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Shock Index

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161. Vital sign patterns before shock-related cardiopulmonary arrest. (PubMed)

. 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

162. Standardized Team-Based Care for Cardiogenic Shock. (PubMed)

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

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2019 Journal of the American College of Cardiology

163. Effectiveness of extracorporeal shock wave monotherapy for avascular necrosis of femoral head: A systematic review protocol of randomized controlled trial. (PubMed)

Effectiveness of extracorporeal shock wave monotherapy for avascular necrosis of femoral head: A systematic review protocol of randomized controlled trial. Previous clinical studies have reported that extracorporeal shock wave (EPSW) monotherapy can effectively treat avascular necrosis of femoral head (ANFH). However, no systematic review has been conducted to assess its effectiveness and safety for patients with ANFH. Therefore, this study will systematically assess the effectiveness (...) and safety of EPSW monotherapy for patients with ANFH.In this study, the following electronic databases will be searched from their inceptions to the present: Cochrane Library, EMBASE, PUBMED, Cumulative Index to Nursing and Allied Health Literature, China National Knowledge Infrastructure, and Chinese Biomedical Literature Database. This study will include randomized controlled trials for assessing the effectiveness and safety of EPSW monotherapy for patients with ANFH. Two independent authors

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2019 Medicine

164. The effect of extracorporeal shock wave therapy on the treatment of moderate to severe knee osteoarthritis and cartilage lesion. (PubMed)

The effect of extracorporeal shock wave therapy on the treatment of moderate to severe knee osteoarthritis and cartilage lesion. Knee osteoarthritis (KOA) is a major cause leading to chronic bone and muscle pain. Extracorporeal shock wave therapy (ESWT) has been applied in treating KOA in recent years.From April 2016 to April 2017, 82 patients were diagnosed with KOA that received ESWT were selected as the ESWT group. The treatment parameters were as follows, 2.0 bar, 0.25 mJ/mm, and 8 Hz/s (...) for twice a week for 4 weeks continuously. In addition, 104 patients receiving oral administration of nonsteroidal anti-inflammatory drugs (NSAIDs) from April 2015 to April 2016 were also selected as the NSAIDs group. At 4, 8, 12, and 16 weeks upon the completion of treatment, the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were adopted to evaluate the changes in pain and function of patients in both groups. For the ESWT group, the 50-m quick walk

2019 Medicine

165. Effect of Increasing Blood Pressure With Noradrenaline on the Microcirculation of Patients With Septic Shock and Previous Arterial Hypertension. (PubMed)

; arterial hypertension: 16.4 ± 3.5 mm/mm to 19.1 ± 3 mm/mm; groups: p = 0.51; T0 and T1: p < 0.001; group and time interaction: p = 0.70), and microcirculatory flow index (control: 2.1 ± 0.6 to 2.4 ± 0.6; arterial hypertension: 2.1 ± 0.5 to 2.6 ± 0.2; groups: p = 0.71; T0 and T1: p = 0.002; group and time interaction: p = 0.45) in both groups.Increasing mean arterial pressure with noradrenaline in septic shock patients improves density and flow in small vessels of sublingual microcirculation. However (...) Effect of Increasing Blood Pressure With Noradrenaline on the Microcirculation of Patients With Septic Shock and Previous Arterial Hypertension. To assess whether an increase in mean arterial pressure in patients with septic shock and previous systemic arterial hypertension changes microcirculatory and systemic hemodynamic variables compared with patients without arterial hypertension (control).Prospective, nonblinded, interventional study.Three ICUs in two teaching hospitals.After informed

2019 Critical Care Medicine

166. Utilization and Outcomes of Temporary Mechanical Circulatory Support Devices in Cardiogenic Shock. (PubMed)

Utilization and Outcomes of Temporary Mechanical Circulatory Support Devices in Cardiogenic Shock. Cardiogenic shock (CS) is associated with high morbidity and mortality despite recent advances in the temporary mechanical circulatory support (MCS) devices. The current utilization and outcomes of these MCS devices with or without vasopressors compared with conventional medical therapy (no-MCS) in CS remain poorly described. The study population was extracted from the 2014 Nationwide Readmissions (...) Database using International Classification of Diseases, Ninth Revision, Clinical Modification codes for CS, temporary MCS devices, and vasopressor infusion. Study end points included in-hospital all-cause mortality, length of index hospital stay (LOS), the likelihood of receiving invasive treatment, postprocedural bleeding, vascular complications, total hospitalization charges, and discharge disposition. A total of 59,148 discharges with a diagnosis of CS were identified (age 67 years; 38.5% female

