394 results match your criteria: "Shock Distributive"
Vasoactive Agents in Burn Patients - Perspectives on Angiotensin-II.
J Burn Care Res
December 2024
Regional One Health, Department of Pharmacy, Memphis, TN, USA.
Severe burn injury poses significant clinical challenges, often necessitating the use of vasoactive agents to maintain perfusion. This narrative review explores the current landscape of vasoactive agents in acute burn shock resuscitation and severe burn-injured patients who develop septic shock, with a particular focus on the potential role of the novel vasoactive agent, synthetic angiotensin-II (AT-II), in these settings. While catecholamines and vasopressin remain cornerstone therapies, adverse effects, variable patient response, and a new understanding of burn injury pathophysiology highlight the potentially evolving role of vasoactive agents in these clinical scenarios.
View Article and Find Full Text PDFCardiac Complications of Immune Checkpoint Inhibitors and Chimeric Antigen Receptor T Cell Therapy.
Cardiol Clin
February 2025
Division of Cardiology, Department of Internal Medicine, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805, USA; Department of Medicine (Research), Cardio-Oncology Program, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805, USA. Electronic address:
Article Synopsis
- - Immune checkpoint inhibitors and chimeric antigen receptor T-cell therapy have drastically improved cancer treatment but can lead to serious cardiovascular issues, notably myocarditis.
- - Diagnosis of ICI-myocarditis involves using a combination of biomarkers, imaging, and endomyocardial biopsy, while cytokine release syndrome (CRS) presents similar symptoms to distributive shock.
- - Effective management includes stopping the offending therapy, providing immunosuppression with corticosteroids for ICI-myocarditis, and using interleukin-6 antagonists for CRS, requiring close collaboration between oncologists and cardiologists for optimal care.
Outcomes of Pressure Ulcer Injuries Classified by Race: A 10-Year Nationwide Analysis.
Cureus
October 2024
Internal Medicine, South Shore University Hospital, Bay Shore, USA.
Article Synopsis
- The study aimed to assess the prevalence and impact of pressure ulcer injuries (PIs) in minority groups within U.S. hospitals, focusing on their association with long-term pressure on bony areas.
- Utilizing the National Inpatient Sample from 2011 to 2020, the researchers analyzed a total of 5,993,667 PI admissions and matching controls, comparing factors like age, gender, insurance type, and comorbidity levels.
- Findings revealed that male patients, older individuals (75+), and those on Medicare/Medicaid were more likely to develop PIs, with African Americans showing a higher risk compared to Whites and experiencing different rates of associated complications.
Developments in the epidemiology of calcium channel blocker poisoning and implications for management.
Curr Opin Crit Care
December 2024
Department of Emergency Medicine Hennepin Healthcare.
Purpose Of Review: The aim of this study was to outline recent developments in calcium channel blocker (CCB) poisoning. The dihydropyridine CCB amlodipine is commonly prescribed in the United States, and amlodipine poisoning is increasing in frequency, presenting new challenges for clinicians because current paradigms of CCB poisoning management arose from literature on non-dihydropyridine agents.
Recent Findings: Amlodipine is now the most common CCB involved in poisoning.
An ovine septic shock model of live bacterial infusion.
Intensive Care Med Exp
October 2024
Critical Care Research Group, The Prince Charles Hospital, 627 Rode Road, Level 3 Clinical Sciences Building, Chermside, Brisbane, QLD, 4032, Australia.
Article Synopsis
- Escherichia coli is a leading cause of bloodstream infections and sepsis, but existing animal models fail to replicate the complexities of these conditions, hindering the development of effective treatments.
- Researchers aimed to create a more accurate large-animal model of septic shock using sheep, by infusing a specific strain of antibiotic-resistant E. coli and closely monitoring their health over 48 hours.
- The study successfully induced septic shock in five sheep, showing consistent and reproducible results, including significant drops in blood pressure and increases in lactate levels following the bacterial infusion.
A case report of fatal anaphylaxis on first exposure to rasburicase just before lymphoma treatment.
Allergy Asthma Clin Immunol
October 2024
Department of Hematology and Oncology, Japanese Red Cross Narita Hospital, Narita, Japan.
Article Synopsis
- * A case involving a 71-year-old woman with lymphoma resulted in fatal anaphylactic shock following her first dose of rasburicase, leading to multiple complications including heart compression and significant bleeding.
- * This case highlights that while it’s uncommon, rasburicase can cause deadly anaphylaxis even in patients who have not previously been exposed to the drug.
