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Postintubation Sedation After a Formulary Change From Succinylcholine to Rocuronium in a Critical Care Transport Organization.
Air Med J
May 2022
Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts. Electronic address:
Objective: Rocuronium is increasingly used as a first-line neuromuscular blocker (NMB) in rapid sequence intubation by transport teams. Prior work has shown that rocuronium is associated with a delay in postintubation sedation compared with intubation with succinylcholine.
Methods: Boston MedFlight is a consortium-based transport organization.
Medical therapy in severe hypercortisolism.
Best Pract Res Clin Endocrinol Metab
March 2021
SEMPR, Serviço de Endocrinologia e Metabologia, Departamento de Clínica Médica, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil. Electronic address:
Severe hypercortisolism is characterized as a life-threatening endocrine condition in patients with Cushing syndrome, usually related to the concomitant onset of one or more comorbidities, requiring rapid normalization of cortisol concentrations and aggressive treatment of associated complications. It is mainly, but not exclusively, caused by ectopic ACTH syndrome, and the diagnosis of severity is more accurate when is based on simultaneous evaluation of the clinical course and manifestations of the disease, cortisol levels and systematic search of comorbidities. Once the severity and imminent risk to life are established, urgent therapeutic measures must be taken and etiological investigation postponed until the patient is stabilized.
View Article and Find Full Text PDFUsing Etomidate in a Two-month-old Infant with Cushing Syndrome due to Adrenocortical Carcinoma.
J Clin Res Pediatr Endocrinol
March 2022
Division of Pediatric Endocrinology, Severance Children’s Hospital, Department of Pediatrics, Institute of Endocrinology, Yonsei University College of Medicine, Seoul, Korea
Cushing syndrome (CS) is a rare disease caused by hypercortisolemia. Although surgical treatment is the first-line treatment in CS, the appropriate medication for the patient’s condition should be selected when medical treatment is needed. Etomidate is an adrenal-blocking drug used to treat CS and the most suitable for severe hypercortisolemia and adrenocortical carcinoma (ACC), due to cardiovascular stability and an anti-tumorigenic effect.
View Article and Find Full Text PDFAdrenally Directed Medical Therapies for Cushing Syndrome.
J Clin Endocrinol Metab
January 2021
Neuroendocrine Unit and Neuroendocrine and Pituitary Tumor Clinical Center, Massachusetts General Hospital, Boston, Massachusetts.
Context: Endogenous Cushing syndrome (CS) is characterized by excess cortisol secretion, which is driven by tumorous secretion of corticotropin in the majority of patients. Untreated, CS results in substantial morbidity and mortality. Tumor-directed surgery is generally the first-line therapy for CS.
View Article and Find Full Text PDFA National Survey: Current Clinical Practice in Pediatric Anesthesia for Congenital Heart Surgery.
World J Pediatr Congenit Heart Surg
May 2020
Department of Anesthesiology and Intensive Care Medicine, Rheinische Friedrich-Wilhelms-University, University Medical Center, Bonn, Germany.
Background: Providing anesthesia for pediatric patients undergoing congenital cardiac surgery is complex and requires profound knowledge and clinical experience. Prospective studies on best anesthetic management are missing, partially due to different standards. The aim of the present study was to survey the current standard practice in anesthetic management in pediatric cardiac surgical centers in Germany.
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