Journal of critical care
-
Journal of critical care · Dec 2017
Review Comparative StudyHypertonic saline in critical illness - A systematic review.
The optimal approach to fluid management in critically ill patients is highly debated. Fluid resuscitation using hypertonic saline was used in the past for more than thirty years, but has recently disappeared from clinical practice. Here we provide an overview on the currently available literature on effects of hypertonic saline infusion for fluid resuscitation in the critically ill. ⋯ Fluid resuscitation using hypertonic saline results in volume expansion and less total infusion volume. This may be of interest in oedematous patients with intravascular volume depletion. When such strategies are employed, renal effects may differ markedly according to prior intravascular volume status. Hypertonic saline induced changes in serum osmolality and electrolytes return to baseline within a limited period in time. Sparse evidence indicates that resuscitation with hypertonic saline results in less perioperative complications, ICU days and mortality in selected patients. In conclusion, the use of hypertonic saline may have beneficial features in selected critically ill patients when carefully chosen. Further clinical studies assessing relevant clinical outcomes are warranted.
-
Journal of critical care · Dec 2017
Review Meta AnalysisMagnesium status and magnesium therapy in cardiac surgery: A systematic review and meta-analysis focusing on arrhythmia prevention.
To investigate magnesium as prophylaxis or treatment of postoperative arrhythmias in cardiac surgery (CS) patients. To assess impact on biochemical and patient-centered outcomes. ⋯ Magnesium administration post-CS appears to reduce AF without significant adverse events. There is limited evidence to support magnesium administration for prevention of other arrhythmias.
-
Journal of critical care · Dec 2017
Review Meta AnalysisRisk factors for postoperative acute mesenteric ischemia among adult patients undergoing cardiac surgery: A systematic review and meta-analysis.
We aimed to seek risk factors for AMI among adult patients undergoing cardiac surgery. ⋯ 14 risk factors were associated with an increased risk of AMI, which indicated that AMI might occur via stenosis or occlusion of mesenteric vessels, reduced blood volume or maldistribution of blood flow.
-
Journal of critical care · Dec 2017
ReviewEncephalitis and myelitis in tropical countries: Report from the Task Force on Tropical Diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
Tropical diseases are those that occur primarily or solely in the tropics, and as such include infectious diseases that are particularly prevalent in hot, humid conditions. The incidence of encephalitis in tropical countries is reported to be as high as 6.34/100,000/year. ⋯ Transverse myelitis (TM) is an inflammation of the spinal cord which has a wide variety of clinical presentations depending on the degree (severity of myelin and neuronal injury) and site of spinal cord involvement. In the present article we discuss the various forms of tropical, viral encephalitides and myelitis and the diagnosis and management.
-
Journal of critical care · Dec 2017
ReviewViral hemorrhagic fever in the tropics: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine.
Viral hemorrhagic fevers (VHFs) are a group of illnesses caused by four families of viruses namely Arenaviruses, Filoviruses, Bunyaviruses, and Flaviviruses. Humans are not the natural reservoir for any of these organisms and acquire the disease through vectors from animal reservoirs. ⋯ The resultant microvascular damage leads to increased vascular permeability, organ dysfunction and even death. The management is generally supportive but antiviral agents are of benefit in certain circumstances.