Semaglutide-Induced Acute Pancreatitis Leading to Death After Four Years of Use.
Cureus
September 2024
Pulmonary and Critical Care, St. Francis Hospital, Hartford, USA.
Article Synopsis
- Glucagon-like peptide-1 receptor agonists (GLP-1RAs), like semaglutide, are commonly used to manage type 2 diabetes by helping regulate blood sugar, reduce weight, and protect the heart.
- A 74-year-old man with multiple health issues developed severe pancreatitis after using semaglutide for four years, particularly following a recent dose increase.
- Despite the absence of known risk factors for pancreatitis, his condition rapidly worsened, leading to complications such as shock, renal failure, respiratory distress, and ultimately, death, suggesting a potential connection between prolonged GLP-1RA use and acute pancreatitis.
[Fluid resuscitation and application of vasoactive drugs in septic shock: timing, evaluation criteria, and specifications].
Zhonghua Jie He He Hu Xi Za Zhi
October 2024
Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an 710032, China.
Article Synopsis
- - Septic shock (SS) is a severe complication of sepsis, making it a critical focus in treating critically ill patients, characterized as a type of distributive shock.
- - Standard management for SS includes fluid resuscitation and vasoactive drugs, but effective monitoring of various physiological indicators during treatment is still not clear.
- - The authors will suggest recommendations for using fluid therapy and vasoactive drugs based on recent guidelines and literature to improve individualized and dynamic treatment strategies.
Clinical Outcomes of Angiotensin II Therapy in Vasoplegic Shock: A Systematic Review and Meta-Analysis.
Life (Basel)
August 2024
Medical Intensive Care, Department of Medicine, Hamad Medical Corporation, Doha 3050, Qatar.
Article Synopsis
- Angiotensin II is a hormone that causes blood vessels to tighten, which can raise blood pressure, particularly in cases of vasodilatory shock where other treatments fail.
- A systematic review and meta-analysis were conducted to assess how effective angiotensin II is in improving outcomes like survival rates and blood pressure during vasoplegic shock.
- The analysis included eight studies, and findings suggested that angiotensin II did not significantly lower in-hospital mortality compared to standard treatments, indicating similar safety and efficacy levels.
Critical Care Ultrasound in Shock: A Comprehensive Review of Ultrasound Protocol for Hemodynamic Assessment in the Intensive Care Unit.
J Clin Med
September 2024
Critical and Intensive Care Medicine Department, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá 110111, Colombia.
Article Synopsis
- Shock is a critical condition that can lead to organ failure if not recognized and treated quickly, especially in the ICU where it's frequently seen.
- A review introduces an ultrasound-based protocol to assess hemodynamics in shock, categorizing it by cardiac index and identifying its different causes like obstructive, hypovolemic, cardiogenic, and distributive shock.
- Utilizing critical care ultrasound helps clinicians not only diagnose the type of shock but also tailor the treatment effectively while monitoring patient progress, improving overall outcomes.
Angiotensin II-Real-Life Use and Literature Review.
Medicina (Kaunas)
September 2024
Faculty of Medicine, University of Maribor, 2000 Maribor, Slovenia.
Article Synopsis
- Angiotensin II, a vasopressor introduced in 2017, induces vasoconstriction by activating the renin-angiotensin-aldosterone system, but high costs limit its use.
- It's particularly effective for treating vasoplegic and cardiogenic shock in patients unresponsive to other treatments like catecholamines and vasopressin.
- Despite its benefits, there's limited data on the best timing for administration and how to use it alongside other vasopressors, prompting ongoing studies to fill these knowledge gaps.
Thrombotic Safety of Angiotensin II for Distributive Shock in the Cardiothoracic Intensive Care Unit.
J Pharm Pract
September 2024
Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA.
Article Synopsis
- Angiotensin II (ATII) has been linked to higher thrombosis risk, but there's limited research on its effects in patients with mechanical circulatory support (MCS).
- This retrospective study analyzed adult patients in the cardiothoracic intensive care unit (CTICU) on temporary MCS between September 2018 and August 2022, comparing those who received ATII with a control group.
- While the study found that patients receiving ATII had numerically higher rates of thrombosis (41.5% vs 20.6%), the difference wasn't statistically significant, highlighting the need for more research on ATII's safety in MCS patients.
The Outcomes of the Initial Misclassification of Undifferentiated Hypotension in the Emergency Department: A Prospective Observational Study.
