The American journal of emergency medicine
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Esmolol is a highly selective beta 1 receptor blocker with various effects such as slowing heart rate, lowering blood pressure and reducing myocardial oxygen consumption. However, few studies have reported the use of beta blockers in sepsis with multiple organ dysfunctions. This study aimed to investigate the effects of esmolol on reducing apoptosis and inflammation in early sepsis rats with abdominal infection. ⋯ The administration of esmolol in early sepsis may reduce inflammation, inhibit apoptosis and protect key organs.
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Case Reports
Never say never: Identification of acute pulmonary embolism on non-contrast computed tomography imaging.
Acute undifferentiated illness remains a critical challenge for the emergency physician. The diagnostic evaluation and treatment decisions on such severely ill patients often needs to be made in an expedited fashion. Situations occur wherein the ideal or recommended workup is not always feasible due to time or patient specific factors. We present two cases of patients with undifferentiated acute illness who had undergone non-contrast CT (computed tomography) scanning and subsequently had central pulmonary embolism identified upon careful review of their CT studies.
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Review Meta Analysis
Effect of paracetamol (acetaminophen) on body temperature in acute stroke: A meta-analysis.
The objective of this study was to assess the efficacy of paracetamol (acetaminophen) on body temperature in acute stroke. ⋯ Acetaminophen showed some capability to decrease body temperature for acute stroke. Acetaminophen could not improve functional outcome and reduce adverse events of patients with acute stroke.
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Randomized Controlled Trial
The effect of hypertonic saline and mannitol on coagulation in moderate traumatic brain injury patients.
Hyperosmolar therapy, using either hypertonic saline (HTS) or mannitol (MT), is considered the treatment of choice for intracranial hypertension, a disorder characterized by high intracranial pressure (ICP). However, hyperosmolar agents have been postulated to impair coagulation and platelet function. The aim of this study was to identify whether HTS and MT could affect coagulation in moderate traumatic brain injury (TBI) patients. ⋯ ROTEM parameters included CT (clotting time), CFT (clot formation time), maximum clot firmness (MCF) measured by MCF (EXTEM and INTEM), MCF (FIBTEM) and standard coagulation tests (p>0.05). No significant differences were found between the two groups. Moreover, ROTEM parameters did not show significant changes at different time points after administration of the hyperosmolar solutions (p>0.05). Conclusions Overall, use of 3% HTS and 20% MT for the control of ICP did not significantly affect patients' coagulation function. Therefore, hyperosmotic solution is safe and does not increase the risk of intracranial rebleeding.