Persistent hypotension resolved by neostigmine administration in a dog in which atracurium was used

2021 ◽  
Author(s):  
Enzo Vettorato
Keyword(s):  
Persistent Hypotension

scholarly journals Management of Trazodone Overdose with Severe Hypotension

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Luis David Camacho ◽  
Jack Stearns ◽  
Richard Amini
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Adrenergic Receptors ◽  
Intentional Ingestion ◽  
Severe Hypotension ◽  
Associated Symptoms ◽  
Management Plans ◽  
Persistent Hypotension

Trazodone is a medication that possesses antidepressant, anxiolytic, and hypnotic properties. Its mechanism of action includes blockade of serotonin type 2 receptors, weak inhibition of serotonin reuptake, blockade of histamine 1 receptors, and blockade of alpha-1-adrenergic receptors. We present a case of intentional ingestion of an estimated 2500 mg of trazodone leading to persistent hypotension, requiring aggressive fluid resuscitation, pressor support, and intensive care unit admission. Complications associated with trazodone overdoses are significant and clinicians should be aware of the associated symptoms and necessary management plans necessary for such ingestions.

A Rare Occult Malignancy Causing Persistent Hypotension

2019 ◽  
Author(s):  
S. Waheed ◽  
H.M. Zubair ◽  
M.R. Zafar
Keyword(s):  
Occult Malignancy ◽  
Persistent Hypotension

scholarly journals Effect of midodrine versus placebo on time to vasopressor discontinuation in patients with persistent hypotension in the intensive care unit (MIDAS): an international randomised clinical trial

2020 ◽  
Vol 46 (10) ◽  
pp. 1884-1893 ◽  
Author(s):  
Peter Santer ◽  
◽  
Matthew H. Anstey ◽  
Maria D. Patrocínio ◽  
Bradley Wibrow ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Randomised Clinical Trial ◽  
Persistent Hypotension

scholarly journals Passive Leg Raise: Feasibility and Safety of the Maneuver in Patients With Undifferentiated Shock

2018 ◽  
Vol 35 (10) ◽  
pp. 1123-1128 ◽  
Author(s):  
William Toppen ◽  
Elizabeth Aquije Montoya ◽  
Stephanie Ong ◽  
Daniela Markovic ◽  
Yuhan Kao ◽  
...  
Keyword(s):  
Prospective Trial ◽  
Vital Signs ◽  
Patient Comfort ◽  
Objective Measures ◽  
Nursing Workload ◽  
Passive Leg Raise ◽  
Sedation And Analgesia ◽  
Impact Patient Care ◽  
The Impact ◽  
Persistent Hypotension

Purpose: Passive leg raise (PLR), in combination with technologies capable of capturing stroke volume changes, has been widely adopted in the management of shock. However, dedicated evaluation of safety, feasibility, and receptiveness of patients and nursing staff to PLR maneuver is missing. Methods: A noninterventional, prospective trial recruited adult patients with onset of undifferentiated shock within 24 hours with persistent vasopressor requirements despite fluid resuscitation. A standardized PLR maneuver was used to compare two noninvasive hemodynamic monitoring systems, each without significant impact on the performance of the maneuver. Safety and efficacy of the PLR were evaluated via subjective and objective measures. Objective measures of patient comfort and tolerance were evaluated through changes in vital signs, sedation, and analgesia requirements. Nurses and awake patients completed surveys on their experience. Results: Seventy-nine patients were enrolled. Testing was aborted in 2 cases for medical reasons (one patient developed rapid atrial fibrillation, second had profound desaturation). Of all, 5.4% of patients required additional vasopressor support after completion of the PLR maneuver due to persistent hypotension and 4.1% of patients required additional sedation. Among awake patients (N = 35), 6% reported pain and 29% reported discomfort. A total of 11% of nurses reported minor technical difficulties with the maneuver. Conclusion: Passive leg raise maneuver leads to a few serious but reversible complications in a selected population of hemodynamically unstable patients. Although it provides relevant diagnostic information, it may impact patient care. Treating physician should be aware of infrequent but possible complications and appreciate the impact of the maneuver on patients’ comfort and nursing workload.

scholarly journals Management of Persistent Hypotension after Resection of Parasagittal Meningioma

2014 ◽  
Vol 2 (3) ◽  
pp. 483-487
Author(s):  
Salih Gulsen
Keyword(s):  
Frontal Sinus ◽  
Air Embolism ◽  
Sagittal Sinus ◽  
Large Size ◽  
Clinical Series ◽  
Emissary Veins ◽  
Cranial Mri ◽  
Persistent Hypotension ◽  
Normal Respiration ◽  
Parasagittal Meningioma