J Clin Med
September 2024
Department of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei 100225, Taiwan.
Article Synopsis
- The study investigates how the initial misclassification of undifferentiated hypotension (UH) in the emergency department (ED) impacts patients' clinical outcomes.
- It included 270 adult patients who presented with UH, categorizing them into groups based on whether their initial and final shock diagnoses matched.
- Findings showed that misclassified patients had higher hospitalization rates and lower discharge rates from the ED, but surprisingly, survival to discharge was not affected by the misclassification.
Extracorporeal cardiopulmonary resuscitation: a comparison of two experimental approaches and systematic review of experimental models.
Intensive Care Med Exp
September 2024
Department of Intensive Care, Erasme hospital, Hopital Universitaire de Bruxelles (HUB), Route de Lennik, 808, 1070, Brussels, Belgium.
Article Synopsis
- - The study focuses on improving survival and reducing brain injuries in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR) by developing experimental animal models due to challenges in human research.
- - Researchers conducted experiments on pigs, comparing two models of untreated ventricular fibrillation and standard CPR, finding significant brain blood flow issues and varying levels of brain injury across the models.
- - A systematic review of 52 studies showed discrepancies in methods and results of ECPR research, highlighting the need for standardized models to facilitate better comparisons and understanding of outcomes in future studies.
Angiotensin II as a Vasopressor for Perioperative Hypotension in Solid Organ Transplant.
Biomedicines
August 2024
Department of Pharmacy Practice, University of Illinois Chicago College of Pharmacy, Chicago, IL 60612, USA.
Article Synopsis
- Patients undergoing transplantation often experience hypotension due to factors like anesthesia, surgical stress, and fluid shifts, necessitating effective vasopressor support.
- Traditional vasopressors like norepinephrine and epinephrine may help but can cause complications, including arrhythmias, which are concerning in transplant cases.
- A new synthetic vasopressor, angiotensin II (AT2S-[Giapreza]), shows promise in stabilizing blood pressure while potentially preserving kidney function and reducing risk of arrhythmias, though more research is needed to confirm its efficacy and safety in transplant patients.
Idiopathic Systemic Capillary Leak Syndrome: Report of a Pediatric Case.
Acta Med Port
November 2024
Unidade de Cuidados Intensivos e Especiais Pediátricos. Unidade Local de Saúde Amadora/Sintra. Amadora. Portugal.
Article Synopsis
- The idiopathic systemic capillary leak syndrome leads to recurrent hypovolemia and shock due to fluid leaking into the space outside of blood vessels, with no known cause.
- A case study of a healthy seven-year-old boy showed initial symptoms like abdominal pain and fatigue, followed by serious fluid issues and compartment syndrome.
- Despite the severity, he recovered quickly, and key tests indicated no inflammation or infection, highlighting the complexity of diagnosing this rare and potentially fatal condition.
The use of angiotensin II for the management of distributive shock: expert consensus statements.
J Anesth Analg Crit Care
August 2024
Department of Anesthesia and Intensive Care, University Hospital of Modena, Modena, Italy.
Article Synopsis
- A panel of Italian intensive care specialists explored the use of angiotensin II (ATII) in treating distributive shock, considering patient factors and the effectiveness of existing treatment protocols.
- They employed a modified Delphi technique to establish consensus on clinical questions and statements related to ATII, resulting in agreement on 13 key statements from a survey.
- The panel concluded that ATII could be beneficial for specific patients, particularly those with reduced angiotensin-converting enzyme activity or high renin levels, while also noting potential barriers to its use.
Enhanced Negative Pressure Wound Therapy Shortens Hospital Stay for Major Burn Patients: Case Series.
Plast Reconstr Surg Glob Open
August 2024
From the Universidad El Bosque, Bogotá, Colombia.
Article Synopsis
- The length of hospital stay (LOS) is an important measure for planning resources and evaluating care quality in burn treatment, with NPWTi-d emerging as a promising therapy for burns.
- The study involved three patients, aged 16 to 42, treated with NPWTi-d after skin grafts, leading to an average LOS reduction of 23.2%.
- All patients showed successful healing outcomes and improved skin graft survival, despite facing some systemic complications from shock.
Uncommon Millettia pachycarpa Benth poisoning: A case report.
Medicine (Baltimore)
July 2024
Intensive Care Department, West China Hospital of Sichuan University, China.
Article Synopsis
- Millettia pachycarpa Benth can cause serious poisoning due to its rotenone content, leading to respiratory and central nervous system issues, and potentially death.
