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Shock Index

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141. [Clinical value of early liquid resuscitation guided by passive leg-raising test combined with transthoracic echocardiography in patients with septic shock]. (Abstract)

[Clinical value of early liquid resuscitation guided by passive leg-raising test combined with transthoracic echocardiography in patients with septic shock]. To explore the clinical value of early fluid resuscitation guided by passive leg-raising test (PLR) combined with transthoracic echocardiography (TTE) in patients with septic shock.A prospective randomized controlled trial (RCT) was conducted. Seventy-four patients with septic shock admitted to China-Japan Friendship Hospital from January (...) mmHg, urine volume ≥ 0.5 mL×kg-1×h-1, and central venous blood oxygen saturation (ScvO2) ≥ 0.70 within 6 hours. Vasoactive drugs were used when the patients could not achieve the treatment goals. The MAP, lactic acid (Lac), oxygenation index (PaO2/FiO2) and ScvO2 of the patients were determined at 6 hours of treatment, and serum C-reactive protein (CRP) and chest CT were reviewed at 48 hours of treatment, and compared with those before treatment. The total hospital stay and the mortality were

2019 Zhonghua wei zhong bing ji jiu yi xue Controlled trial quality: uncertain

142. [Effect of traditional Chinese medicine syndrome differentiation and standard bundle therapy in patients with septic shock]. (Abstract)

[Effect of traditional Chinese medicine syndrome differentiation and standard bundle therapy in patients with septic shock]. To evaluate an effective and feasible quantitative evaluation table of traditional Chinese medicine (TCM) syndrome differentiation, and to observe the effect of combination of TCM syndrome differentiation and standard bundle therapy in patients with septic shock.A prospective randomized controlled trial was conducted. The septic shock patients with acute deficiency (...) of TCM symptoms. The circulation and tissue perfusion, severity of disease, organ function, inflammation response, adjuvant treatment and 28-day mortality were compared between the two groups.A total of 50 patients with septic shock were enrolled in the analysis, 25 in control group and 25 in Shenfu group. The markedly effective rate of TCM symptoms score in Shenfu group was significantly higher than that in control group [60.0% (15/25) vs. 16.0% (4/25), P < 0.01]. There was no significant difference

2019 Zhonghua wei zhong bing ji jiu yi xue Controlled trial quality: uncertain

143. Outcomes in Cardiogenic Shock from Acute Coronary Syndrome Depending on Severity of Obesity. (Abstract)

Outcomes in Cardiogenic Shock from Acute Coronary Syndrome Depending on Severity of Obesity. We reviewed 54,044 adult cases of cardiogenic shock (CS) accompanying acute coronary syndrome from the 2005 to 2014 Nationwide Inpatient Sample. We evaluated outcomes among patients who were nonobese, obese (body mass index 30.0 to 39.9 kg/m2) and extremely-obese (body mass index ≥40 kg/m2). A multivariate analysis was performed to assess their impact on in-hospital mortality. There were 3,602 (6.6

2019 American Journal of Cardiology

144. Effect of Shen-Fu Injection () on Hemodynamics in Early Volume Resuscitation Treated Septic Shock Patients. (Abstract)

, there was no significant change of extra-vascular lung water index between the two groups (P>0.05).SFI significantly improved hemodynamic indices such as CI, GEDI, MAP and HR in early volume resuscitation treated septic shock patients. (...) Effect of Shen-Fu Injection () on Hemodynamics in Early Volume Resuscitation Treated Septic Shock Patients. To investigate the hemodynamic effect of Shen-Fu Injection (, SFI) in early volume resuscitation treated septic shock patients by monitoring pulse indicator continuous cardiac output (PICCO).All septic shock patients admitted in the Intensive Care Unit of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January 1st, 2014 to December 31th, 2015, were