2019 American Journal of Cardiology

167. Profile and Outcomes of Surgical Treatment for Ventricular Septal Rupture in Patients with Shock. (PubMed)

cardiogenic shock (67.6%) and 34 without cardiogenic shock (32.4%), who underwent surgical treatment in the Department of Adult Cardiac Surgery of Fuwai Hospital between January 2002 and December 2017. Baseline characteristics and outcomes in patients with ventricular septal rupture with and without cardiogenic shock were assessed.There were no differences in hypertension, diabetes, history of myocardial infarction, body mass index, or location of ventricular septal rupture between patients (...) Profile and Outcomes of Surgical Treatment for Ventricular Septal Rupture in Patients with Shock. The outcomes of surgical treatment of ventricular septal rupture complicating acute myocardial infarction are worse in patients with cardiogenic shock.This study aimed to identify clinical characteristics and outcomes in patients with ventricular septal rupture presenting with cardiogenic shock.A retrospective analysis was performed in 105 consecutive ventricular septal rupture patients, 71with

2019 Annals of Thoracic Surgery

168. 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 (PubMed)

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

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2019 BMJ open Controlled trial quality: predicted high

169. Efficacy and safety of 1C class antiarrhythmic agent (propafenone) for supraventricular arrhythmias in septic shock compared to amiodarone: protocol of a prospective randomised double-blind study. (PubMed)

Efficacy and safety of 1C class antiarrhythmic agent (propafenone) for supraventricular arrhythmias in septic shock compared to amiodarone: protocol of a prospective randomised double-blind study. Supraventricular arrhythmias contribute to haemodynamic compromise in septic shock. A retrospective study generated the hypothesis that propafenone could be more effective than amiodarone in achieving and maintaining sinus rhythm (SR). Certain echocardiographic parameters may predict a successful (...) cardioversion and help in the decision on rhythm or rate control strategy.The trial includes septic shock patients with new-onset arrhythmia, but without severe impairment of the left ventricular ejection fraction. After baseline echocardiography, the patient is randomised to receive a bolus and maintenance dose of either amiodarone or propafenone. The primary outcome is the proportion of patients that have achieved rhythm control at 24 hours after the start of the infusion. The secondary outcomes

2019 BMJ open Controlled trial quality: predicted high

170. Circulating dipeptidyl peptidase 3 and alteration in haemodynamics in cardiogenic shock: results from the OptimaCC trial. (PubMed)

(SAPS II), lower cardiac index and lower estimated glomerular filtration rate. More importantly, in CS patients with high cDPP3 at inclusion, those who rapidly decreased cDPP3 at 24 h exhibited a striking reduction in the occurrence of refractory shock and death.In CS patients, cDPP3 gives an early prediction of outcome, including development of refractory status and/or survival.clinicaltrials.gov Identifier NCT01367743.© 2019 The Authors. European Journal of Heart Failure © 2019 European Society (...) Circulating dipeptidyl peptidase 3 and alteration in haemodynamics in cardiogenic shock: results from the OptimaCC trial. Dipeptidyl peptidase 3 (DPP3) is a protease involved in the degradation of cardiovascular mediators. Its administration has been shown to be associated with impaired cardiac contraction and kidney haemodynamics while its inhibition restored cardiac contraction in a pre-clinical model of severe heart failure in mice. Circulating DPP3 (cDPP3) was found to be elevated in shock

2019 European Journal of Heart Failure Controlled trial quality: predicted high

171. The Effects Of Extracorporeal Shock Wave Therapy On Pain, Disability And Life Quality Of Chronic Low Back Pain Patients. (PubMed)

The Effects Of Extracorporeal Shock Wave Therapy On Pain, Disability And Life Quality Of Chronic Low Back Pain Patients. Low back pain is the most common form of pain related to the musculoskeletal system disorders. ESWT has been suggested as a new treatment modality in CLBP and its effectiveness has been investigated in a small number of studies.The aim of this study is to investigate the effect of Extracorporeal Shockwave Therapy (ESWT) on pain, functional status, and quality of life compared (...) (NRS), Oswestry Disability Index (ODI), Hospital Anxiety and Depression Scale (HADS), Short-form 36 (SF-36). The data were obtained before treatment (W0), at sixth (W6) and twelfth week (W12).In Group 1, statistically significant improvement was found in all parameters of rest and movement NRS, ODI, HADS and SF-36 except for emotional role at both W6 and W12 compared to W0(P < .05). Comparison of the difference scores of the two groups showed significantly superior improvement in Group 1 for all

2019 Alternative Therapies in Health & Medicine Controlled trial quality: uncertain

172. Radial extracorporeal shock wave device appearance does not influence clinical outcomes: A randomized controlled trial. (PubMed)

