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  1 / 11492 MEDLINE  
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[PMID]:29505505
[Au] Autor:Zhang ZG; Liu XM
[Ti] Título:A case report with shock induced by tolvaptan in an elderly patient with congestive heart failure.
[So] Source:Medicine (Baltimore);97(1):e8706, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Tolvaptan (TLV) is a new vasopressin type 2 receptor antagonist effective in patients with heart failure (HF). Accumulating evidences have revealed that treatment with TLV does not alter the blood pressure significantly. PATIENT CONCERNS: An 84-year-old man was diagnosed with acute exacerbation of chronic HF due to ischemic cardiomyopathy, arrhythmia, mitral and aortic regurgitation. Treatment with TLV increased the urine volume and improved the dyspnea. After 4 days use of TLV (3.75 mg QD, 7.5 mg QD, 7.5 mg QD, and 15 mg QD, respectively), decrease in blood pressure to less than 90/60 mmHg was observed continuously and the lowest blood pressure was 80/37 mmHg. He was apyretic and felt only thirsty. Central venous pressure was 12 cmH2O. DIAGNOSES: Because no other medications were changed and no signs of hypovolemic, septic, allergic, or cardiac shock were detected, we suspected an adverse reaction to TLV. INTERVENTION: Intravenous hydration was performed with 250 mL of normal saline. OUTCOMES: His blood pressure increased gradually and the statue of hypotention lasted for 14 hours. The dose of TLV was decreased to 7.5 mg/d from the next day to discharge. During this period, his blood pressure was stable at about 125/60 mmHg. LESSONS: TLV has side effect of severe hypotension that is consistent with its physiological activity. The dose should be increased gradually to achieve the desired effect, while attention should be paid to potential drug interactions.
[Mh] Termos MeSH primário: Antagonistas de Receptores de Hormônios Antidiuréticos/efeitos adversos
Benzazepinas/efeitos adversos
Insuficiência Cardíaca/tratamento farmacológico
Choque/induzido quimicamente
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidiuretic Hormone Receptor Antagonists); 0 (Benzazepines); 21G72T1950 (tolvaptan)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008706


  2 / 11492 MEDLINE  
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[PMID]:29374924
[Au] Autor:Zeng QL; Wang QM; Li N; Luo QZ
[Ad] Endereço:Department of Nursing, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China.
[Ti] Título:[Advances in the research of application of urine output monitoring in prevention and treatment of burn shock].
[So] Source:Zhonghua Shao Shang Za Zhi;34(1):29-31, 2018 Jan 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Fluid therapy is a crucial treatment for patients with extensive burn, which affects patients'prognosis directly. Accurate urine output measurement plays an irreplaceable role in guiding fluid resuscitation in clinic. As one of the best indexes in traditional burn resuscitation, urine output comprehensively reflects systemic circulation. However, it doesn't fully reflect all the specific chapters of microcirculation and systemic circulation and deficient cellular oxygen metabolism exactly. We need to use urine output combined with other shock parameters to ensure adequate fluid replacement. Currently, the most common way of urine output monitoring is manual measurement. The article reviews the application of urine output monitoring in guiding fluid resuscitation of burn shock.
[Mh] Termos MeSH primário: Queimaduras/terapia
Hidratação
Ressuscitação/métodos
Choque/prevenção & controle
[Mh] Termos MeSH secundário: Seres Humanos
Microcirculação
Oxigênio
Choque/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
S88TT14065 (Oxygen)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2018.01.006


  3 / 11492 MEDLINE  
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[PMID]:29374922
[Au] Autor:Wang DY; Xie WG; Xi MM; Li Z; Wang B
[Ad] Endereço:Department of Burns, Tongren Hospital of Wuhan University & Wuhan Third Hospital, Wuhan 430060, China.
[Ti] Título:[Effects of application of pulse contour cardiac output monitoring technology in early treatment of patients with large area burns].
