A retrospective review of fluid balance control in CRRT

2017 ◽  
Vol 30 (6) ◽  
pp. 314-319 ◽  
Author(s):  
Hugh Davies ◽  
Gavin D. Leslie ◽  
David Morgan
Keyword(s):  
Fluid Balance ◽  
Retrospective Review ◽  
Balance Control

Open Abdomen after Two Trauma Laparotomies: Do Diuretics Help?

2021 ◽  
pp. 000313482110503
Author(s):  
Sigrid Williamson ◽  
Anas Qatanani ◽  
Alison Muller ◽  
Anthony Martin ◽  
Thomas A. Geng ◽  
...  
Keyword(s):  
Fluid Balance ◽  
Retrospective Review ◽  
Open Abdomen ◽  
Fascial Closure ◽  
Trauma Patients ◽  
The Third ◽  
Cumulative Fluid Balance ◽  
Primary Fascial Closure

Data are lacking regarding the use of diuretics in facilitating closure of the open abdomen (OA). For patients with an OA after 2 laparotomies, we hypothesized that diuretic use was associated with a higher rate of primary fascial closure than no diuretic use. A retrospective review of patients with trauma laparotomies over 7 years was performed. Primary fascial closure (PFC) was defined as apposition of fascial edges without interposition mesh. Of 321 patients, 30 (9%) remained with an OA after 2 laparotomies. Prior to the third laparotomy, median cumulative fluid balance was +12.6 L. Thirteen (43%) received diuretics. Primary fascial closure rates were similar for diuretic use vs no diuretic (38% vs 59%, P = .46). Primary fascial closure was not associated with age ( P = .2), gender ( P = 0.7), cumulative fluid balance ( P = .3), or units of packed cells ( P = .4). Diuretic use in trauma patients with an OA after 2 laparotomies was not associated with successful PFC.

scholarly journals Draining Fluids through a Peritoneal Catheter in Newborns after Cardiac Surgery Helps to Control Fluid Balance

2010 ◽  
Vol 2010 ◽  
pp. 1-3
Author(s):  
Elisa Ruano Cea ◽  
Philippe Jouvet ◽  
Suzanne Vobecky ◽  
Aicha Merouani
Keyword(s):  
Cardiac Surgery ◽  
Fluid Balance ◽  
Balance Control ◽  
Diuretic Therapy ◽  
Right Ventricular Dysfunction ◽  
Safe Alternative ◽  
Fluid Removal ◽  
Peritoneal Drainage ◽  
Urine Electrolytes ◽  
Control Fluid

Dialysis can be used in severe cases, but may not be well tolerated. In such patients, peritoneal drainage could be an alternative option for fluid removal. We report the case of a newborn with a truncus arteriosus who developed postoperatively a complicated clinical course with right ventricular dysfunction, prerenal condition as well as fluid overload despite diuretic therapy. Dialysis was indicated for fluid removal. Peritoneal dialysis was started using a surgically placed Tenckhoff catheter and stopped due to inefficacy and leaks and no other modalities of dialysis were used. However, the catheter was left in place over a period of two months for fluid drainage and removed because of unexplained fever. In order to determine the effect of peritoneal drainage, we selected a period of one week before and one week after the removal of the drain to compare daily clinical data, urine electrolytes and renal function and found a positive effect on fluid balance control. We conclude that the fluid removal by continuous peritoneal drainage is a simple and safe alternative that can be used to control fluid balance in infants after cardiac surgery.