2019 Chinese journal of integrative medicine

145. Radial extracorporeal shock wave device appearance does not influence clinical outcomes: A randomized controlled trial. Full Text available with Trip Pro

to give a more sophisticated appearance; group III, standard radial extracorporeal shock wave device modified to give a more austere appearance. The radial extracorporeal shock waves emitted by the 3 devices were identical. Primary outcome was foot function, measured with the Foot Function Index. Secondary outcomes were pain at different times, measured with a visual analogue scale, and plantar fascia thickness, measured with ultrasound.All variables decreased significantly from baseline assessment (...) Radial extracorporeal shock wave device appearance does not influence clinical outcomes: A randomized controlled trial. To determine whether the appearance of a radial extracorporeal shock wave device affects clinical outcomes in chronic plantar fasciitis.Randomized controlled parallel assessor-blinded clinical trial.A total of 135 patients were assigned to 3 groups: group I, standard radial extracorporeal shock wave device; group II, standard radial extracorporeal shock wave device modified

2019 Journal of Rehabilitation Medicine Controlled trial quality: predicted high

146. A double-blind, placebo-controlled, randomised, multicentre, proof-of-concept and dose-finding phase II clinical trial to investigate the safety, tolerability and efficacy of adrecizumab in patients with septic shock and elevated adrenomedullin concentrat Full Text available with Trip Pro

A double-blind, placebo-controlled, randomised, multicentre, proof-of-concept and dose-finding phase II clinical trial to investigate the safety, tolerability and efficacy of adrecizumab in patients with septic shock and elevated adrenomedullin concentrat Sepsis remains a major health problem with an increasing incidence, high morbidity and high mortality. Apart from treatment with antibiotics and organ support, no approved specific adjunct therapies currently exist. Adrenomedullin (ADM (...) ) is a vasoactive peptide. High plasma concentrations of ADM correlate with worse outcome in sepsis patients. Preclinical work with the non-neutralising ADM-binding antibody adrecizumab showed promising effects in animal models of septic shock, including improved vascular barrier function, reduced vasopressor demand and organ dysfunction and increased survival. Therapeutic use of adrecizumab may therefore improve outcome in critically ill patients with septic shock and high ADM plasma concentrations. Phase I

2019 BMJ open Controlled trial quality: predicted high

147. Pre-hospital mechanical ventilation in septic shock patients. (Abstract)

and retrospectively analysed. Septic shock was defined according to the international sepsis-3 consensus conference. Patient's characteristics, interventions, prehospital ventilatory parameters and outcome were retrieved from medical records. The association between the tidal volume indexed on ideal body weight (VTIBW) and mortality at day 28 was evaluated.Fifty-nine patients were included. Septic shock was mainly associated with pulmonary (64%) infection. Mean pre-hospital VTIBW was 7 ± 1 ml.kg-1 in the overall (...) Pre-hospital mechanical ventilation in septic shock patients. Mechanical ventilation can cause deleterious effects on the lung and thus alter patient's prognosis. The aim of this study was to describe the characteristics of prehospital mechanical ventilation in patients with septic shock requiring mechanical ventilation in the prehospital setting.Patients with septic shock subjected to pre-hospital intubation and mechanical ventilation by a mobile intensive care unit were consecutively included

2019 American Journal of Emergency Medicine

148. Effectiveness of Radial Extracorporeal Shock Wave Therapy (rESWT) When Combined With Supervised Exercises in Patients With Subacromial Shoulder Pain: A Double-Masked, Randomized, Sham-Controlled Trial (Abstract)

Effectiveness of Radial Extracorporeal Shock Wave Therapy (rESWT) When Combined With Supervised Exercises in Patients With Subacromial Shoulder Pain: A Double-Masked, Randomized, Sham-Controlled Trial Subacromial shoulder pain is a common complaint, and radial extracorporeal shock wave therapy (rESWT) is increasingly used to treat this condition. Although many therapists use rESWT in combination with supervised exercises, no studies have evaluated the additional effect of rESWT with supervised (...) ) by computer-generated randomization in blocks of 20 to receive either rESWT or sham rESWT in addition to supervised exercises. The rESWT and sham rESWT were performed once a week with additional supervised exercises once a week for the first 4 weeks. The following 8 weeks, the patients received supervised exercises twice a week. The primary outcome was change in the Shoulder Pain and Disability Index (SPADI) after 24 weeks. Patients and outcome assessors were masked to group assignment.At 24 weeks