[So] Source:Zhonghua Shao Shang Za Zhi;34(1):14-20, 2018 Jan 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To analyze the changes and relationship of early hemodynamic indexes of patients with large area burns monitored by pulse contour cardiac output (PiCCO) monitoring technology, so as to assess the guiding value of this technology in the treatment of patients with large area burns during shock period. Eighteen patients with large area burns, confirming to the study criteria, were admitted to our unit from May 2016 to May 2017. Pulse contour cardiac output index (PCCI), systemic vascular resistance index (SVRI), global end-diastolic volume index (GEDVI), and extravascular lung water index (EVLWI) of patients were monitored by PiCCO instrument from admission to post injury day (PID) 7, and they were calibrated and recorded once every four hours. The fluid infusion coefficients of patients at the first and second 24 hours post injury were calculated. The blood lactic acid values of patients from PID 1 to 7 were also recorded. The correlations among PCCI, SVRI, and GEDVI as well as the correlation between SVRI and blood lactic acid of these 18 patients were analyzed. Prognosis of patients were recorded. Data were processed with one-way analysis of variance, single sample test and Bonferroni correction, Pearson correlation analysis, and Spearman rank correlation analysis. (1) There was statistically significant difference in PCCI value of patients from post injury hour (PIH) 4 to 168 ( =7.428, <0.01). The PCCI values of patients at PIH 4, 8, 12, 16, 20, and 24 were (2.4±0.9), (2.6±1.2), (2.2±0.6), (2.6±0.7), (2.8±0.6), and (2.7±0.7) L·min(-1)·m(-2,) respectively, and they were significantly lower than the normal value 4 L·min(-1)·m(-2)( =-3.143, -3.251, -11.511, -8.889, -6.735, -6.976, <0.05 or <0.01). At PIH 76, 80, 84, 88, 92, and 96, the PCCI values of patients were (4.9±1.5), (5.7±2.0), (5.9±1.7), (5.5±1.3), (5.3±1.1), and (4.9±1.4) L·min(-1)·m(-2,) respectively, and they were significantly higher than the normal value ( =2.277, 3.142, 4.050, 4.111, 4.128, 2.423, <0.05 or <0.01). The PCCI values of patients at other time points were close to normal value ( >0.05). (2) There was statistically significant difference in SVRI value of patients from PIH 4 to 168 ( =7.863, <0.01). The SVRI values of patients at PIH 12, 16, 20, 24, and 28 were (2 298±747), (2 581±498), (2 705±780), (2 773±669), and (3 109±1 215) dyn·s·cm(-5)·m(2,) respectively, and they were significantly higher than the normal value 2 050 dyn·s·cm(-5)·m(2)( =0.878, 3.370, 2.519, 3.747, 3.144, <0.05 or <0.01). At PIH 4, 8, 72, 76, 80, 84, 88, 92, and 96, the SVRI values of patients were (1 632±129), (2 012±896), (1 381±503), (1 180±378), (1 259±400), (1 376±483), (1 329±385), (1 410±370), and (1 346±346) dyn·s·cm(-5)·m(2,) respectively, and they were significantly lower than the normal value ( =-4.593, -0.112, -5.157, -8.905, -7.914, -5.226, -6.756, -6.233, -7.038, <0.01). The SVRI values of patients at other time points were close to normal value ( >0.05). (3) There was no statistically significant difference in the GEDVI values of patients from PIH 4 to 168 ( =0.704, >0.05). The GEDVI values of patients at PIH 8, 12, 16, 20, and 24 were significantly lower than normal value ( =-3.112, -3.554, -2.969, -2.450, -2.476, <0.05). The GEDVI values of patients at other time points were close to normal value ( >0.05). (4) There was statistically significant difference in EVLWI value of patients from PIH 4 to 168 ( =1.859, <0.01). The EVLWI values of patients at PIH 16, 20, 24, 28, 32, 36, and 40 were significantly higher than normal value ( =4.386, 3.335, 6.363, 4.391, 7.513, 5.392, 5.642, <0.01). The EVLWI values of patients at other time points were close to normal value ( >0.05). (5) The fluid infusion coefficients of patients at the first and second 24 hours post injury were 1.90 and 1.39, respectively. The blood lactic acid values of patients from PID 1 to 7 were 7.99, 5.21, 4.57, 4.26, 2.54, 3.13, and 3.20 mmol/L, respectively, showing a declined tendency. (6) There was obvious negative correlation between PCCI and SVRI ( =-0.528, <0.01). There was obvious positive correlation between GEDVI and PCCI ( =0.577, <0.01). There was no obvious correlation between GEDVI and SVRI ( =0.081, >0.05). There was obvious positive correlation between blood lactic acid and SVRI ( =0.878, <0.01). (7) All patients were cured except the one who abandoned treatment. PiCCO monitoring technology can monitor the changes of early hemodynamic indexes and volume of burn patients dynamically, continuously, and conveniently, and provide valuable reference for early-stage comprehensive treatment like anti-shock of patients with large area burns.
