Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan
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Currently in Japan, the preferred method for blood purification in patients with acute renal failure is continuous hemodiafiltration (CHDF). However, CHDF filters out various antifungal drugs such as fluconazole through large pores in the membrane used. Systemic fungal infection is still one of the main causes of death and complications in critically ill patients in intensive care units (ICUs). ⋯ There was no significant difference in the serum micafungin C/D-time profiles between the patients receiving and not receiving CHDF. These results show that CHDF does not affect the pharmacokinetics of micafungin. Therefore it is not necessary to adjust the micafungin dose in patients receiving CHDF.
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Randomized Controlled Trial
Effects of low-dose milrinone on weaning from cardiopulmonary bypass and after in patients with mitral stenosis and pulmonary hypertension.
The phosphodiesterase inhibitor milrinone is usually preferred in patients with pulmonary hypertension and myocardial dysfunction after cardiopulmonary bypass. We investigated the effects of low-dose milrinone on pulmonary hypertension in the immediate pre- and postoperative period. Forty-seven patients were randomized to the control and milrinone groups. ⋯ A total of 21.7% of the patients in the control group required vasopressors in the perioperative period. Both groups demonstrated similar hematologic variables except that the hemoglobin level in the control group was significantly lower during postoperative days 1 and 7. Low-dose milrinone for a short-term during weaning from cardiopulmonary bypass may be used in patients with mitral stenosis and pulmonary hypertension for its effects on pulmonary artery pressures, less inotropic and vasopressor requirements, and fluid balance.
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Randomized Controlled Trial
Effects of propofol and midazolam on lipids, glucose, and plasma osmolality during and in the early postoperative period following coronary artery bypass graft surgery: a randomized trial.
It is not clear how levels of serum lipids and glucose and plasma osmolality change during propofol infusion in the pre- and postoperative period of coronary artery bypass graft surgery (CABG). This prospective, randomized, controlled trial evaluated changes in these parameters during propofol or midazolam infusion during and in the early postoperative period following surgery. Twenty patients undergoing CABG were randomized preoperatively into two groups: 10 patients received propofol (induction 1.5 mg/kg, maintenance 1.5 mg kg(-1) h(-1)) and 10 patients received midazolam (induction 0.5 mg/kg, maintenance 0.1 mg kg(-1) h(-1)). ⋯ Changes in glucose levels did not differ significantly different between the two groups. In patients with normal serum lipids, glucose, and plasma osmolality undergoing CABG, propofol infusion for maintenance anesthesia is not associated with dangerous changes in serum lipids, glucose, and plasma osmolality compared with midazolam. A propofol infusion technique for maintenance of anesthesia for cardiac surgery where serum lipids and glucose may be of concern could be recommended as an alternative to midazolam.
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Randomized Controlled Trial Comparative Study
Postoperative effects of opioid analgesics administered via continuous perfusion and patient controlled analgesia after open heart surgery.
Critical care nurses and physicians are familiar with the principles of patient controlled analgesia and the opioid analgesics' regimens and observations necessary for pain control in the postoperative cardiac surgical patients. The objective of the study was to compare the effects of morphine, fentanyl, meperidine, remifentanil and tramadol which were administered by patient controlled analgesia and continuous intravenous infusion combination on the various parameters. This study was designed as prospective randomised trial. ⋯ There were no significant differences between the groups for pain management except higher visual analog scales on tramadol. Headache, stomach-ache and, palpitations were observed in our patients. Remifentanil, meperidine, fentanyl and morphine showed similar effect with each other for pain relief except tramadol.
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Comparative Study
Method for estimating the order of influenza infection between adults and children.
This paper puts forward a method for determining the infection order of influenza between adults and children from the daily variations in the amount of influenza anti-viral agents treated at a pharmacy. The time series of Tamiflu Capsule for adults and Tamiflu Dry Syrup for children are compared by means of the cross-correlation function. The results from pharmacies located in Tokyo and Kanagawa show that the influenza infection period of adults is earlier than that of children, indicating the infection order: first adults and second children. However, a pharmacy in Saitama yields no clear result.