Various complications including air embolism have been discussed in large clinical series regarding the parasagittal meningioma. We presented and discussed the patient suffering from persistent hypotension after excision of parasagittal meningioma. A 47-year-old man was admitted to our hospital with complaints of headache and frontal region swelling. His cranial MRI showed a bilaterally located parasagittal meningioma at the anterior one third of the sagittal sinus. Conspicuously, he had large frontal sinus and its length was about totally 7 cm in sagittal and transverse part.During cranitomy, we had to open frontal sinus because of its large size and open the sagittal sinus while removing of the tumor. So coincidental opening of the superior sagittal sinus and/or emissary veins located within diploe of the cranium and frontal sinus may cause hypotension after extubation due to normal respiration led to air escaping from the frontal sinus to the emissary veins placed next to the frontal sinus. Bilateral application of the tamponade embedded with vaseline inside to the nose prevents air escaping from the frontal sinus to the emissary veins.

scholarly journals Persistent Hypotension and Intestinal Infarction in A Patient with Primary Amyloidosis

1975 ◽  
Vol 68 (6) ◽  
pp. 1587-1592 ◽  
Author(s):  
Andrew Mallory ◽  
John E. Struthers ◽  
Fred Kern
Keyword(s):  
Primary Amyloidosis ◽  
Intestinal Infarction ◽  
Persistent Hypotension

scholarly journals Post mortem coronary angiography in a preemie heart – a case report

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Amna Qasim ◽  
Duraisamy Balaguru ◽  
Ashraf M. Aly
Keyword(s):  
Coronary Angiography ◽  
Congenital Heart ◽  
Heart Defects ◽  
Interventricular Septum ◽  
Coronary Vessels ◽  
Imaging Procedures ◽  
Diagnostic Modality ◽  
Case Presentation ◽  
Vascular Structures ◽  
Persistent Hypotension

Abstract Background Postmortem coronary angiography has been used in forensic medicine for several decades but its use has never been documented in neonatal hearts. The objective of this case is to report the use of postmortem coronary angiography as a diagnostic modality for neonates suspected to have complex congenital heart anomalies. Case presentation A 36-week-old female infant required extracorporeal membranous oxygenation for persistent hypotension on day 1 of life. A congenital echocardiogram (ECHO) on day 3 of life revealed multiple anomalous vascular structures within the interventricular septum. The infant passed away on day 4 of life after the parents elected to withdraw support. A consent for autopsy was taken from the parents and a postmortem coronary angiography was performed. The coronary vessels were injected with Iodixanol contrast via a 24 G angiocath under fluoroscopy. The anomalous septal vessels were identified as dilated coronary artery and vein. No other anomalies were identified. Conclusion Postmortem coronary angiography complements other imaging procedures in understanding the nature of some complex congenital heart defects and in determining the cause of death in such neonates.

scholarly journals Is persistent hypotension after transient cardiogenic shock associated with an inflammatory response?

2008 ◽  
Vol 41 (8) ◽  
pp. 648-656 ◽  
Author(s):  
M. Park ◽  
Maciel A.T. ◽  
D.T. Noritomi ◽  
M.K. Brunialti ◽  
R. Salomão ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Cardiogenic Shock ◽  
Persistent Hypotension

Should Vasopressors Be Started Early in Septic Shock?

2021 ◽  
Vol 42 (05) ◽  
pp. 683-688
Author(s):  
Luca Cioccari ◽  
Stephan M. Jakob ◽  
Jukka Takala
Keyword(s):  
Septic Shock ◽  
Tissue Perfusion ◽  
Conclusive Evidence ◽  
Morbidity And Mortality ◽  
Blood Pressure Targets ◽  
Source Of Infection ◽  
Increased Risk ◽  
Resuscitation Strategy ◽  
Definition Of ◽  
Persistent Hypotension

AbstractSepsis can influence blood volume, its distribution, vascular tone, and cardiac function. Persistent hypotension or the need for vasopressors after volume resuscitation is part of the definition of septic shock. Since increased positive fluid balance has been associated with increased morbidity and mortality in sepsis, timing of vasopressors in the treatment of septic shock seems crucial. However, conclusive evidence on timing and sequence of interventions with the goal to restore tissue perfusion is lacking. The aim of this narrative review is to depict the pathophysiology of hypotension in sepsis, evaluate how common interventions to treat hypotension interfere with physiology, and to give a resume of the results from clinical studies focusing on targets and timing of vasopressor in sepsis. The majority of studies comparing early versus late administration of vasopressors in septic shock are rather small, single-center, and retrospective. The range of “early” is between 1 and 12 hours. The available studies suggest a mean arterial pressure of 60 to 65 mm Hg as a threshold for increased risk of morbidity and mortality, whereas higher blood pressure targets do not seem to add further benefits. The data, albeit mostly from observational studies, speak for combining vasopressors with fluids rather “early” in the treatment of septic shock (within a 0–3-hour window). Nevertheless, the optimal resuscitation strategy should take into account the source of infection, the pathophysiology, the time and clinical course preceding the diagnosis of sepsis, and also comorbidities and sepsis-induced organ dysfunction.

scholarly journals Persistent Hypotension in the ICU: A Case Series of Niacin Deficiency

2020 ◽  
Author(s):  
J.D. Salciccioli ◽  
A. Yalcin ◽  
A. Rivadeneira ◽  
P.F. Clardy ◽  
J. McCannon
Keyword(s):  
Case Series ◽  
Niacin Deficiency ◽  
Persistent Hypotension
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