[Mh] Termos MeSH primário: Queimaduras/terapia
Débito Cardíaco
Monitorização Fisiológica/métodos
Ressuscitação
[Mh] Termos MeSH secundário: Água Extravascular Pulmonar
Hidratação
Hemodinâmica
Seres Humanos
Choque/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2018.01.004


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[PMID]:29374921
[Au] Autor:Xiao R; Huang YS; Lin GA; Yuan SA; Hu DS
[Ad] Endereço:Burn Center, the 159th Hospital of PLA, Zhumadian 463008, China.
[Ti] Título:[Effects of cardiac support on delayed resuscitation in extensively burned patients with shock].
[So] Source:Zhonghua Shao Shang Za Zhi;34(1):8-13, 2018 Jan 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To explore the effects of cardiac support on delayed resuscitation in extensively burned patients with shock. Clinical data of 62 extensively burned patients with shock on admission, admitted to the 159th Hospital of PLA (hereinafter referred to as our hospital) from January 2012 to January 2017, were retrospectively analyzed. They were divided into cardiac support group ( =35) and control group ( =27) according to the use of deslanoside and ulinastatin. All patients were treated with routine fluid resuscitation based on the formula of the Third Military Medical University till post injury hour (PIH) 48. Patients in cardiac support group were given slow intravenous injection of deslanoside which was added in 20 mL 100 g/L glucose injection with first dose of 0.4 to 0.6 mg, 0.2 to 0.4 mg per 6 to 8 h, no more than 1.6 mg daily, and slow intravenous injection of 1×10(5)U ulinastatin which was added in 100 mL 50 g/L glucose injection, once per 12 h. Other treatments of patients in the two groups followed the same conventional procedures of our hospital. The following data of the two groups of patients were collected. (1) The data of urine volume per hour within PIH 48, heart rate, mean arterial pressure (MAP), central venous pressure (CVP), blood lactic acid, base excess, hematocrit, and albumin at PIH 48 were recorded. (2) The input volumes of electrolyte, colloid within the first and second 24 hours post burn and the total fluid input volumes within PIH 48 were recorded. (3) The data of creatine kinase, creatine kinase isoenzyme-MB, lactate dehydrogenase, total bile acid, alanine aminotransferase, aspartate aminotransferase, ß(2)-microglobulin, urea nitrogen, and creatinine at PIH 48 were recorded. (4) The complications including cardiac failure, pulmonary edema, pleural effusion, seroperitoneum, renal failure, sepsis, and death were also recorded. Data were processed with independent sample test, Fisher's exact test, Pearson chi-square test, or continuous correction chi-square test. (1) There were no statistically significant differences in urine volume within PIH 48, heart rate, MAP, CVP, hematocrit, or albumin at PIH 48 between the patients of two groups ( =0.150, 0.488, 0.805, 0.562, 1.742, 0.696, >0.05). While the levels of blood lactic acid and base excess were respectively (4.2±2.2) and (-4.3±2.0) mmol/L in patients of cardiac support group, which were significantly better than (5.9±1.7) and (-6.0±3.1) mmol/L in patients of control group ( =3.249, 2.480, <0.05 or <0.01). (2) There was no statistically significant difference in input volume of colloid within the first 24 hours post burn between the patients of two groups ( =0.642, >0.05). The input volume of electrolyte within the first 24 hours post burn, the input volumes of electrolyte and colloid within the second 24 hours post burn, and the total fluid input volume within PIH 48 of patients in cardiac support group were significantly less than