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

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2019 Journal of Rehabilitation Medicine Controlled trial quality: predicted high

173. Impact of norepinephrine on right ventricular afterload and function in septic shock-a strain echocardiography study. (PubMed)

Impact of norepinephrine on right ventricular afterload and function in septic shock-a strain echocardiography study. In this observational study, the effects of norepinephrine-induced changes in mean arterial pressure (MAP) on right ventricular (RV) systolic function, afterload and pulmonary haemodynamics were studied in septic shock patients. We hypothesised that RV systolic function improves at higher doses of norepinephrine/MAP levels.Eleven patients with septic shock requiring (...) elastance, (Epa ) and pulmonary vascular resistance index, (PVRI). RV free wall peak strain was the primary end-point.At highest compared to lowest norepinephrine dose/MAP level, RV free wall peak strain increased from -19% to -25% (32%, P = .003), accompanied by increased tricuspid annular plane systolic excursion (22%, P = .01). At the highest norepinephrine dose/MAP, RV end-diastolic area index (16%, P < .001), central venous pressure (38%, P < .001), stroke volume index (7%, P = .001), mean

2019 Acta Anaesthesiologica Scandinavica

174. Assessing and managing hypovolemic shock in puerperal women. (PubMed)

in pregnancy. The Shock Index [SI] is one composite vital sign that may help in the identification of women with hypovolemic shock. Values of SI ≥ 1 in the first hour postpartum indicate cardiac decompensation, and treatment should be implemented immediately. From the diagnosis of PPH, first-line measures should ensure coordinated care actions including the availability of blood derivatives, the establishment of conditions for volume replacement, oxygen therapy, and identification and timely treatment (...) Assessing and managing hypovolemic shock in puerperal women. The major cause of maternal death worldwide is postpartum hemorrhage (PPH). Early identification is the basis for adequate treatment. In addition to the visual estimation of blood loss, clinical signs could offer a more reliable representation of the cardiovascular system of the bleeding woman. However, in postpartum women, recognition of hypovolemic shock through vital signs is impaired owing to physiological cardiovascular changes

2019 Best practice & research. Clinical obstetrics & gynaecology

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

, 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

176. 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

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

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

[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

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

[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

179. Comments on GEDI vs. CVP goal-directed fluid resuscitation for chronic obstructive pulmonary disease patients with septic shock: A randomized controlled trial. (PubMed)

University of Chinese Medicine, Guangzhou, 510120, Guangdong Province, China.. Electronic address: 3021376873@qq.com. eng Letter 2019 03 11 United States Am J Emerg Med 8309942 0735-6757 IM Central venous pressure (CVP) Chronic obstructive pulmonary disease (COPD) Fluid resuscitation Global end-diastolic volume index (GEDI) Septic shock 2019 03 03 2019 03 11 2019 3 31 6 0 2019 3 31 6 0 2019 3 31 6 0 ppublish 30926228 S0735-6757(19)30168-8 10.1016/j.ajem.2019.03.019 (...) Comments on GEDI vs. CVP goal-directed fluid resuscitation for chronic obstructive pulmonary disease patients with septic shock: A randomized controlled trial. 30926228 2019 08 26 1532-8171 37 9 2019 Sep The American journal of emergency medicine Am J Emerg Med Comments on GEDI vs. CVP goal-directed fluid resuscitation for chronic obstructive pulmonary disease patients with septic shock: A randomized controlled trial. 1803-1804 S0735-6757(19)30168-8 10.1016/j.ajem.2019.03.019 Cai Hairong H

2019 The American journal of emergency medicine Controlled trial quality: predicted high

180. [Effects of different target blood pressure resuscitation on peripheral blood inflammatory factors and hemodynamics in patients with traumatic hemorrhagic shock]. (PubMed)

[Effects of different target blood pressure resuscitation on peripheral blood inflammatory factors and hemodynamics in patients with traumatic hemorrhagic shock]. To investigate the target blood pressure level of restrictive fluid resuscitation in patients with traumatic hemorrhagic shock.Sixty patients with traumatic hemorrhagic shock admitted to the First Affiliated Hospital of Bengbu Medical College from January 2016 to December 2018 were enrolled. All patients were resuscitated with sodium (...) the three groups. Three groups of patients were resuscitated for 30 minutes to achieve the target blood pressure level and maintain 30 minutes. With the prolongation of fluid resuscitation time, the central venous pressure (CVP), cardiac output (CO) and cardiac index (CI) were increased slowly in the three groups, and reached a steady state at about 30 minutes after resuscitation, especially in the high MAP group and the middle MAP group. The expressions of serum inflammatory factors in the three groups

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

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