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Shock Index

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181. Determinants and prognosis of high-sensitivity cardiac troponin T peak plasma concentration in patients hospitalized for non-cardiogenic shock Full Text available with Trip Pro

patients were hospitalized in the intensive care unit for non-cardiogenic shock and the median peak high-sensitivity cardiac troponin T was 55.1 [24.5-136] pg/mL. A multivariate analysis combining all variables showed that higher body mass index (t = 2.52, P = 0.01), lower left ventricular systolic function (t = -2.73, P = 0.007), higher white blood cell count (t = 3.72, P = 0.0001), lower creatinine clearance (t = -2.84, P = 0.0005), higher lactate level (t = 2.62, P = 0.01) and ST-segment depression (...) Determinants and prognosis of high-sensitivity cardiac troponin T peak plasma concentration in patients hospitalized for non-cardiogenic shock The aim of this study was to assess the determinants and prognostic value of high-sensitivity cardiac troponin T peak plasma concentration in intensive care unit patients with non-cardiogenic shock.A prospective observational cohort study was conducted in a single intensive care unit between November 2014 and December 2015.During the study period, 206

2018 SAGE open medicine

182. Midazolam increases preload dependency during endotoxic shock in rabbits by affecting venous vascular tone Full Text available with Trip Pro

Midazolam increases preload dependency during endotoxic shock in rabbits by affecting venous vascular tone Septic patients often require sedation in intensive care unit, and midazolam is one of the most frequently used sedatives among them. But the interaction between midazolam and septic shock is not known. The aim of this study is to investigate the effects of midazolam on preload dependency in an endotoxic shock model by evaluating systemic vascular tone and cardiac function.Eighteen rabbits (...) were randomly divided into three groups: Control group, MID1 group and MID2 group. Rabbits underwent ketamine anaesthesia and mechanical ventilation, and haemodynamic assessments were recorded in three groups (T0). Endotoxic shock was induced by lipopolysaccharide intravenously, and fluid resuscitation and norepinephrine were administered to obtain the baseline mean arterial pressure (MAP) (T1). Rabbits received equivalent normal saline (Control) and two consecutive dosages of midazolam: 0.3 mg kg

2018 Annals of intensive care

183. Tensile Property of ANSI 304 Stainless Steel Weldments Subjected to Cavitation Erosion Based on Treatment of Laser Shock Processing Full Text available with Trip Pro

Tensile Property of ANSI 304 Stainless Steel Weldments Subjected to Cavitation Erosion Based on Treatment of Laser Shock Processing Tensile property was one important index of mechanical properties of ANSI 304 stainless steel laser weldments subjected to cavitation erosion (CE). Laser shock processing (LSP) was utilized to strengthen the CE resistance, and the tensile property and fracture morphology were analyzed through three replicated experiment times. Results showed tensile process

2018 Materials

184. Role of Combining Peripheral with Sublingual Perfusion on Evaluating Microcirculation and Predicting Prognosis in Patients with Septic Shock Full Text available with Trip Pro

Role of Combining Peripheral with Sublingual Perfusion on Evaluating Microcirculation and Predicting Prognosis in Patients with Septic Shock Measurement of general microcirculation remains difficult in septic shock patients. The peripheral perfusion index (PI) and sublingual microcirculation monitoring are thought to be possible methods. This study was performed to determine whether assessing microcirculation by PI and a new parameter, proportion of perfusion vessel change rate (△PPV) from (...) sublingual microcirculation monitoring, can be associated with patients' outcome.A prospective observational study was carried out, including 74 patients with septic shock in a mixed intensive care unit. Systemic hemodynamic variables were obtained at T0 and 6 h after (T6). PI and sublingual microcirculation indicators were obtained using a bedside monitor and a sidestream dark-field device, respectively. The t-test, analysis of variance, Mann-Whitney U-test, Kruskal-Wallis test, receiver operating

2018 Chinese medical journal

185. Comparison Between Extracorporeal Shock Wave Therapy and Intra-articular Hyaluronic Acid Injections in the Treatment of First Carpometacarpal Joint Osteoarthritis Full Text available with Trip Pro