2017 EvidenceUpdates

149. Standardized Team-Based Care for Cardiogenic Shock. Full Text available with Trip Pro

Standardized Team-Based Care for Cardiogenic Shock. Cardiogenic shock (CS) is a multifactorial, hemodynamically complex syndrome associated with high mortality. Despite advances in reperfusion and mechanical circulatory support, management remains highly variable and outcomes poor.This study investigated whether a standardized team-based approach can improve outcomes in CS and whether a risk score can guide clinical decision making.A total of 204 consecutive patients with CS were identified. CS (...) etiology, patient demographic characteristics, right heart catheterization, mechanical circulatory support use, and survival were determined. Cardiac power output (CPO) and pulmonary arterial pulsatility index (PAPi) were measured at baseline and 24 h after the CS diagnosis. Thresholds at 24 h for lactate (<3.0 mg/dl), CPO (>0.6 W), and PAPi (>1.0) were determined. Using logistic regression analysis, a validated risk stratification score was developed.Compared with 30-day survival of 47% in 2016, 30

2019 Journal of the American College of Cardiology

150. Vital sign patterns before shock-related cardiopulmonary arrest. (Abstract)

. Pre-arrest values for systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate (HR), shock index, and end-tidal carbon dioxide (EtCO2) were modeled against time using polynomial linear regression. The "terminal inflection point" beyond which arrest was imminent was identified where slope equals 1.0 (shock index) or -1.0 (SBP, MAP, HR, EtCO2) and was then compared to initial values.Air ambulance services.70 helicopter patients over age fourteen suffering cardiac arrest.SBP and MAP (...) demonstrated a gentle decline followed by acceleration beyond the inflection point (SBP 80.7 mmHg, MAP 61.9 mmHg). HR demonstrated an increase followed by a terminal drop, but inflection point values fell within normal range. Shock index increased gradually from a mean of 0.9 to the inflection point of 1.1. Initial EtCO2 values declined gradually from normal (34.4 mmHg) to the inflection point (24.7 mmHg), then dropped precipitously into arrest. All inflection points occurred 2-5 min prior to arrest.Vital

2019 Resuscitation

151. Therapeutic efficacy of extracorporeal shock wave combined with hyaluronic acid on knee osteoarthritis. Full Text available with Trip Pro

Therapeutic efficacy of extracorporeal shock wave combined with hyaluronic acid on knee osteoarthritis. This retrospective study investigated the efficacy and safety of extracorporeal shock wave (EPSW) combined with hyaluronic acid (HA) for patients with knee osteoarthritis (KOA).This retrospective study included 70 patients with KOA. Of those subjects, 35 of them received EPSW combined HA, and were allocated to a treatment group, while the other 35 participants received HA alone and were (...) allocated to a control group. Patients in both groups were treated for a total of 8 weeks. The primary outcome was measured by visual analog scale (VAS). The secondary outcomes were measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee injury and osteoarthritis outcome score (KOOS). In addition, adverse events (AEs) were also evaluated. All outcomes were measured before and after the treatment.After the treatment, patients in the treatment group exhibited better

