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  1 / 17227 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


  2 / 17227 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


  3 / 17227 MEDLINE  
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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


  4 / 17227 MEDLINE  
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[PMID]:29465593
[Au] Autor:Lou X; Lu G; Zhao M; Jin P
[Ad] Endereço:Emergency Department.
[Ti] Título:Preoperative fluid management in traumatic shock: A retrospective study for identifying optimal therapy of fluid resuscitation for aged patients.
[So] Source:Medicine (Baltimore);97(8):e9966, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Fluid resuscitation was used on aged patients with traumatic shock in their early postoperative recovery. The present study aimed to assess whether different fluid resuscitation strategies had an influence on aged patients with traumatic shock.A total of 219 patients with traumatic shock were recruited retrospectively. Lactated Ringer and hydroxyethyl starch solution were transfused for fluid resuscitation before definite hemorrhagic surgery. Subjects were divided into 3 groups: group A: 72 patients were given aggressive fluid infusion at 20 to 30 mL/min to restore normal mean arterial pressure (MAP) of 65 to 75 mm Hg. Group B: 72 patients were slowly given restrictive hypotensive fluid infusion at 4 to 5 mL/min to maintain MAP of 50 to 65 mm Hg. Group C: 75 patients were given personalized infusion to achieve MAP of 75 to 85 mm Hg. Preoperative infusion volume, preoperative MAP, optimal initial points for surgery, postoperative shock time and mortality rates at 6 and 24 hours after surgery were determined.No significant difference in clinical characteristics was found among the 3 groups. Amount of preoperative infusion was considerably lower in the restrictive group (P < .01, compared with group A). A significant difference in preoperative infusion volume was found between the personalized and other 2 groups (P < .01, compared with groups A and B). Patients in the personalized resuscitation group achieved a higher preoperative MAP (P < .01 compared with Group B; P < .05, compared with group A) and required less prepared time for surgery (P < .01 compared with groups A and B). In addition, a lower mortality rate at 6 and 24 hours after operation was observed in the subjects with personalized therapy (P < .05, compared with group B).Personalized management of fluid resuscitation in traumatized aged patients with appropriate volume and speed of fluid transfusion, suggesting increased survival rate and less prepared time for surgery.
[Mh] Termos MeSH primário: Hidratação/métodos
Cuidados Pré-Operatórios/métodos
Ressuscitação/métodos
Choque Traumático/terapia
[Mh] Termos MeSH secundário: Idoso
Pressão Arterial
Feminino
Seres Humanos
Derivados de Hidroxietil Amido/administração & dosagem
Soluções Isotônicas/administração & dosagem
Masculino
Período Pré-Operatório
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydroxyethyl Starch Derivatives); 0 (Isotonic Solutions); 8022-63-7 (Ringer's lactate)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009966


  5 / 17227 MEDLINE  
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[PMID]:29424979
[Au] Autor:Germes-Piña F; Acosta-Orozco DM; Flores-Franco RA; Verdugo-Castro PN
[Ti] Título:[Pneumomediastinum associated with hyperemesis gravidarum: a case report].
[Ti] Título:Neumomediastino secundario a hiperémesis gravídica: reporte de un caso..
[So] Source:Ginecol Obstet Mex;84(9):586-92, 2016 Sep.
[Is] ISSN:0300-9041
[Cp] País de publicação:Mexico
[La] Idioma:spa
[Ab] Resumo:Background: The hyperemesis gravidarum is a severe illness of nauseas and vomit that is present in the first trimester of the pregnancy, it has an incidence of 0.3 to 2%, it has been associated to weight loss, electrolytic disturbances, ketonuria, dehydration and in very seldom cases spontaneous pneumomediastinum. Clinical case: A 21 years old female patient, primigest, in the first trimester of gestation, she started her disease with nauseas and vomiting more than 15 times during 6 hours period, odynophagia, dysphonia and pain in the cervical region, loss of 5 kilograms in the last month. The physical examination showed the patient in bad conditions, dehydration, neck with volume increased and emphysema subcutaneus, crakles until torax. Laboratory findings with hypokalemia, leukocytosis, acute kidney failure, and elevation of hepatic enzymes. The initial treatment was with intravenous fluids resuscitation, hydroelectrolytic balance restoration, antiemetic treatment and rest, it was taken TC of neck and torax, and was exclude any laryngeal and esophageal injury and perforation, but it showed air in the mediastinum. Conservative management with favorable evolution and completed resolution in 7 days. Conclusion: It is very important that the medical doctor must keep in mind the different diagnosis of and take an opportune decision in case of present those complications potentially fatal to the mother.
[Mh] Termos MeSH primário: Hiperêmese Gravídica/complicações
Enfisema Mediastínico/etiologia
Complicações na Gravidez/diagnóstico
[Mh] Termos MeSH secundário: Antieméticos/administração & dosagem
Diagnóstico Diferencial
Feminino
Hidratação/métodos
Seres Humanos
Hiperêmese Gravídica/diagnóstico
Hiperêmese Gravídica/terapia
Enfisema Mediastínico/diagnóstico
Enfisema Mediastínico/terapia
Gravidez
Complicações na Gravidez/terapia
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiemetics)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180210
[St] Status:MEDLINE