those in control group ( =2.703, 4.223, 3.437, 2.515, <0.05 or <0.01). (3) The levels of creatine kinase, creatine kinase isoenzyme-MB, lactate dehydrogenase, total bile acid, alanine aminotransferase, aspartate aminotransferase, ß(2)-microglobulin, urea nitrogen, and creatinine of patients in cardiac support group at PIH 48 were significantly lower than those in control group ( =3.066, 3.963, 3.225, 2.943, 2.431, 3.084, 4.052, 2.915, 3.353, <0.05 or <0.01). (4) The occurrences of pleural effusion and seroperitoneum and mortality of patients in cardiac support group were significantly lower than those in control group ( (2)=5.514, 6.984, 4.798, <0.05 or <0.01). There were no statistically significant differences in cardiac failure, pulmonary edema, renal failure, and sepsis between the patients of two groups [ (2)=1.314 (sepsis), >0.05]. The cardiotonic and cardiac protection treatments in delayed resuscitation of extensively burned patients with shock contribute to improving the cellular anonic metabolism, reducing the volume of fluid resuscitation, and mitigating the ischemic and hypoxic damage to organs, so as to lay foundation for decreasing further complication incidences and mortality.
[Mh] Termos MeSH primário: Queimaduras
Ressuscitação
Choque
[Mh] Termos MeSH secundário: Coloides
Hidratação
Hematócrito
Seres Humanos
Edema Pulmonar
Estudos Retrospectivos
Sepse
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Colloids)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2018.01.003


  5 / 11492 MEDLINE  
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[PMID]:29374920
[Au] Autor:Huang YS
[Ad] Endereço:Institute of Burn Research, the First Affiliated Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, Army Medical University (the Third Military Medical University), Chongqing 400038, China.
[Ti] Título:[Autophagy and hypoxic ischemic myocardial damage after severe burn].
[So] Source:Zhonghua Shao Shang Za Zhi;34(1):3-7, 2018 Jan 20.
[Is] ISSN:1009-2587
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:It is an important clinical subject to illuminate the mechanisms of myocardial damage in the early stage post severe burn in prevention against and treatment of burn shock, which may offer a targeted " dynamic support" in the treatment of severe burn patients. In recent years, the role of autophagy in hypoxic myocardial injury has attracted much attention. Autophagy is a physiological phenomenon on intracellular digestion process of long-life proteins and the aging and damaged organelles through lysosomal system, and it is essential for maintaining the homeostasis of cells. Severe hypoxia/ischemia causes lysosome dysfunction, insufficient fusion between autophagosome and lysosome, accumulation of autophagosomes, and damaged autophagy flux, thus leading to cell dysfunction and cell death. To study the roles of autophagy and explore the potential signals in autophagy modulation will provide a new therapeutic target for alleviating cardiac dysfunction following severe burn.
[Mh] Termos MeSH primário: Autofagia
Queimaduras/complicações
Queimaduras/patologia
Miocárdio/patologia
[Mh] Termos MeSH secundário: Animais
Queimaduras/terapia
Seres Humanos
Hipóxia/etiologia
Lisossomos
Traumatismo por Reperfusão Miocárdica
Choque/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1009-2587.2018.01.002


  6 / 11492 MEDLINE  
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[PMID]:28471119
[Au] Autor:Dai J; Chen SJ; Yang BS; Lü SM; Zhu M; Xu YF; Chen J; Cai HW; Mao W
[Ad] Endereço:Department of Cardiology, Zhejiang Provincial Hospital of Traditional Chinese Medicine, Hangzhou 310006, China.