2019 Medicine

152. Procalcitonin-guided algorithm to reduce length of antibiotic therapy in patients with severe sepsis and septic shock Full Text available with Trip Pro

of antibiotic therapy in patients with severe sepsis and septic shock. BMC Infectious Diseases 2013; 13: 158 PubMedID DOI Indexing Status Subject indexing assigned by NLM MeSH Adult; Aged; Aged, 80 and over; Algorithms; Anti-Bacterial Agents /therapeutic use; Biomarkers /blood; Calcitonin /blood; Drug Monitoring /methods; Drug Utilization /statistics & Female; Germany; Humans; Intensive Care Units; Male; Middle Aged; Protein Precursors /blood; Retrospective Studies; Sepsis /diagnosis /drug therapy (...) Procalcitonin-guided algorithm to reduce length of antibiotic therapy in patients with severe sepsis and septic shock Procalcitonin-guided algorithm to reduce length of antibiotic therapy in patients with severe sepsis and septic shock Procalcitonin-guided algorithm to reduce length of antibiotic therapy in patients with severe sepsis and septic shock Hohn A, Schroeder S, Gehrt A, Bernhardt K, Bein B, Wegscheider K, Hochreiter M Record Status This is a critical abstract of an economic

2013 NHS Economic Evaluation Database.

153. Renal resistive index as an early predictor and discriminator of acute kidney injury in critically ill patients; A prospective observational cohort study. Full Text available with Trip Pro

Renal resistive index as an early predictor and discriminator of acute kidney injury in critically ill patients; A prospective observational cohort study. Acute kidney injury (AKI) complicates shock. Diagnosis is based on rising creatinine, a late phenomenon. Intrarenal vasoconstriction occurs earlier. Measuring flow resistance in the renal circulation, Renal Resistive Index (RRI), could become part of vital organ function assessment using Doppler ultrasound. Our aim was to determine whether (...) RRI on ICU admission is an early predictor and discriminator of AKI developed within the first week.In this prospective cohort of mixed ICU patients with and without shock, RRI was measured <24-h of admission. Besides routine variables, sublingual microcirculation and bioelectrical impedance were measured. AKI was defined by the Kidney Disease Improving Global Outcomes criteria. Uni- and multivariate regression and Receiver Operating Characteristics curve analyses were performed.Ninety-nine

2018 PLoS ONE

154. Prognostic value of shock index in children with septic shock. (Abstract)

Prognostic value of shock index in children with septic shock. Septic shock is frequent in children and is associated with high mortality and morbidity rates. Early recognition of severe sepsis improve outcome. Shock index (SI), ratio of heart rate (HR) and systolic blood pressure (SBP), may be a good noninvasive measure of hemodynamic instability that has been poorly studied in children. The aim of the study was to explore the usefulness of SI as an early index of prognosis for septic shock (...) in children.The study was retrospective and performed in 1 pediatric intensive care unit at a university hospital. The following specific data were collected at 0, 1, 2, 4, and 6 hours after admission: HR and SBP for SI calculation and lactate concentration. Patients were divided into 2 groups according to their outcome (death/survival).A total of 146 children admitted with septic shock between January 2000 and April 2010 were included. Shock index was significantly different between survivors

2013 Pediatric Emergency Care

155. Is Shock Index Associated With Outcome in Children With Sepsis/Septic Shock? (Abstract)

Is Shock Index Associated With Outcome in Children With Sepsis/Septic Shock? To investigate the association between PICU shock index (the ratio of heart rate to systolic blood pressure) and PICU mortality in children with sepsis/septic shock. To explore cutoff values for shock index for ICU mortality, how change in shock index over the first 6 hours of ICU admission is associated with outcome, and how the use of vasoactive therapy may affect shock index and its association (...) with outcome.Retrospective cohort.Single-center tertiary PICU.Five hundred forty-four children with the diagnosis of sepsis/septic shock.None.From January 2003 to December 2009, 544 children met International Pediatric Sepsis Consensus Conference of 2005 criteria for sepsis/septic shock. Overall mortality was 23.7%. Among all patients, hourly shock index was associated with mortality: odds ratio of ICU mortality at 0 hour, 1.08, 95% CI (1.04-1.12); odds ratio at 1 hour, 1.09 (1.04-1.13); odds ratio at 2 hours, 1.09