- A case study reports on an elderly male who lost consciousness for 3 hours after eating the fruit, showing serious blood gas imbalances indicating poisoning.
- The patient received advanced treatment including continuous renal replacement therapy and mechanical ventilation, and after 5 days in the hospital, he was discharged without significant issues, highlighting the importance of quick intervention in such poisonings.
Proposal for the use of angiotensin II in distributive shock after extracorporeal circulation - position paper of the Section of Intensive Care Medicine and the Section of Cardiothoracic Anaesthesiology of the Polish Society of Anaesthesiology and Intensive Therapy.
Kardiochir Torakochirurgia Pol
June 2024
Department of Anaesthesiology and Intensive Care, Silesian Centre for Heart Diseases, Zabrze, Poland.
Article Synopsis
- Angiotensin II (AT) is a strong vasoconstrictor used to treat severe low blood pressure during vasoplegic shock.
- * Recent experiences in cardiac surgery have led to the development of initial treatment guidelines for using AT.
- * This paper suggests using AT specifically for managing distributive shock after procedures involving extracorporeal circulation.
Severe distributive shock, neutrophilic dermatosis, and ST-elevation myocardial infarction in the setting of azathioprine hypersensitivity syndrome.
Allergy Asthma Clin Immunol
July 2024
Section of Critical Care, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Article Synopsis
- * A case study highlighted a 59-year-old man with Crohn's disease who experienced a severe hypersensitivity reaction leading to shock and acute coronary syndrome after taking azathioprine.
- * The patient's condition improved after stopping the azathioprine and starting glucocorticoid therapy, emphasizing the importance of quick identification and management of this adverse reaction.
Food protein-induced enterocolitis syndrome (FPIES): Beyond the guidelines.
J Food Allergy
December 2023
Department of Pediatrics, NYU Grossman School of Medicine, New York, New York, and.
Article Synopsis
- FPIES is a type of food allergy affecting about 0.51-0.9% of children and 0.22% of adults in the U.S., causing severe symptoms like projectile vomiting and diarrhea within hours of eating trigger foods.
- The most common triggers include cow's milk, oat, rice, avocado, and in some cases, fruits like banana and apple; it can present in various forms, such as acute or chronic, with a generally favorable outcome for infants.
- Diagnosis is challenging due to a lack of specific biomarkers, and management involves avoiding trigger foods, monitoring tolerance, and treating acute episodes with hydration and antiemetics.
Mixed Shock Complicating Cardiogenic Shock: Frequency, Predictors, and Clinical Outcomes.
Circ Heart Fail
July 2024
Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy (L.B., G.F., A.C., V.R., B.P., L.C., M.G., V.P., S.S., F.C., S.A., A.M.S.).
Article Synopsis
- * In a study of 200 patients with pure CS, 24.5% developed MS, with lower blood pressure, liver damage, and suspected infection identified as independent predictors of its occurrence.
- * MS is associated with higher in-hospital mortality (53.1% vs. 27.8%) and longer hospital stays, while using temporary mechanical support can reduce the chances of death for affected patients.
Survival and Vision Restoration Following Severe Metformin-associated Metabolic Acidosis With Transient Blindness: A Case Report and Review of the Literature.
J Community Hosp Intern Med Perspect
March 2024
Department of Internal Medicine, McLaren Health Care/Michigan State University, Flint, MI, USA.
Article Synopsis
- - Metformin-associated lactic acidosis (MALA) is a dangerous condition linked to the diabetes medication metformin, with a mortality rate of around 55%, and symptoms can range from abdominal pain to severe issues like blindness and renal failure.
- - A case is presented of a female in her early 70s who showed signs of altered mental status and new blindness, later diagnosed with severe acidosis and a very high metformin concentration, requiring intubation and advanced renal therapy.
- - The patient eventually stabilized and was moved to a regular medical unit, highlighting the importance for doctors to consider MALA when evaluating severe acidosis in patients.
Circulatory support with triple cannulation V-PaA ECMO in a patient with acute right ventricular failure and refractory hypoxemia secondary to diffuse alveolar hemorrhage: A case report.
Respir Med Case Rep
June 2024
Cardiac Critical Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Article Synopsis
- * She faced severe complications, including respiratory failure and acute right ventricular failure, leading to distributive shock despite receiving medical treatment.
- * The medical team employed a unique approach of veno-pulmonary-arterial cannulation to provide circulatory support with ECMO, successfully aiding the patient's recovery from multiple organ failures.