[Ti] Título:Recurrence of non-cardiogenic pulmonary edema and sustained hypotension shock in cystic pheochromocytoma.
[So] Source:J Zhejiang Univ Sci B;18(5):449-452, 2017 May.
[Is] ISSN:1862-1783
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:Pheochromocytoma is a rare neuroendocrine tumor which derives from chromaffin cells of the adrenal gland or relevant to sympathetic nerves and ganglia. The clinical features of pheochromocytoma are various. Paroxysmal episodes of serious hypertension, headache, palpitation, and diaphoresis are the typical manifestations (Bravo, 2004). Hypotension shock, pulmonary edema, and acute coronary syndrome induced by pheochromocytoma are uncommon (Malindretos et al., 2008; Batisse-Lignier et al., 2015). In this study, we present a rare case of cystic pheochromocytoma causing recurrent hypotension shock, non-cardiogenic pulmonary edema, and acute coronary syndrome, and the possible mechanisms are discussed.
[Mh] Termos MeSH primário: Neoplasias das Glândulas Suprarrenais/complicações
Neoplasias das Glândulas Suprarrenais/diagnóstico
Feocromocitoma/complicações
Feocromocitoma/diagnóstico
Edema Pulmonar/diagnóstico
Edema Pulmonar/etiologia
Choque/etiologia
[Mh] Termos MeSH secundário: Neoplasias das Glândulas Suprarrenais/terapia
Cistos/complicações
Cistos/diagnóstico
Cistos/terapia
Diagnóstico Diferencial
Feminino
Seres Humanos
Hipotensão/diagnóstico
Hipotensão/etiologia
Hipotensão/terapia
Meia-Idade
Feocromocitoma/terapia
Edema Pulmonar/terapia
Recuperação de Função Fisiológica
Recidiva
Choque/diagnóstico
Choque/prevenção & controle
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.1631/jzus.B1600411


  7 / 11492 MEDLINE  
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[PMID]:29208261
[Au] Autor:Kinser KN; Panach K; Dominguez AR
[Ad] Endereço:Pediatric Residency Program, Department of Pediatrics, University of California Los Angeles, Los Angeles, California.
[Ti] Título:Recurrent Malignancy-Associated Atypical Neutrophilic Dermatosis With Noninfectious Shock.
[So] Source:Am J Med Sci;354(6):626-632, 2017 12.
[Is] ISSN:1538-2990
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Sweet syndrome (SS) or acute febrile neutrophilic dermatosis presents with the sudden onset of fever, leukocytosis and tender, erythematous, edematous, well-demarcated papules and plaques that histopathologically demonstrate a dense neutrophilic infiltrate. A total of 20% of patients with SS have malignancy-associated disease that can present with bullous or atypical skin lesions that mimic pyoderma gangrenosum, another neutrophilic dermatosis. Both entities exist on a spectrum, and in the context of underlying malignancy, these neutrophilic diseases become less clinically distinct. The literature also describes life-threatening cases of neutrophilic dermatoses that mimic severe sepsis. We present a fatal case of a patient with chronic eosinophilic leukemia with recurrent episodes of malignancy-associated atypical neutrophilic dermatosis characterized by necrotic skin lesions, pulmonary infiltrates and noninfectious shock and we also summarize the clinical presentations of an additional 10 patients reported in the literature. We conducted a PubMed search of articles published up to and in 2015, focusing on the English and Spanish literature with SS cross-referenced with the following search terms: neutrophilic dermatosis, pyoderma gangrenosum, shock, multiorgan failure and systemic inflammatory response syndrome. The articles were reviewed and the patients׳ clinical and laboratory findings were summarized. Cases of atypical neutrophilic dermatosis presenting with noninfectious shock syndrome are likely underrecognized clinically and underreported in the literature. Patients with malignancy-associated atypical neutrophilic dermatoses associated with noninfectious shock syndrome typically have multisystem disease characterized by recurrent episodes and typically have poor prognoses.
