:28584568
[Au] Autor:Mizrahi DJ; Kaushik C; Adamo R
[Ad] Endereço:Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, USA.
[Ti] Título:Hypovolemic Shock and Hemoperitoneum from Spontaneous Avulsion of a Large Pedunculated Uterine Leiomyoma.
[So] Source:J Radiol Case Rep;11(3):15-21, 2017 Mar.
[Is] ISSN:1943-0922
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Hemoperitoneum with hypovolemic shock from avulsion of a pedunculated leiomyoma is a rare but highly fatal condition that can occur spontaneously or as a result of trauma. We report a case of hemoperitoneum and hypovolemic shock secondary to a bleeding leiomyoma detected via computed tomography (CT) scan in a 39 year old premenopausal, gravida 0 female that presented with abdominal pain and became hemodynamically unstable in the emergency department. A preoperative bimanual exam revealed a mass consistent with a 20 week gestational uterus. Following fluid resuscitation, the patient underwent emergent myomectomy and ligation of the right uterine artery and was discharged home in good condition.
[Mh] Termos MeSH primário: Hemoperitônio/diagnóstico por imagem
Hemoperitônio/etiologia
Hipovolemia/diagnóstico por imagem
Hipovolemia/etiologia
Leiomioma/complicações
Leiomioma/diagnóstico por imagem
Neoplasias Uterinas/complicações
Neoplasias Uterinas/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Feminino
Hemoperitônio/cirurgia
Seres Humanos
Hipovolemia/cirurgia
Leiomioma/cirurgia
Ligadura
Ruptura Espontânea
Tomografia Computadorizada por Raios X
Neoplasias Uterinas/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170607
[St] Status:MEDLINE
[do] DOI:10.3941/jrcr.v11i3.3054


  8 / 1316 MEDLINE  
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[PMID]:28539354
[Au] Autor:Kay VL; Sprick JD; Rickards CA
[Ad] Endereço:Institute for Cardiovascular and Metabolic Diseases, University of North Texas Health Science Center, Fort Worth, Texas.
[Ti] Título:Cerebral oxygenation and regional cerebral perfusion responses with resistance breathing during central hypovolemia.
[So] Source:Am J Physiol Regul Integr Comp Physiol;313(2):R132-R139, 2017 Aug 01.
[Is] ISSN:1522-1490
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Resistance breathing improves tolerance to central hypovolemia induced by lower body negative pressure (LBNP), but this is not related to protection of anterior cerebral blood flow [indexed by mean middle cerebral artery velocity (MCAv)]. We hypothesized that inspiratory resistance breathing improves tolerance to central hypovolemia by maintaining cerebral oxygenation (ScO ), and protecting cerebral blood flow in the posterior cerebral circulation [indexed by posterior cerebral artery velocity (PCAv)]. Eight subjects (4 male/4 female) completed two experimental sessions of a presyncopal-limited LBNP protocol (3 mmHg/min onset rate) with and without (Control) resistance breathing via an impedance threshold device (ITD). ScO (via near-infrared spectroscopy), MCAv and PCAv (both via transcranial Doppler ultrasound), and arterial pressure (via finger photoplethysmography) were measured continuously. Hemodynamic responses were analyzed between the Control and ITD condition at baseline (T1) and the time representing 10 s before presyncope in the Control condition (T2). While breathing on the ITD increased LBNP tolerance from 1,506 ± 75 s to 1,704 ± 88 s ( = 0.003), both mean MCAv and mean PCAv were similar between conditions at T2 ( ≥ 0.46), and decreased by the same magnitude with and without ITD breathing ( ≥ 0.53). ScO also decreased by ~9% with or without ITD breathing at T2 ( = 0.97), and there were also no differences in deoxygenated (dHb) or oxygenated hemoglobin (HbO ) between conditions at T2 ( ≥ 0.43). There was no evidence that protection of regional cerebral blood velocity (i.e., anterior or posterior cerebral circulation) nor cerebral oxygen extraction played a key role in the determination of tolerance to central hypovolemia with resistance breathing.
[Mh] Termos MeSH primário: Resistência das Vias Respiratórias
Velocidade do Fluxo Sanguíneo
Volume Sanguíneo
Encéfalo/metabolismo
Circulação Cerebrovascular
Hipovolemia/fisiopatologia
Oxigênio/sangue
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Consumo de Oxigênio
Mecânica Respiratória
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
S88TT14065 (Oxygen)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170830
[Lr] Data última revisão:
170830
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170526
[St] Status:MEDLINE
[do] DOI:10.1152/ajpregu.00385.2016


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[PMID]:28478878
[Au] Autor:Schultze BS
[Ad] Endereço:Oregon Health & Science University, School of Nursing, Adult-Gerontlogy Acute Care Nurse Practitioner Program, 3455 S.W U.S. Veterans Hospital Road, Portland, OR 97239, USA. Electronic address: schultbe@ohsu.edu.
[Ti] Título:Fluid Management in Lung Transplant Patients.
[So] Source:Nurs Clin North Am;52(2):301-308, 2017 Jun.
[Is] ISSN:1558-1357
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Overall, there is a lack of randomized controlled trials examining the correlation between fluid volume delivery and outcomes in postoperative lung transplant patients. However, using thoracic surgery patients as a guide, the evidence suggests that hypervolemia correlates with pulmonary edema and should be avoided in lung transplant patients. However, it is recognized that patients with hemodynamic instability may require volume for attenuation of this situation, but it can likely be mitigated with the use of inotropic medication to maintain adequate perfusion and avoid the development of edema.
[Mh] Termos MeSH primário: Hemodinâmica
Hidrodinâmica
Hipovolemia/terapia
Transplante de Pulmão/efeitos adversos
Transplante de Pulmão/métodos
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/terapia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE


  10 / 1316 MEDLINE  
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[PMID]:28478875
[Au] Autor:Bailey BA; Davis S; Witherspoon B
[Ad] Endereço:Department of Advanced Practice, Vanderbilt University Medical Center, 1161 21st Avenue South, AA-1214 Medical Center North, Nashville, TN 37232, USA. Electronic address: brooke.a.bailey@vanderbilt.edu.
[Ti] Título:Assessment of Volume Status Using Ultrasonography.
[So] Source:Nurs Clin North Am;52(2):269-279, 2017 Jun.
[Is] ISSN:1558-1357
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ultrasonography is a first-line diagnostic tool when evaluating volume status in the critical care patient population. Ultrasonography leads to a prompt diagnosis and more appropriate management plan, while decreasing health care costs, time to diagnosis, hospital length of stay, time to definitive operation, and mortality. It is recommended that critical care providers treating critically ill patients be skilled and competent in critical care ultrasonography. As the critical care population and the shortage of critical care physicians increases, advanced practice providers are becoming more prevalent in critical care areas and should be competent in this skill as well.
[Mh] Termos MeSH primário: Determinação do Volume Sanguíneo/métodos
Estado Terminal/terapia
Hipovolemia/diagnóstico
Ultrassonografia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170515
[Lr] Data última revisão:
170515
[Sb] Subgrupo de revista:AIM; IM; N
[Da] Data de entrada para processamento:170509
[St] Status:MEDLINE



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