Comparison Between Extracorporeal Shock Wave Therapy and Intra-articular Hyaluronic Acid Injections in the Treatment of First Carpometacarpal Joint Osteoarthritis To compare extracorporeal shockwave therapy (ESWT) with hyaluronic acid (HA) intra-articular injections in terms of pain relief, improvement in hand function, and strength in subjects with first carpometacarpal (CMC) joint osteoarthritis.Fifty-eight patients received either focused ESWT or HA injection once a week for 3 consecutive (...) weeks. In the ESWT group, 2,400 consecutive pulses were performed during each treatment session using a frequency of 4 Hz and an energy flux density of 0.09 mJ/mm2. The HA group underwent one cycle of three injections of 0.5 cm3 HA. The main outcome measures were pain and hand function as measured by the visual analogue scale (VAS) and Duruoz Hand Index (DHI), respectively. The secondary outcomes were grip and pinch strength. Each assessment was performed at baseline, at the end of treatment

2018 Annals of rehabilitation medicine

186. Selective Osmotic Shock for Islet Isolation in the Cadaveric Canine Pancreas Full Text available with Trip Pro

Selective Osmotic Shock for Islet Isolation in the Cadaveric Canine Pancreas Currently, islet isolation is performed using harsh collagenases that cause nonspecific injury to both islets and exocrine tissue, negatively affecting the outcome of cell transplantation. We evaluated a novel islet isolation protocol utilizing high concentrations of glucose to cause selective osmotic shock (SOS). Islets have a membrane glucose transporter that allows adaptation to changes in glucose concentrations (...) of the mean islet yield for groups 1 to 4 was 428 ± 159, 560 ± 257, 878 ± 443, and 990 ± 394 islet equivalents per gram, respectively. Purity ranged from 37% to 45% without the use of density gradient centrifugation and was not significantly different between groups. Islet cell viability was excellent overall (89%) and did not differ between treatment protocol. Islet function was best in groups treated with 300 mOsm of glucose (stimulation index [SI] = 3.3), suggesting that the lower concentration

2018 Cell transplantation

187. Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock Full Text available with Trip Pro

were recorded at baseline, in haemorrhagic shock, and after resuscitation. Data are presented as median with interquartile range. Comparisons between time points were made using Friedman's test and the degree of correlation between two variables was expressed as Spearman's rank correlation coefficient.Mean arterial pressure and cardiac index (CI) decreased and lactate concentration increased after induction of shock, and haemodynamics recovered after resuscitation. The flow density (...) Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock This study aimed to investigate the feasibility of optical coherence tomography angiography (OCT-A) for quantitative analysis of flow density to assess changes in retinal perfusion in an experimental model of haemorrhagic shock.Haemorrhagic shock was induced in five healthy, anaesthetized sheep by stepwise blood withdrawal of 3 × 10 ml∙kg- 1 body weight. OCT

2018 Critical Care

188. ET-26 hydrochloride (ET-26 HCl) has similar hemodynamic stability to that of etomidate in normal and uncontrolled hemorrhagic shock (UHS) rats. Full Text available with Trip Pro

on therapeutic index, heart rate (HR), mean arterial pressure (MAP), maximal rate for left ventricular pressure rise (Dmax/t), and maximal rate for left ventricular pressure decline (Dmin/t) were investigated in healthy rats and a rat model of uncontrolled hemorrhagic shock (UHS).50% effective dose (ED50) and 50% lethal dose (LD50) were determined after single bolus doses of propofol, etomidate, or ET-26 HCl using the Bliss method and the up and down method, respectively. All rats were divided into either (...) ET-26 hydrochloride (ET-26 HCl) has similar hemodynamic stability to that of etomidate in normal and uncontrolled hemorrhagic shock (UHS) rats. ET-26 HCl is a promising sedative-hypnotic anesthetic with virtually no effect on adrenocortical steroid synthesis. However, whether or not ET-26 HCl also has a sufficiently wide safety margin and hemodynamic stability similar to that of etomidate and related compounds remains unknown. In this study, the effects of ET-26 HCl, etomidate and propofol

2017 PLoS ONE

189. Prognostic Value of Secretoneurin in Patients With Severe Sepsis and Septic Shock: Data From the Albumin Italian Outcome Sepsis Study. Full Text available with Trip Pro