[Mh] Termos MeSH primário: Síndrome Hipereosinofílica/complicações
Choque/etiologia
Síndrome de Sweet/etiologia
[Mh] Termos MeSH secundário: Idoso
Evolução Fatal
Feminino
Seres Humanos
Pulmão/diagnóstico por imagem
Pulmão/patologia
Choque/diagnóstico
Síndrome de Sweet/patologia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE


  8 / 11492 MEDLINE  
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[PMID]:29391095
[Au] Autor:Schellenberg M; Strumwasser A; Grabo D; Clark D; Matsushima K; Inaba K; Demetriades D
[Ad] Endereço:Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, California, USA.
[Ti] Título:Delta Shock Index in the Emergency Department Predicts Mortality and Need for Blood Transfusion in Trauma Patients.
[So] Source:Am Surg;83(10):1059-1062, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Shock Index (SI = heart rate/systolic blood pressure) predicts outcomes among trauma patients. Studies have also shown that the change in SI between the field and Emergency Department (ED) arrival (Delta SI) predicts mortality in trauma. Given the lack of reliable prehospital data, Delta SI may more accurately prognosticate if used within the ED. All trauma patients arriving to our Level I trauma center in 2014 were reviewed. Patients were matched for age, gender, mechanism of injury, and injury severity score. SI and ED Delta SI were calculated. ED Delta SI >0.1 and ≤0.1 defined the study groups. Pregnant patients, pediatric patients, and patients with incomplete data were excluded. Outcomes included intensive care unit (ICU) length of stay, blood products, and mortality. A total of 2591 patients were identified (n = 1294 patients analyzed). After matching, patients with ED Delta SI >0.1 had greater mortality (6.6 vs 2.6%, P = 0.010), need for blood transfusion (1764 vs 565 cc, P < 0.001), and ICU length of stay (5.6 vs 3.8 days, P = 0.014) compared with patients with ED Delta SI ≤0.1. In conclusion, ED Delta SI >0.1 is associated with increased mortality, need for blood transfusion, and ICU length of stay. Delta SI may be superior to traditional SI for trauma outcome prognostication.
[Mh] Termos MeSH primário: Transfusão de Sangue/estatística & dados numéricos
Técnicas de Apoio para a Decisão
Serviço Hospitalar de Emergência
Índice de Gravidade de Doença
Choque/diagnóstico
Ferimentos e Lesões/mortalidade
Ferimentos e Lesões/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Criança
Pré-Escolar
Cuidados Críticos/estatística & dados numéricos
Feminino
Seres Humanos
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
Prognóstico
Estudos Retrospectivos
Choque/etiologia
Índices de Gravidade do Trauma
Ferimentos e Lesões/complicações
Ferimentos e Lesões/diagnóstico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


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[PMID]:29327898
[Au] Autor:Krca B; Dzudovic B; Vukotic S; Ratkovic N; Subotic B; Vranes D; Rusovic S; Obradovic S
[Ti] Título:Association of different electrocardiographic patterns with shock index, right ventricle systolic pressure and diameter, and embolic burden score in pulmonary embolism.
[So] Source:Vojnosanit Pregl;73(10):921-6, 2016 Oct.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Some electrocardiographic (ECG) patterns are characteristic for pulmonary embolism but exact meaning of the different ECG signs are not well known. The aim of this study was to determine the association between four common ECG signs in pulmonary embolism [complete or incomplete right bundle branch block (RBBB), S-waves in the aVL lead, S1Q3T3 sign and negative T-waves in the precordial leads] with shock index (SI), right ventricle diastolic diameter (RVDD) and peak systolic pressure (RVSP) and embolic burden score (EBS). Methods: The presence of complete or incomplete RBBB, S waves in aVL lead, S1Q3T3 sign and negative T-waves in the precordial leads were determined at admission ECG in 130 consecutive patients admitted to the intensive care unit of a single tertiary medical center in a 5-year period. Echocardiography examination with measurement of RVDD and RVSP, multidetector computed tomography pulmonary angiography (MDCT-PA) with the calculation of EBS and SI was determined during the admission process. Multivariable regression models were calculated with ECG parameters as independent variables and the mentioned ultrasound, MDCT-PA parameters and SI as dependent variables. Results: The presence of S-waves in the aVL was the only independent predictor of RVDD (F = 39.430, p < 0.001; adjusted R2 = 0.231) and systolic peak right ventricle pressure (F = 29.903, p < 0.001; adjusted R2 = 0.185). Negative T-waves in precordial leads were the only independent predictor for EBS (F = 24.177, p < 0.001; R2 = 0.160). Complete or incomplete RBBB was the independent predictor of SI (F = 20.980, p < 0.001; adjusted R2 = 0.134). Conclusion: In patients with pulmonary embolism different ECG patterns at admission correlate with different clinical, ultrasound and MDCT-PA parameters. RBBB is associated with shock, Swave in the aVL is associated with right ventricle pressure and negative T-waves with the thrombus burden in the pulmonary tree.
