Fluid management in adult patients undergoing venoarterial extracorporeal membrane oxygenation: A scoping review.

Background: The use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) as a cardiocirculatory support has tremendously increased in critically ill patients. Although fluid therapy is an essential component of the hemodynamic management of VA-ECMO patients, the optimal fluid resuscitation strategy remains controversial. We performed a scoping review to map out the existing knowledge on fluid management in terms of fluid type, dosing and the impact of fluid balance on VA-ECMO patient outcomes.

Ultrafast Cooling With Total Liquid Ventilation Mitigates Early Inflammatory Response and Offers Neuroprotection in a Porcine Model of Cardiac Arrest.

Background: Brain injury is one of the most serious complications after cardiac arrest (CA). To prevent this phenomenon, rapid cooling with total liquid ventilation (TLV) has been proposed in small animal models of CA (rabbits and piglets). Here, we aimed to determine whether hypothermic TLV can also offer neuroprotection and mitigate cerebral inflammatory response in large animals.

Investigation of fingolimod-induced lymphocyte sequestration on inflammatory response and neurological damages after cardiac arrest.

Background: A sepsis-like syndrome is known to occur after cardiac arrest, leading to cerebral infiltration by white blood cells (WBC). We hypothesized that pharmacological sequestration of WBC, and more specifically lymphocytes within lymphoid tissues, could reduce the cerebral infiltration by these inflammatory cells and subsequent acute brain injury in a porcine model of cardiac arrest. Lymphocyte sequestration was induced by the sphingosine-1 phosphate receptors agonist fingolimod.

Impact of arginine-vasopressin on regional perfusions in a porcine model of post-resuscitation syndrome.

Background: Post-cardiac arrest (CA) shock is associated with multiple organ failure, including acute kidney injury, and is the leading cause of early death among patient successfully resuscitated from CA. Arginine-vasopressin (AVP) may be an interesting therapeutic alternative or complement to noradrenaline (NAD) to both control shock and preserve regional, especially renal, organ perfusions.

Methods: 18 swine (24-39 kg) were submitted to 14 min of ventricular fibrillation and cardio-pulmonary resuscitation.

The impact of extracorporeal membrane oxygenation on antifungal pharmacokinetics: A systematic review.

Background And Objective: The use of extracorporeal membrane oxygenation (ECMO) as a cardiocirculatory or respiratory support has tremendously increased in critically ill patients. In the setting of ECMO support, invasive fungal infections are a severe cause of morbidity and mortality. This vulnerable population is at risk of suboptimal antifungal exposure due to an increased volume of distribution (Vd), drug sequestration and decreased clearance.

DFT mechanistic study of the chemical fixation of CO by aziridine derivatives.

Using density functional theory (DFT), we treat the reaction of coupling of CO with aziridine in gas phase, in the presence of water and of a green catalyst (NaBr). Computations show that, in gas phase, this ring-opening conversions to oxazolidinones initiates by coordinating a CO molecule to the nitrogen atom of the aziridine. Then, a nucleophilic interaction between one oxygen atom of the coordinated CO and the carbon atom of the aziridine occurs.

Delayed presentation of spinal cord injury without radiographic abnormality (SCIWORA): a case report.

Spinal Cord Injury without Radiographic Abnormality (SCIWORA) is an unprecedented event to occur in adults but may lead to serious complications including permanent neurological impairments and death. In this article, we report a case of a 60-year-old male presenting to the emergency for a head and neck trauma after a motorbike accident, who reported only a neck ache and a normal primary neurological exam. The evolution was marked by the occurrence of paraplegia with a diminished sphincter tone and hypoesthesia beneath the T12 dermatome level after six hours, confirmed by the Magnetic Resonance Imaging (MRI).

Vibration analysis of nanobeams subjected to gradient-type heating due to a static magnetic field under the theory of nonlocal elasticity.

Nanoelectromechanical systems (NEMS) have received great interest from researchers around the world since the advent of nanotechnology and nanoengineering. This can be attributed due to the unique characteristics of NEMS devices and their wide range of applications. Among these applications, nanobeams and nanotubes now have an important role in the design of a variety of NEMS engineering devices.

Analgesia nociception index as a tool to predict hypotension after spinal anaesthesia for elective caesarean section.

Arterial hypotension is the main disadvantage of spinal anaesthesia (SA) for caesarean delivery with deleterious effects on maternal-foetal outcomes. Recently, a non-invasive device 'analgesia nociception index' (ANI) has been developed to evaluate the parasympathetic component of the nervous autonomous system. The aim of this study was to evaluate the ability of ANI to predict the risk of hypotension after SA for elective caesarean section.

Drug related adverse events due to cardiotropic agents : Epidemiology and prognosis in the emergency department.