Prognostic Value of Secretoneurin in Patients With Severe Sepsis and Septic Shock: Data From the Albumin Italian Outcome Sepsis Study. Secretoneurin directly influences cardiomyocyte calcium handling, and circulating secretoneurin levels seem to improve risk prediction in patients with myocardial dysfunction by integrating information on systemic stress, myocardial function, and renal function. Accordingly, in this study, we hypothesized that secretoneurin would improve risk prediction (...) in patients with sepsis and especially in patients with septic shock as these patients are more hemodynamically unstable.Multicenter, interventional randomized clinical trial.Multicenter, pragmatic, open-label, randomized, prospective clinical trial testing fluid administration with either 20% human albumin and crystalloids or crystalloid solutions alone in patients with severe sepsis or septic shock (The Albumin Italian Outcome Sepsis).In total, 540 patients with septic shock and 418 patients with severe

2018 Critical Care Medicine Controlled trial quality: uncertain

190. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock Full Text available with Trip Pro

and consumption, gastric mucosal PCO 2 , RBC velocity, or skin capillary flow. Another single-center ( ) trial compared, in norepinephrine-treated septic shock , dose titration to maintain MAP at 65 mm Hg versus achieving 85 mm Hg. In this trial, targeting high MAP increased cardiac index from 4.8 (3.8–6.0) to 5.8 (4.3–6.9) L/min/m 2 but did not change renal function, arterial lactate levels, or oxygen consumption. A third single-center trial ( ) found improved microcirculation, as assessed by sublingual (...) , including small study size, using an initial index time of an arbitrary time point such as emergency department arrival, and indexing of outcome to delay in time to the first antimicrobial (regardless of activity against the putative pathogen) ( , ). Other negative studies not included in this meta-analysis are compromised by equating bacteremia with sepsis (as currently defined to include organ failure) and septic shock ( ). Many of these studies are also compromised by indexing delays to easily

2016 European Respiratory Society

191. Advanced non-contrasted computed tomography post-processing by CT-Calculometry (CT-CM) outperforms established predictors for the outcome of shock wave lithotripsy. (Abstract)

Advanced non-contrasted computed tomography post-processing by CT-Calculometry (CT-CM) outperforms established predictors for the outcome of shock wave lithotripsy. To evaluate the predictive value of advanced non-contrasted computed tomography (NCCT) post-processing using novel CT-calculometry (CT-CM) parameters compared to established predictors of success of shock wave lithotripsy (SWL) for urinary calculi.NCCT post-processing was retrospectively performed in 312 patients suffering from (...) upper tract urinary calculi who were treated by SWL. Established predictors such as skin to stone distance, body mass index, stone diameter or mean stone attenuation values were assessed. Precise stone size and shape metrics, 3-D greyscale measurements and homogeneity parameters such as skewness and kurtosis, were analysed using CT-CM. Predictive values for SWL outcome were analysed using logistic regression and receiver operating characteristics (ROC) statistics.Overall success rate (stone

2018 World journal of urology

192. High- versus low-energy extracorporeal shock-wave therapy for myofascial pain syndrome of upper trapezius: A prospective randomized single blinded pilot study. Full Text available with Trip Pro

High- versus low-energy extracorporeal shock-wave therapy for myofascial pain syndrome of upper trapezius: A prospective randomized single blinded pilot study. To compare the efficacy of high- and low-energy extracorporeal shock wave therapy (ESWT) for patients with myofascial pain syndrome (MPS) of the upper trapezius.Thirty patients (3 men, 27 women) were randomly assigned to receive either high-energy ESWT (0.210 mJ/mm) or low-energy ESWT (0.068 mJ/mm). Both groups received 1500 pulses (...) of ESWT once a week, for 2 weeks. Outcome measurement was assessed by verbal numeric pain scale (VNS), neck disability index (NDI), neck range of motion (ROM) (flexion, extension, rotation, lateral bending), and pressure threshold (PT). Statistical analysis was performed with significance level of P < .05.No statistically significant differences of demographic and clinical characteristics existed between the 2 groups. VNS, NDI, neck ROM (rotation to sound side, lateral bending to affected side