  6 / 17227 MEDLINE  
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[PMID]:29390270
[Au] Autor:Zhao X; Li Y; Kong HY; Zhang L; Wen XH
[Ad] Endereço:Department of Anesthesiology, Zhejiang University International Hospital, Hangzhou.
[Ti] Título:Anesthetic management of off-pump simultaneous coronary artery bypass grafting and lobectomy: Case report and literature review.
[So] Source:Medicine (Baltimore);96(50):e8780, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Survey data show approximately 10% patients with lung cancer may present concomitant coronary heart disease. Simultaneous surgery is a challenge for anesthetist. We review our experience in the anesthesia with 5 patients who required simultaneous off-pump coronary artery bypass grafting (OPCABG) and pulmonary resection for lung cancer. PATIENT CONCERNS: Between 2014 and 2016, 5 patients with ASA (American Society of Anesthesiologists) grade II or III, underwent combined OPCABG and lung resection in the first Affiliated Hospital, Zhejiang University School of Medicine. DIAGNOSES: All five patients were diagnosed with coronary heart disease and peripheral pulmonary carcinoma INTERVENTIONS:: Five patients received general anesthesia with double-lumen endobronchial tube for lung separation. The anesthetics were used, which caused slight hemodynamic fluctuations during induction of anesthesia; while during the maintenance of anesthesia, supplemented by Dexmedetomidine, the drug doses were titrated according to the depth of anesthesia. Guided by cardiac index (CI), stroke volume variation (SVV) and oxygen delivery (DO2), different strategies were taken at the different stage of surgery, during lung resection, SVV was kept about 13% to 15%, and less than 10% during OPCABG. OUTCOMES: Five patients were transferred to intensive care unit (ICU) with intubation after surgery, duration of ventilation was 10 to 18 hours, and length of ICU stay and hospital stay were 1.8 to 2.5 ds and 11 to 16 ds, respectively. All of patients were discharged with not any perioperative complication. LESSONS: In summary, anesthetists should focus on the maintenance of the balance between oxygen supply and demanding, which was achieved by close monitoring, titration of anesthetics and goal-directed fluid therapy during surgical procedures.
[Mh] Termos MeSH primário: Anestesia Geral
Ponte de Artéria Coronária sem Circulação Extracorpórea
Pneumonectomia
[Mh] Termos MeSH secundário: Adenocarcinoma/cirurgia
Idoso
Carcinoma de Células Escamosas/cirurgia
Doença da Artéria Coronariana/cirurgia
Feminino
Hidratação
Seres Humanos
Neoplasias Pulmonares/cirurgia
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008780


  7 / 17227 MEDLINE  
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[PMID]:29465577
[Au] Autor:Peng T; Hu Z; Yang X; Gao Y; Ma C
[Ad] Endereço:Department of Nephrology, Shandong University Qilu Hospital, Jinan City, China.
[Ti] Título:Nitrite-induced acute kidney injury with secondary hyperparathyroidism: Case report and literature review.
[So] Source:Medicine (Baltimore);97(8):e9889, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Acute kidney injury (AKI) with hyperparathyroidism caused by nitrite was rare, and renal function and parathyroid hormone (PTH) decreased to normal range after therapy. PATIENT CONCERNS: Acute kidney injury was diagnosed in a 40-year-old male with hyperparathyroidism and cyanosis of his hands and both forearms. DIAGNOSES: The patient ate some recently pickled vegetables, and he experienced nausea, vomiting and diarrhoea without oliguria or anuria; Additionally, his hands and both forearms had a typical blue ash appearance. After admission, the laboratory findings indicated theincreasing serum creatinine (Scr) and parathyroid hormone (PTH). He was diagnosed as acute kidney injury with hyperparathyroidism caused by nitrite. INTERVENTIONS: The patient stopped eating the pickled vegetables and was given rehydration, added calories and other supportive therapy without any glucocorticoids. OUTCOMES: According to his clinical manifestations, laboratory findings and imaging results, the patient was diagnosed with acute kidney injury with secondary hyperparathyroidism. He was given symptomatic supportive care therapy. After one week, the serum creatinine, parathyroid hormone (PTH), hypercalcemia, hyperphosphatemia, proteinuria, and urine red blood cell values decreased to normal range. LESSONS: Nitrite-induced acute kidney injury with secondary hyperparathyroidism was relatively rare. After therapy, the function of the kidney and parathyroid returned to normal. This case suggests that detailed collection of medical history, physical examination and correct symptomatic treatment is very important.
[Mh] Termos MeSH primário: Lesão Renal Aguda/induzido quimicamente
Hiperparatireoidismo Secundário/induzido quimicamente
Nitritos/envenenamento
[Mh] Termos MeSH secundário: Lesão Renal Aguda/terapia
Adulto
Cianose/induzido quimicamente
Diarreia/induzido quimicamente
Hidratação
Conservação de Alimentos
Seres Humanos
Hiperparatireoidismo Secundário/terapia
Masculino
Náusea/induzido quimicamente
Apoio Nutricional
Vômito/induzido quimicamente
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Nitrites)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180227
[Lr] Data última revisão:
180227
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009889