Introduction: The severity of cardiotropic agents overuse is related to the risk of cardiac and hemodynamic life-threatening situations. Toxicity is attributed to their narrow therapeutic spectrum and pharmacodynamic properties. The clinical presentation, however, remains polymorphic and represents a challenge for the emergency physician to relate accountability to the exact agent.

Prognostic Value of High-sensitivity Troponin I in Patients with Septic Shock: A Prospective Observational Study.

Background: Myocardial dysfunction is one of the mechanisms involved in the pathophysiology of septic shock. The role of troponin as a surrogate of myocardial injury in septic shock is still debated. The aim of this study was to assess the prognostic value of high-sensitivity cardiac troponin I (hs-cTnI) assay in predicting 28-day mortality in patients with septic shock.

Efficacy and safety of Parecoxib for prevention of catheter-related bladder discomfort in patients undergoing transurethral resection of bladder tumor: Prospective randomised trial.

Background And Aims: Catheter-related bladder discomfort (CRBD) is the urge to void or discomfort in the suprapubic region secondary to an indwelling urinary catheter. We aimed to evaluate the safety and efficacy of single-dose of intravenous parecoxib in reducing the incidence and severity of CRBD in patients undergoing transurethral resection of bladder tumor (TURBT).

Methods: Sixty-one adult patients, American Society of Anesthesiologists physical status I or II, undergoing elective TURBT under spinal anaesthesia, were randomly allocated to receive 40 mg of IV parecoxib (group P; = 29) or an equal volume of normal saline (control group C; = 32).

First report of extensively-drug-resistant Proteus mirabilis isolate carrying plasmid-mediated bla in a Tunisian intensive care unit.

Emergence of the New Delhi metallo-β-lactamase (NDM-1), an Ambler class B metallo-β-lactamase able to hydrolyse all β-lactams except monobactams, constitutes a critical and increasingly important medical issue. The acquisition of bla is of particular concern for Proteus mirabilis, which is intrinsically resistant to tetracycline, tigecycline and colistin, as this will make clinical treatment extremely difficult. To the authors' knowledge, this is the first report of the bla gene in an extensively-drug-resistant P.

NDM-1- and OXA-23-producing Acinetobacter baumannii isolated from intensive care unit patients in Tunisia.

Gastrointestinal colonisation by carbapenem-resistant Acinetobacter baumannii (CRAB) is a critical step before nosocomial infection. This study evaluated CRAB intestinal carriage in patients admitted to a Tunisian ICU and determined the antimicrobial resistance mechanisms involved. From December 2014 to February 2015, all 63 patients admitted to the ICU were screened for rectal CRAB colonisation upon admission and once weekly thereafter.

[Safety and efficacy of intravenous tranexamic acid in endoscopic transurethral resections in urology: Prospective randomized trial].

Background: Endoscopic urological procedures (transurethral resection of the prostate TURP/transurethral resection of bladder tumor TURBT) are not without risk of significant bleeding. This risk is due to the vascular nature of the tissues and their high levels of fibrinolytic enzymes in the tissues and urine. This study was conducted to evaluate the safety and efficacy of the antifibrinolytic agent tranexamic acid (TXA) in reducing blood loss in patients undergoing TURP/TURBT and transfusion requirement.

Pain Measurement in Mechanically Ventilated Patients with Traumatic Brain Injury: Behavioral Pain Tools Versus Analgesia Nociception Index.

Introduction: Pain is highly prevalent in critically ill trauma patients, especially those with a traumatic brain injury (TBI). Behavioral pain tools such as the behavioral pain scale (BPS) and critical-care pain observation tool are recommended for sedated noncommunicative patients. Analysis of heart rate variability (HRV) is a noninvasive method to evaluate autonomic nervous system activity.

A comparison between intravenous lidocaine and ketamine on acute and chronic pain after open nephrectomy: A prospective, double-blind, randomized, placebo-controlled study.

Background: Recently, there has been increasing interest in the use of analgesic adjuncts such as intravenous (IV) ketamine and lidocaine.

Objectives: To compare the effects of perioperative IV lidocaine and ketamine on morphine requirements, pain scores, quality of recovery, and chronic pain after open nephrectomy.

Study Design: A prospective, randomized, placebo-controlled, double-blind trial.

High Prevalence of Gut Microbiota Colonization with Broad-Spectrum Cephalosporin Resistant in a Tunisian Intensive Care Unit.

Healthcare-associated infections due to cefotaxime-resistant (CTX-R) have become a major public health threat, especially in intensive care units (ICUs). Often acquired nosocomially, CTX-R can be introduced initially by patients at admission. This study aimed to determine the prevalence and genetic characteristics of CTX-R -intestinal carriage in ICU patients, to evaluate the rate of acquisition of these organisms during hospitalization, and to explore some of the associated risk factors for both carriage and acquisition.