2018 Medicine Controlled trial quality: uncertain

193. Microcirculatory Impairment Is Associated With Multiple Organ Dysfunction Following Traumatic Hemorrhagic Shock: The MICROSHOCK Study. (Abstract)

curve 0.87 [0.76-0.99]) compared with highest recorded lactate (area under curve 0.69 [0.53-0.84]), cardiac index (area under curve 0.66 [0.49-0.83]) and lowest recorded systolic blood pressure (area under curve 0.54 [0.39-0.70]).Microcirculatory hypoperfusion immediately following traumatic hemorrhagic shock and resuscitation is associated with increased multiple organ dysfunction syndrome. Microcirculatory variables are better prognostic indicators for the development of multiple organ dysfunction (...) Microcirculatory Impairment Is Associated With Multiple Organ Dysfunction Following Traumatic Hemorrhagic Shock: The MICROSHOCK Study. To assess the relationship between microcirculatory perfusion and multiple organ dysfunction syndrome in patients following traumatic hemorrhagic shock.Multicenter prospective longitudinal observational study.Three U.K. major trauma centers.Fifty-eight intubated and ventilated patients with traumatic hemorrhagic shock.Sublingual incident dark field microscopy

2018 Critical Care Medicine

194. Pseudoaneurysm rupture with hemorrhagic shock in a patient with periprosthetic hip joint infection: A case report. Full Text available with Trip Pro

should have an elevated index of suspicion in the presence of intrapelvic migration of the acetabular component. While facing a PA rupture with/without hemorrhagic shock in patients with coexisting hip PJI, ALCS ball implantation and subsequent ESGR might be an effective method to save the patient's life and limb. (...) Pseudoaneurysm rupture with hemorrhagic shock in a patient with periprosthetic hip joint infection: A case report. Although pseudoaneurysm (PA) formation following primary and revision total hip arthroplasty (THA) is rare, PA rupture may lead to severe complications that can result in a threat to life and limb.A 65-year-old man presented with acute hemorrhagic discharge for one day from the chronic hip sinus secondary to revision THA that had been performed 6 years ago, for which he had

2018 Medicine

195. Predictors of intra-aortic balloon pump hemodynamic failure in non-acute myocardial infarction cardiogenic shock. Full Text available with Trip Pro

from 2010 to 2015 who underwent IABP insertion for cardiogenic shock complicating acute decompensated heart failure not due to AMI.In the overall cohort, which consisted primarily of patients with chronic systolic heart failure (89%), IABP significantly augmented cardiac index and lowered systemic vascular resistance (P<.05). Despite this improvement, 28% of these patients died (24%) or require urgent escalation in mechanical circulatory support (MCS) (4%). Multivariable regression revealed (...) Predictors of intra-aortic balloon pump hemodynamic failure in non-acute myocardial infarction cardiogenic shock. To characterize patient profile and hemodynamic profile of those undergoing intra-aortic balloon pump (IABP) for cardiogenic shock and define predictors of hemodynamic failure of IABP support.Clinical characteristics of IABP support in cardiogenic shock not related to acute myocardial infarction (AMI) remain poorly characterized.We retrospectively studied a cohort of 74 patients

2018 American Heart Journal

196. Evolution of Acute Kidney Injury and Its Association With Systemic Hemodynamics in Children With Fluid-Refractory Septic Shock. (Abstract)

Evolution of Acute Kidney Injury and Its Association With Systemic Hemodynamics in Children With Fluid-Refractory Septic Shock. There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock.Prospective cohort study.PICU of a tertiary care hospital.All patients with fluid-refractory septic (...) shock (n = 61) between September 2010 and February 2014.Hemodynamic variables using noninvasive ultrasound cardiac output monitor were measured at admission and 6 hourly thereafter till 48 hours. We used the Kidney Disease: Improving Global Outcomes criteria to define and stage acute kidney injury. Associations between various hemodynamic variables and development of acute kidney injury were evaluated. Severe acute kidney injury was defined as stage 2 or 3 acute kidney injury and was compared