A “Traffic Light” approach to fluid balance control during CRRT

2016 ◽  
Vol 29 (2) ◽  
pp. 120-121
Author(s):  
Hugh Davies ◽  
Gavin Leslie
Keyword(s):  
Fluid Balance ◽  
Balance Control ◽  
Traffic Light

ModelHeart: a resident-led implementation of metrics to reduce 30-day heart failure readmissions

2018 ◽  
Vol 94 (1114) ◽  
pp. 436-441 ◽  
Author(s):  
Sergey Kachur ◽  
Patricia Kachur ◽  
Tauseef Akhtar ◽  
Elias Collado ◽  
Martha Espinosa-Friedman ◽  
...  
Keyword(s):  
Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Fluid Balance ◽  
Retrospective Review ◽  
Cleveland Clinic ◽  
Outpatient Setting ◽  
Medicare Payment ◽  
Readmission Rates ◽  
Discharged Patients

Hospitals have been penalised for excessive 30-day readmissions via Medicare payment penalties. As such there has been keen interest in finding ways of reducing readmissions. The basis for the study was a retrospective review of heart failure (HF) admissions at Cleveland Clinic Florida from 1 January 2010 to 31 December 2010. The result of this was a set of metrics associated with >30 day span between admissions: N-terminal pro-brain natriuretic peptide by at least 23%, fluid balance of ≤−1.3 L and sodium ≥135 mEq/L on discharge. The ModelHeart trial was a prospective resident-led validation of these criteria that consisted of education about and implementation of these metrics. A total of 200 patients carrying a diagnosis of HF, admitted between 1 November 2012 and 14 January 2014 were included in the trial. Of the 200 enrolled patients, 94% of discharged patients met at least one criteria, 58% met at least two criteria and 20% met all three. There were forty-eight all-cause 30-day readmissions. 30-day readmission rates between themore than equal to two criteria cohort and the remaining patients were not significantly different (p=0.71). Overall readmission rates were higher in the 2011–2012 retrospective patient pool (19%) versus the ModelHeart cohort (11%), and proportional differences were significant, (p<0.001). This may suggest that education provided sufficient awareness to alter discharge practices outside of the measured metrics. However, the lack of significant differences between groups with respect to discharge metrics suggests that further study is needed to refine the metrics and that reducing HF readmissions involves a continuum of care that spans the inpatient and outpatient setting.

scholarly journals Effect of fluid balance control in critically ill patients: Design of the stepped wedge trial POINCARE-2

2019 ◽  
Vol 83 ◽  
pp. 109-116
Author(s):  
Nelly Agrinier ◽  
Alexandra Monnier ◽  
Laurent Argaud ◽  
Michel Bemer ◽  
Jean-Marc Virion ◽  
...  
Keyword(s):  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Balance Control ◽  
Stepped Wedge ◽  
Stepped Wedge Trial

Noise-Induced Balance Loss? Rethinking Clinical Implications of Noise Exposure

2019 ◽  
Vol 4 (6) ◽  
pp. 1418-1422
Author(s):  
Bre Myers ◽  
J. Andrew Dundas
Keyword(s):  
Vestibular System ◽  
Noise Exposure ◽  
Balance Control ◽  
Scope Of Practice ◽  
Hearing Conservation ◽  
Exposed Population ◽  
Auditory Systems ◽  
Current Article ◽  
Balance Loss ◽  
Cross System

Purpose The primary aim of the current article is to provide a brief review of the literature regarding the effects of noise exposure on the vestibular and balance control systems. Although the deleterious effects of noise on the auditory system are widely known and continue to be an active area of research, much less is known regarding the effects of noise on the peripheral vestibular system. Audiologists with working knowledge of how both systems interact and overlap are better prepared to provide comprehensive care to more patients as assessment of both the auditory and vestibular systems has been in the audiologists' scope of practice since 1992. Method A narrative review summarizes salient findings from the archival literature. Results Temporary and permanent effects on vestibular system function have been documented in multiple studies. Hearing conservation, vestibular impairment, and fall risk reduction may be more intimately related than previously considered. Conclusions A full appreciation of both the vestibular and auditory systems is necessary to address the growing and aging noise-exposed population. More cross-system studies are needed to further define the complex relationship between the auditory and vestibular systems to improve comprehensive patient care.

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