2013 Pediatric Critical Care Medicine

156. An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR

An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Dr. Smith's ECG Blog: An elderly man with sudden cardiogenic shock, diffuse ST depressions, and STE in aVR Wednesday, October 31, 2018 Written by Pendell Meyers 84 yo M with history of a “valve problem” presented for sudden onset chest pain and trouble breathing while eating lunch. He was sitting bolt upright, diaphoretic, tachypneic, with bilateral crackles. Although his BP was 126/84, he was in acute (...) cardiogenic shock. Here is his initial ECG: Sinus tach with occasional PACs. Relatively normal QRS complex with diffuse significant ST depression including leads V2-V6, I, aVL, II, III, and aVF, with ST elevation in aVR. The vector of ST depression is maximal in leads V5 and II, consistent with diffuse subendocardial ischemia. There is no evidence of any single vessel OMI (Occlusion MI). This is not consistent with posterior OMI, which would have ST depression maximal in V2-V4 usually without diffuse ST

2018 Dr Smith's ECG Blog

157. Lyophilized plasma for the treatment of adults with hemorrhagic shock: clinical and cost-effectiveness, safety, and guidelines

. No evaluation of the quality of this assessment has been made for the HTA database. Citation CADTH. Lyophilized plasma for the treatment of adults with hemorrhagic shock: clinical and cost-effectiveness, safety, and guidelines. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response - Summary of Abstracts. 2014 Authors' conclusions No relevant literature was identified regarding lyophilized plasma for treating adults with hemorrhagic shock. Final publication URL Indexing Status (...) Subject indexing assigned by CRD MeSH Cost-Benefit Analysis; Plasma; Safety; Shock, Hemorrhagics Language Published English Country of organisation Canada Province or state Ontario English summary An English language summary is available. Address for correspondence Canadian Agency for Drugs and Technologies in Health (CADTH), 865 Carling Avenue, Suite 600, Ottawa, Ontario Canada, K1S 5S8 Email: requests@cadth.ca AccessionNumber 32014000814 Date abstract record published 16/07/2014 Health Technology

2014 Health Technology Assessment (HTA) Database.

158. Bolused (vice infused) tranexamic acid in adults experiencing hemorrhagic shock: safety, patient benefits, and guidelines

regarding bolused (vice infused) tranexamic acid in adults experiencing hemorrhagic shock. Final publication URL Indexing Status Subject indexing assigned by CRD MeSH Humans; Shock, Hemorrhagic; Tranexamic Acid Language Published English Country of organisation Canada Province or state Ontario English summary An English language summary is available. Address for correspondence Canadian Agency for Drugs and Technologies in Health (CADTH), 865 Carling Avenue, Suite 600, Ottawa, Ontario Canada, K1S 5S8 (...) Bolused (vice infused) tranexamic acid in adults experiencing hemorrhagic shock: safety, patient benefits, and guidelines Bolused (vice infused) tranexamic acid in adults experiencing hemorrhagic shock: safety, patient benefits, and guidelines Bolused (vice infused) tranexamic acid in adults experiencing hemorrhagic shock: safety, patient benefits, and guidelines CADTH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation

2014 Health Technology Assessment (HTA) Database.

159. Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up

Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up CADTH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality (...) of this assessment has been made for the HTA database. Citation CADTH. Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response - Summary of Abstracts. 2014 Authors' conclusions One evidence-based guideline was identified regarding the medical follow-up and discharge of people who have received an electric shock from a conducted electrical weapon. Final publication URL

2014 Health Technology Assessment (HTA) Database.

160. Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up

of this assessment has been made for the HTA database. Citation CADTH. Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up. Ottawa: Canadian Agency for Drugs and Technologies in Health (CADTH). Rapid Response. 2014 Authors' conclusions One evidence-based guideline was identified regarding the medical follow-up and discharge of people who have received an electric shock from a conducted electrical weapon. Final publication URL Indexing Status Subject (...) Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up Electric shocks from conducted electric weapons: long-term clinical effects and guidelines for medical follow-up CADTH Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality

2014 Health Technology Assessment (HTA) Database.

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