  8 / 17227 MEDLINE  
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[PMID]:28471112
[Au] Autor:Yao F; Lu YQ; Jiang JK; Gu LH; Mou HZ
[Ad] Endereço:Department of Emergency Medicine, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China.
[Ti] Título:Immune recovery after fluid resuscitation in rats with severe hemorrhagic shock.
[So] Source:J Zhejiang Univ Sci B;18(5):402-409, 2017 May.
[Is] ISSN:1862-1783
[Cp] País de publicação:China
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To investigate the effects of resuscitation with normal saline (NS), hypertonic saline (HTS), and hydroxyethyl starch (HES) on regulatory T cells (Tregs), helper T 1 (Th1)/Th2 and cytotoxic T 1 (Tc1)/Tc2 profiles in the treatment of hemorrhagic shock. METHODS: Rats subjected to severe hemorrhagic shock were resuscitated for 30 min with NS (n=8), HTS (n=8), or HES (n=8); sham (n=8) and naive control (n=8) groups were used for comparison. Following fluid resuscitation, the whole shed blood was reinfused for 30 min, and the rats were observed with continuous hemodynamic monitoring for 120 min. CD4 CD25 Foxp3 Treg proportions, Th1/Th2 and Tc1/Tc2 profiles in spleen were analyzed by three-color flow cytometry. RESULTS: The proportion of CD4 CD25 Foxp3 Tregs and ratios of Th1/Th2 and Tc1/Tc2 did not differ among control, sham, and HTS groups, but were significantly lower in NS and HES groups (both P<0.05 vs. sham); NS and HES levels were similar. The level of Tc1 was significantly increased in HTS (P<0.05 vs. sham), and levels of Tc2 were increased in NS, HES, and HTS groups compared to sham (all P<0.05), but did not differ from each other. CONCLUSIONS: HTS resuscitation has a greater impact on immune system recovery than NS or HES by preserving the proportion of Tregs and maintaining the balance between Th1/Th2 and Tc1/Tc2 cells in the spleen. Thus, HTS resuscitation provides potential immunomodulatory activity in the early stage after hemorrhagic shock.
[Mh] Termos MeSH primário: Hidratação/métodos
Derivados de Hidroxietil Amido/administração & dosagem
Ressuscitação/métodos
Solução Salina Hipertônica/administração & dosagem
Choque Hemorrágico/imunologia
Choque Hemorrágico/terapia
Cloreto de Sódio/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Imunidade Inata/imunologia
Fatores Imunológicos/administração & dosagem
Masculino
Ratos
Ratos Sprague-Dawley
Recuperação de Função Fisiológica/efeitos dos fármacos
Recuperação de Função Fisiológica/imunologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydroxyethyl Starch Derivatives); 0 (Immunologic Factors); 0 (Saline Solution, Hypertonic); 451W47IQ8X (Sodium Chloride)
[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.B1600370


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[PMID]:29450521
[Au] Autor:Semler MW; Andrews B; Bernard GR
[Ad] Endereço:Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee.
[Ti] Título:Early Resuscitation for Adults With Sepsis in a Low-income Country-Reply.
[So] Source:JAMA;319(6):614-615, 2018 02 13.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ressuscitação
Sepse
[Mh] Termos MeSH secundário: Adulto
Hidratação
Seres Humanos
Pobreza
Choque Séptico
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180217
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20410


  10 / 17227 MEDLINE  
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[PMID]:29450518
[Au] Autor:Nedel WL; Deutschendorf C
[Ad] Endereço:Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
[Ti] Título:Early Resuscitation for Adults With Sepsis in a Low-Income Country.
[So] Source:JAMA;319(6):614, 2018 02 13.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Ressuscitação
Sepse
[Mh] Termos MeSH secundário: Adulto
Hidratação
Seres Humanos
Pobreza
Choque Séptico
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180223
[Lr] Data última revisão:
180223
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180217
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.20406



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