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Management of the dialysis patient in general intensive care.
Br J Anaesth
February 2012
Department of Nephrology, Imperial College London, Hammersmith Hospital, London, UK.
The incidence of end-stage renal disease (ESRD) is rising and represents an important group of patients admitted to intensive care units (ICU). ESRD patients have significant co-morbidities and specific medical requirements. Renal replacement therapy (RRT), cardiovascular disease, disorders of electrolytes, drug metabolism, and sepsis are discussed.
View Article and Find Full Text PDFPropofol infusion syndrome.
Forensic Sci Med Pathol
December 2006
Department of Forensic Medicine Victorian Institute of Forensic Medicine, Monash University, 57-83 Kavanagh Street, 3006, Southbank, Victoria, Australia,
In this article, we present the case of a previously well 31-year-old man who sustained a mild closed-head injury following a motor vehicle incident and was admitted to the intensive care unit of a major teaching hospital. The man was sedated using propofol combined with midazolam and morphine as the main sedating agent. The propofol was started and continued at high dose for 8 days, over which time the patient deteriorated with metabolic acidosis, rhabdomyolysis, renal impairment, and cardiovascular collapse and then died.
View Article and Find Full Text PDFElectrophysiological effects of morphine in an in vitro model of the 'border zone' between normal and ischaemic-reperfused guinea-pig myocardium.
Br J Anaesth
December 2002
Laboratory of Experimental Anesthesiology and Cellular Physiology, UPRES EA 3212, Centre Hospitalier Universitaire, Côte de Nacre, Caen, France.
Background: Morphine is commonly used in clinical practice in pain management. Although morphine has been shown to precondition the myocardium, its effects on action potential parameters and ischaemia-reperfusion-induced arrhythmias and conduction blocks remain unknown.
Methods: In a double-chamber bath, guinea-pig right ventricular muscle strips were subjected partly to normal conditions and partly to 30 min of simulated ischaemia (hypoxia, hyperkalaemia, acidosis, and lack of nutritional substrate) followed by 30 min of reperfusion.
[Rhabdomyolysis with life threatening hyperkalemia masquerading as myocardial infarction in acute intentional poisoning with oral morphine (MST)].
Pol Arch Med Wewn
March 2001
III Oddział Chorób Wewnetrznych, Stołeczny Ośrodek Ostrych Zatruć, Szpital Praski.
A case is described of rhabdomyolysis with life threatening hyperkalemia masquerading as myocardial infarction due to intentional poisoning with oral morphine (M S T 30). A man of 37 y. showed not only the most typical symptoms of opioids intoxication (constricted pupils (miosis), consciousness and ventilation disturbances needing tracheal intubation and long-time i.
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