[Mh] Termos MeSH primário: Bloqueio de Ramo/diagnóstico
Eletrocardiografia
Frequência Cardíaca
Embolia Pulmonar/diagnóstico
Choque/diagnóstico
Função Ventricular Direita
Pressão Ventricular
[Mh] Termos MeSH secundário: Adulto
Idoso
Bloqueio de Ramo/etiologia
Bloqueio de Ramo/fisiopatologia
Angiografia por Tomografia Computadorizada
Ecocardiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Tomografia Computadorizada Multidetectores
Análise Multivariada
Valor Preditivo dos Testes
Embolia Pulmonar/etiologia
Embolia Pulmonar/fisiopatologia
Análise de Regressão
Fatores de Risco
Índice de Gravidade de Doença
Choque/etiologia
Choque/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150512011K


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[PMID]:29381949
[Au] Autor:Ho CY; He ZR; Yang SN; Yang YN
[Ad] Endereço:Department of Pediatrics, E-Da Hospita.
[Ti] Título:Late-onset transient adrenal insufficiency in preterm twins with twin-to-twin transfusion syndrome: A case report.
[So] Source:Medicine (Baltimore);96(47):e8686, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Late-onset transient adrenal insufficiency with circulatory collapse is a rare condition that occurs in preterm infants. Although the incidence of late-onset transient adrenal insufficiency in preterm infants has been reported in Japan, reports from Western countries are lacking. In addition, no study has investigated the effect of twin-to-twin transfusion syndrome (TTTS) in monozygotic twins. PATIENT CONCERNS: A pair of extremely low birth weight twins presented with TTTS. DIAGNOSES: Both twins developed late-onset adrenal insufficiency with oliguria, hypotension, hyponatremia, and pulmonary edema at a postnatal age of 24 days and 51 days, respectively. INTERVENTION: Temporary administration of intravenous hydrocortisone was initiated. OUTCOMES: Their symptoms improved dramatically and they survived the event without any neurologic sequelae after 3 years of follow-up. LESSONS: Late-onset circulatory collapse may occur, especially in extremely preterm infants, even at 2 months after birth. Hydrocortisone therapy is an effective treatment to rescue circulatory collapse caused by adrenal insufficiency in preterm infants and may not affect long-term neuromotor and cognitive outcomes.
[Mh] Termos MeSH primário: Insuficiência Adrenal
Hidrocortisona/administração & dosagem
Lactente Extremamente Prematuro
Choque/tratamento farmacológico
[Mh] Termos MeSH secundário: Corticosteroides/administração & dosagem
Insuficiência Adrenal/complicações
Insuficiência Adrenal/diagnóstico
Insuficiência Adrenal/tratamento farmacológico
Insuficiência Adrenal/fisiopatologia
Feminino
Seguimentos
Idade Gestacional
Seres Humanos
Lactente
Recém-Nascido de Peso Extremamente Baixo ao Nascer
Recém-Nascido
Choque/diagnóstico
Choque/etiologia
Choque/fisiopatologia
Taiwan
Resultado do Tratamento
Gêmeos Monozigóticos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008686



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