Tag: infusion

Upvote Story 9
Convulsive status epilepticus (CSE) is the most common life-threatening childhood neurological emergency. Despite this, there is a lack of high quality evidence supporting medication use after first line benzodiazepines, with current treatment protocols based solely on non-experimental evidence and expert opinion. The current standard of care, phenytoin, is only 60% effective, and associated with considerable adverse effects. A newer anti-convulsant, levetiracetam, can be given faster,... Read More | Comment
Upvote Story 6
Propofol, dexmedetomidine, and opioids are commonly used for patients requiring continuous sedation or analgesia, such as for those receiving mechanical ventilation. Although these medications are generally safe, some may be unable to tolerate them due to hemodynamic status. Ketamine is a rapid acting, dissociative anesthetic used frequently in the emergency department for sedation and, more recently, pain relief. Ketamine use during procedural sedation in the... Read More | Comment
Upvote Story 9
Intravenous caffeine is able to accelerate emergence from isoflurane anesthesia in healthy males without any apparent adverse effects. All randomized participants were included in the analysis. The mean time to emergence with saline was 16.5 ± 3.9 (SD) min compared to 9.6 ± 5.1 (SD) min with caffeine (P = 0.002), a difference of 6.9 min (99% CI, 1.8 to 12), a 42% reduction. Participants emerged at a higher expired... Read More | Comment
Upvote Story 7
Although administration of clonidine is often associated with bradycardia and hypotension, these complications do not seem clinically significant in a mixed PICU population with a high degree of disease severity. Clonidine may have a vasoactive-inotropic sparing effect. The primary endpoints were the prevalences of bradycardia and hypotension. Secondary endpoints were changes in heart rate, blood pressure, Vasoactive-Inotropic Score, COMFORT Behavior score (a sedation scoring scale),... Read More | Comment
Upvote Story 4
Implementation of bolus medications from continuous infusion in PICUs significantly decreased time to begin a bolus dose and increased nursing satisfaction. The practice change also improved medication utilization without negatively impacting patient safety. Timing studies were conducted pre- and post implementation in 29 and 26 occurrences, respectively. The median time from the decision to give a bolus until it began infusing decreased by 169 seconds. Read More | Comment
Upvote Story 16
Saline vs. balanced solutions has been a topic of ongoing debate. Two fresh studies will illuminate this: the SMART and SALT-ED trials. This post summarizes current knowledge, beginning with physiology and working our way to fresh trials. Saline is a hypertonic, acidotic fluid (it’s not “normal”). There is no physiologic reason that infusing it into people is a smart idea. Read More | Comment
Upvote Story 6
Johns Hopkins clinicians and engineers are creating a model for a safer, less costly and more productive clinical unit that can be adopted anywhere. With clinicians spending less time on documenting and gathering supplies, productivity will improve and burnout will be less common. They will focus on what they do best – diagnosing, treating, comforting – but with the support of predictive analytics and precision... Read More | Comment
Upvote Story 7
Sodium lactate has been shown to improve hemodynamics and avoid fluid overload. The objective of this study was to confirm a beneficial effect on fluid balance with sodium lactate infusion and to specify whether the advantage of lactate is related to a negative chloride balance, its particular metabolism, or simply its energy load. This was an interventional, randomized, open-label, controlled experimental study. Fifteen female “large... Read More | Comment
Upvote Story 7
Providing supplemental amino acids to ICU patients during a 3-h period results in improved whole-body net protein balance, without an increase in amino acid oxidation. The primary objective was to investigate if a 24-h intravenous amino acid infusion in critically ill patients has a sustained effect on whole-body protein balance as was seen after 3 h. Secondary objectives were monitoring of amino acid oxidation rate,... Read More | Comment
Upvote Story 7
Volume therapy can be managed according to the fluid balance method, the outcome-guided method, or the goal-directed method. One reason why fluid is needed is that anesthesia disrupts the normal autonomic control of the circulation, whereby redistribution of blood flows may cause local ischemia. General adverse effects of fluid infusion include acute hemodynamic overload, hypothermia, and dilution coagulopathy. Although peripheral edema is caused by both... Read More | Comment
Upvote Story 5
Intraoperative infusion of dexmedetomidine for prevention of postoperative delirium and cognitive dysfunction in elderly patients undergoing major elective non-cardiac surgery. Postoperative delirium occurs in 10% to 60% of elderly patients having major surgery and is associated with longer hospital stays, increased hospital costs, and 1-year mortality. Emerging literature suggests that dexmedetomidine sedation in critical care units is associated with reduced incidence of delirium. However, intraoperative... Read More | Comment
Upvote Story 7
Fluid loading is usually the first step in the resuscitation of patients with acute circulatory failure. Fluid responsiveness is defined as the ability of the left ventricle to increase its stroke volume in response to fluid administration. Studies have shown that only about 50% of unstable critically ill patients will actually respond positively to a fluid challenge. Uncorrected hypovolemia may result in inappropriate administration of... Read More | Comment
Upvote Story 8
Thirty patients were included, 24 with moderate ARDS and 6 with severe ARDS. NMBA infusion was associated with an improvement in oxygenation in both moderate and severe ARDS, accompanied by a decrease in both plateau pressure and total positive end-expiratory pressure. The mean inspiratory and expiratory PL were higher in the moderate ARDS group receiving NMBA than in the control group. In contrast, there was... Read More | Comment
Upvote Story 2
Comparing the methodological rigor of more recent CIN studies to those in the past, it seems clear that earlier studies purporting a causal relationship between AKI and contrast administration were only identifying an association but not a true clinical entity. Older CIN studies were biased by confounding variables (e.g., hemodynamic instability, nephrotoxins), with well-established links to AKI providing a sufficient cause for AKI without implicating... Read More | Comment
Upvote Story 3
Serum concentrations of natalizumab do not appear to rise before patients with relapsing-remitting multiple sclerosis are diagnosed with progressive multifocal leukoencephalopathy, contradicting the hypothesis that exposure to elevated concentrations of the drug is a risk factor for the disease, according to findings from a prospective, observational cohort study. Read More | Comment
Upvote Story 8
Plazomicin an antibiotic being developed to fight multidrug-resistant bacterial infections, has met the primary objective of noninferiority compared with meropenem in a phase 3 registration trial among patients with complicated urinary tract infections (cUTIs) and acute pyelonephritis (AP). The EPIC (Evaluating Plazomicin In cUTI) trial was a multinational, randomized, controlled, double-blind study in adults with complicated cUTIs and AP. Read More | Comment