2018 Critical Care Medicine

197. Three dimensional texture analysis with machine learning provides incremental predictive information for successful shock wave lithotripsy in patients with kidney stones. Full Text available with Trip Pro

included in study. A total of 224, 3-dimensional texture analysis features of each kidney stone, including attenuation measured in HU and the clinical variables body mass index, initial stone size and skin to stone distance, were analyzed using 5 commonly used machine learning models. The data set was split in a ratio of 2/3 for model derivation and 1/3 for validation. Machine learning based predictions of shock wave lithotripsy success in the validation cohort were evaluated by calculating sensitivity (...) , specificity and the AUC.For shock wave lithotripsy success the 3 clinical variables body mass index, initial stone size and skin to stone distance showed an AUC of 0.68, 0.58 and 0.63, respectively. No predictive value was found for HU. A random forest classifier using 3, 3-dimensional texture analysis features had an AUC of 0.79. By combining these 3 features with clinical variables discriminatory accuracy improved further with an AUC of 0.85 for 3-dimensional texture analysis features and skin to stone

2018 Journal of Urology

198. The effects of physical therapy with neuromuscular electrical stimulation in patients with septic shock: Study protocol for a randomized cross-over design. Full Text available with Trip Pro

The effects of physical therapy with neuromuscular electrical stimulation in patients with septic shock: Study protocol for a randomized cross-over design. Septic shock is a potentially fatal organ dysfunction caused by an imbalance of the host response to infection. The changes in microcirculation during sepsis can be explained by the alterations in the endothelial barrier function. Endothelial progenitor cells (EPCs) are a potential recovery index of endothelial function and it an increase (...) in response to neuromuscular electrical stimulation (NMES) was demonstrated. Therefore, the objective of this study is to investigate the effects of NMES in patients with septic shock.It is a study protocol for a randomized cross-over design in an intensive care unit of a tertiary University hospital. Thirty-one patients aged 18 to 65 years. The study will be divided in 2 phases: the phase one will be held in the first 72 hours of septic shock and the phase two after 3 days of first assessment. Patients

2018 Medicine Controlled trial quality: uncertain

199. Extracorporeal shock wave treatment can normalize painful bone marrow edema in knee osteoarthritis: A comparative historical cohort study. Full Text available with Trip Pro

Extracorporeal shock wave treatment can normalize painful bone marrow edema in knee osteoarthritis: A comparative historical cohort study. Bone marrow edema (BME) represents a reversible but highly painful finding in magnetic resonance imaging (MRI) of patients with knee osteoarthritis. The aim of this retrospective study was to evaluate the efficacy of extracorporeal shock wave treatment (ESWT) on painful BME in osteoarthritis of the knee.This study focuses on people who had early-to-mid stage (...) osteoarthritis with knee pain and MRI findings of BME. Patients who underwent ESWT treatment or prescribed alendronate treatment in our department were analyzed. Knee pain and function were measured using the visual analog scale (VAS) for pain and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), respectively. The degree of BME was measured with MRI scans.A total of 126 patients who received ESWT treatment (Group A, n = 82) or alendronate treatment (Group B, n = 44) were included. All

2018 Medicine

200. National Cardiogenic Shock Initiative

infarction) coronary blood flow during index PCI (percutaneous coronary intervention) in culprit lesions. Wean off Vasopressors & Inotropes [ Time Frame: At index PCI (percutaneous coronary intervention), 12-hours post-PCI, 24-hours post-PCI ] Ability to wean off vasopressor & inotropic medication use in patients being treated with early MCS (mechanical circulatory support) during treatment for AMICS (acute myocardial infarction with cardiogenic shock). Maintain CPO >0.6 Watts [ Time Frame: At index PCI (...) myocardial infarction (STEMI) or non-S-T elevation myocardial infarction (NSTEMI) Cardiogenic shock is defined as the presence of at least two of the following: Hypotension (systolic blood pressure ≤90 mm Hg, or inotropes/vasopressors to maintain systolic blood pressure ≥90 mmHg) Signs of end organ hypoperfusion (cool extremities, oliguria or anuria, or elevated lactate levels) Hemodynamic criteria represented by a cardiac index of <2.2 L/min/m2 or a cardiac power output ≤0.6 watts. Patient is supported

2018 Clinical Trials

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