scholarly journals 1427: NET FLUID BALANCE EFFECT ON MORTALITY IN SEPTIC ICU PATIENTS WITH DIABETES

2021 ◽  
Vol 50 (1) ◽  
pp. 716-716
Author(s):  
Bryan Lee ◽  
Nitin Puri ◽  
Sharad Patel
Keyword(s):  
Fluid Balance ◽  
Icu Patients ◽  
Patients With Diabetes

scholarly journals CLINICAL CHARACTERISTICS OF 28 PATIENTS WITH DIABETES AND COVID-19 IN WUHAN, CHINA

2020 ◽  
Vol 26 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Feng Wang ◽  
Yan Yang ◽  
Kun Dong ◽  
Yongli Yan ◽  
Shujun Zhang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Clinical Characteristics ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Invasive Mechanical Ventilation ◽  
Icu Patients ◽  
Patients With Diabetes

Objective: Previous studies on coronavirus disease 2019 (COVID-19) were based on information from the general population. We aimed to further clarify the clinical characteristics of diabetes with COVID-19. Methods: Twenty-eight patients with diabetes and COVID-19 were enrolled from January 29, 2020, to February 10, 2020, with a final follow-up on February 22, 2020. Epidemiologic, demographic, clinical, laboratory, treatment, and outcome data were analyzed. Results: The average age of the 28 patients was 68.6 ± 9.0 years. Most (75%) patients were male. Only 39.3% of the patients had a clear exposure of COVID-19. Fever (92.9%), dry cough (82.1%), and fatigue (64.3%) were the most common symptoms, followed by dyspnea (57.1%), anorexia (57.1%), diarrhea (42.9%), expectoration (25.0%), and nausea (21.4%). Fourteen patients were admitted to the intensive care unit (ICU). The hemoglobin A1c level was similar between ICU and non-ICU patients. ICU patients had a higher respiratory rate, higher levels of random blood glucose, aspartate transaminase, bilirubin, creatine, N-terminal prohormone of brain natriuretic peptide, troponin I, D-dimers, procalcitonin, C-reactive protein, ferritin, interleukin (IL)-2R, IL-6, and IL-8 than non-ICU patients. Eleven of 14 ICU patients received noninvasive ventilation and 7 patients received invasive mechanical ventilation. Twelve patients died in the ICU group and no patients died in the non-ICU group. Conclusion: ICU cases showed higher rates of organ failure and mortality than non-ICU cases. The poor outcomes of patients with diabetes and COVID-19 indicated that more supervision is required in these patients. Abbreviations: COVID-19 = coronavirus disease 2019; ICU = intensive care unit; MERS-CoV = middle East respiratory syndrome-related coronavirus; 2019- nCoV = 2019 novel coronavirus; NT-proBNP = N-terminal prohormone of brain natriuretic peptide; SARS-CoV = severe acute respiratory syndrome-related coronavirus

Renal

2013 ◽  
Author(s):  
Martin Beed ◽  
Richard Sherman ◽  
Ravi Mahajan
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Resuscitation ◽  
Fluid Balance ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Crush Syndrome ◽  
Careful Attention ◽  
Icu Patients ◽  
Balance Disorders ◽  
Maintenance Fluids

Fluid balance disordersAcute kidney injuryRhabdomyolysis/crush syndromeFluid balance disorders include hypovolaemia (oligaemia), dehydration/acute fluid depletion, and hypervolaemia/fluid overload. Careful attention to fluid balance is essential in ICU. Patients are likely to require ‘maintenance’ fluids in addition to any fluid resuscitation.Hypovolaemia (see also Shock, ...

The Impact of IV Electrolyte Replacement on the Fluid Balance of Critically Ill Surgical Patients

2019 ◽  
Vol 85 (10) ◽  
pp. 1171-1174 ◽  
Author(s):  
Andrew S. Wang ◽  
Navpreet K. Dhillon ◽  
Nikhil T. Linaval ◽  
Nicholas Rottler ◽  
Audrey R. Yang ◽  
...  
Keyword(s):  
Critically Ill ◽  
Fluid Balance ◽  
Fluid Administration ◽  
Surgical Patients ◽  
Icu Patients ◽  
Surgical Icu ◽  
The Impact ◽  
To Receive ◽  
Electrolyte Replacement ◽  
Critically Ill Surgical Patients

Avoiding excess fluid administration is necessary when managing critically ill surgical patients. The aim of this study was to delineate the current practices of IVelectrolyte (IVE) replacement in a surgical ICU and quantify their contribution to the fluid balance (FB) status. Patients admitted to the surgical ICU over a six-month period were reviewed. Patients undergoing dialysis and those with ICU stay <72 hours were excluded. A total of 248 patients were included. The median age was 60 years, and 57 per cent were male. Overall, 1131 patient ICU days were analyzed. The median daily FB was 672 mL. IVEs were administered in 62 per cent of ICU days. In days that IVEs were used, negative FB was significantly less likely to be achieved (62% vs 69%, P = 0.02). The most commonly administered IVE was calcium (32% of ICU days); however, the largest volume of IVE was administered in the form of phosphorus (median 225 mL). Diuretics were administered in 17 per cent of ICU days. Patients who received diuretics were significantly more likely to receive IVE (70% vs 61%, P = 0.02). Administration of IVE may contribute to the daily positive FB of surgical ICU patients. Implementation of practices that can ameliorate this effect is encouraged.

scholarly journals Lung Ultrasound-Guided Fluid Management versus Standard Care in Surgical ICU Patients: A Randomised Controlled Trial

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1444
Author(s):  
Daniel-Mihai Rusu ◽  
Ioana Grigoraș ◽  
Mihaela Blaj ◽  
Ianis Siriopol ◽  
Adi-Ionut Ciumanghel ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Fluid Balance ◽  
Standard Care ◽  
Lung Ultrasound ◽  
Controlled Trial ◽  
Fluid Management ◽  
Active Group ◽  
Icu Patients ◽  
Surgical Icu ◽  
Randomised Controlled

The value of lung ultrasound (LU) in assessing extravascular lung water (EVLW) was demonstrated by comparing LU with gold-standard methods for EVLW assessment. However, few studies have analysed the value of B-Line score (BLS) in guiding fluid management during critical illness. The purpose of this trial was to evaluate if a BLS-guided fluid management strategy could improve fluid balance and short-term mortality in surgical intensive care unit (ICU) patients. We conducted a randomised, controlled trial within the ICUs of two university hospitals. Critically ill patients were randomised upon ICU admission in a 1:1 ratio to BLS-guided fluid management (active group) or standard care (control group). In the active group, BLS was monitored daily until ICU discharge or day 28 (whichever came first). On the basis of BLS, different targets for daily fluid balance were set with the aim of avoiding or correcting moderate/severe EVLW increase. The primary outcome was 28-day mortality. Over 24 months, 166 ICU patients were enrolled in the trial and included in the final analysis. Trial results showed that daily BLS monitoring did not lead to a different cumulative fluid balance in surgical ICU patients as compared to standard care. Consecutively, no difference in 28-day mortality between groups was found (10.5% vs. 15.6%, p = 0.34). However, at least 400 patients would have been necessary for conclusive results.

scholarly journals The Development of Intensive Care Unit Acquired Hypernatremia Is Not Explained by Sodium Overload or Water Deficit: A Retrospective Cohort Study on Water Balance and Sodium Handling

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
M. C. O. van IJzendoorn ◽  
H. Buter ◽  
W. P. Kingma ◽  
G. J. Navis ◽  
E. C. Boerma
Keyword(s):  
Water Balance ◽  
Water Deficit ◽  
Fluid Balance ◽  
Sodium Intake ◽  
Severity Of Illness ◽  
Sodium Concentration ◽  
Balance Study ◽  
Icu Patients ◽  
Sodium Overload ◽  
Sodium Handling

Background. ICU acquired hypernatremia (IAH, serum sodium concentration (sNa) ≥ 143 mmol/L) is mainly considered iatrogenic, induced by sodium overload and water deficit. Main goal of the current paper was to answer the following questions: Can the development of IAH indeed be explained by sodium intake and water balance? Or can it be explained by renal cation excretion?Methods.Two retrospective studies were conducted: a balance study in 97 ICU patients with and without IAH and a survey on renal cation excretion in 115 patients with IAH.Results.Sodium intake within the first 48 hours of ICU admission was 12.5 [9.3–17.5] g in patients without IAH (n=50) and 15.8 [9–21.9] g in patients with IAH (n=47),p=0.13. Fluid balance was 2.3 [1–3.7] L and 2.5 [0.8–4.2] L, respectively,p=0.77. Urine cation excretion (urine Na + K) was < sNa in 99 out of 115 patients with IAH. Severity of illness was the only independent variable predicting development of IAH and low cation excretion, respectively.Conclusion. IAH is not explained by sodium intake or fluid balance. Patients with IAH are characterized by low urine cation excretion, despite positive fluid balances. The current paradigm does not seem to explain IAH to the full extent and warrants further studies on sodium handling in ICU patients.

Liberal Glucose Control in ICU Patients With Diabetes

2018 ◽  
Vol 46 (6) ◽  
pp. 935-942 ◽  
Author(s):  
Nora Luethi ◽  
Luca Cioccari ◽  
Peter Biesenbach ◽  
Luca Lucchetta ◽  
Hidetoshi Kagaya ◽  
...  
Keyword(s):  
Glucose Control ◽  
Icu Patients ◽  
Patients With Diabetes

Intramuscular Nerve and Neuromuscular Junction Alteration In Extraocular Muscles of Diabetic Mice

1985 ◽  
Vol 43 ◽  
pp. 682-683
Author(s):  
Bruce R. Pachter
Keyword(s):  
Diabetes Mellitus ◽  
Peripheral Nerves ◽  
Sudden Onset ◽  
Extraocular Muscles ◽  
Diabetic Patients ◽  
Oculomotor Palsy ◽  
Third Nerve Palsy ◽  
Patients With Diabetes ◽  
Intramuscular Nerve ◽  
Oculomotor Nerves

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).

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