scholarly journals Use of focus assessed transthoracic echocardiography (FATE) in the veterinary emergency room

2017 ◽  
Vol 47 (12) ◽  
Author(s):  
Stephany Buba Lucina ◽  
Ana Paula Sarraff-Lopes ◽  
Marlos Gonçalves Sousa
Keyword(s):  
Veterinary Medicine ◽  
Emergency Room ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Transthoracic Echocardiography ◽  
Human Medicine ◽  
Diagnostic Methods ◽  
Therapeutic Approaches ◽  
Echocardiographic Examination

ABSTRACT: The use of bedside focus assessed transthoracic echocardiography (FATE) is widespread in human medicine, and the potential for veterinary medicine has only recently been investigated. Focused echocardiographic examination can be beneficial in critically ill patients compared to other bedside diagnostic methods, as well as facilitating rapid therapeutic approaches in the emergency room. The aim of this review is to discuss FATE and identify its main applications in veterinary medicine. In this context, FATE has proved to be benefical even when carried out by a non-cardiologist physician or veterinarian. However, a few references on this subject exist in the veterinary literature and there is still a need for standardization of this technique for use in animals.

scholarly journals Analysis of the costs of emergency room management of critically ill patients

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Gabriele Valli ◽  
Paolo Fratini ◽  
Nicola Volpe ◽  
Francesca De Marco ◽  
Caterina Pandolfi ◽  
...  
Keyword(s):  
Emergency Room ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Emergency Room Management

Systemic Antifungal Agents

2018 ◽  
Author(s):  
Brett A Melnikoff ◽  
René P Myers
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Antifungal Agents ◽  
Fungal Infections ◽  
Antifungal Prophylaxis ◽  
Morbidity And Mortality ◽  
Transplant Recipients ◽  
Therapeutic Approaches ◽  
Timely Fashion ◽  
Antifungal Chemotherapy

Fungal infections remain an important cause of morbidity and mortality in surgical settings, with critically ill patients, transplant recipients, and sick neonates all especially vulnerable. Fungal infections remain an important cause of morbidity and mortality in surgical settings, with critically ill patients, transplant recipients, and sick neonates all especially vulnerable. Despite the development of a number of new and useful antifungal agents in the past decade and the noteworthy improvements in therapeutic approaches to fungal infections, physicians’ ability to diagnose these infections in a timely fashion remains limited, and patient outcomes remain poor. Antifungal prophylaxis has emerged as a potential means of reducing the occurrence of serious fungal infections. In patient populations estimated to be at high risk for acquiring a fungal infection, antifungal prophylaxis has reduced infection rates by about 50%; however, it has not been shown to significantly improve mortality. This review discusses both established and newly approved systemic antifungal agents. Tables list characteristics of currently available antifungals and antifungal chemotherapy. This review contains 2 tables and 32 references Key words: antifungal chemotherapy, antifungal prophylaxis, antifungals, Candida prophylaxis, systemic antifungal medications

Candidiasis

2018 ◽  
Author(s):  
Brett A Melnikoff ◽  
René P Myers
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Antimicrobial Agents ◽  
Fungal Infections ◽  
Diagnostic Methods ◽  
Ventricular Assist Devices ◽  
Transplant Recipients ◽  
Ventricular Assist ◽  
Disseminated Candidiasis ◽  
Candida Infections

Fungal infections remain an important cause of morbidity and mortality in surgical settings, with critically ill patients, transplant recipients, and sick neonates all especially vulnerable. Over the past few decades, technological and scientific advancements have improved physicians’ ability to sustain life in critically ill patients; developments in chemotherapeutics and immune-based therapies have yielded increased survival for many cancer patients; organ transplantation has evolved dramatically; and the use of invasive therapies (eg, ventricular assist devices) has increased markedly. With these changes has come an increase in the incidence of serious Candida infections. This review covers the definition and classification, epidemiology and risk factors, and clinical evaluation of candidiasis, as well as management of candidemia, acute disseminated candidiasis, nonhematogenous candidiasis, and peritonitis and intra-abdominal abscess. Figures show Candida endophthalmitis in patients with persistent fungemia and superficial candidiasis in the gastrointestinal tract. Tables list clinical presentation and diagnostic methods for common fungal infections, antimicrobial agents of choice for candidal infections, and the latest guidelines for candidiasis. This review contains 2 figures, 3 tables and 131 references Key words: acute disseminated candidiasis, candidemia, candidiasis, candiduria, nonhematogenous candidiasis  

scholarly journals Causes, management and complications of severe adult dehydration in the emergency room

2021 ◽  
Vol 8 (2) ◽  
pp. 943
Author(s):  
Abdulrahman Mohammad Ghafouri ◽  
Shurouq Hamzah Arkoubi ◽  
Talal Maqboul Al-Amri ◽  
Afaf Matar Alshamari ◽  
Mohammed Ali Alqahtani ◽  
...  
Keyword(s):  
Emergency Room ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Skin Diseases ◽  
Caloric Intake ◽  
Fluid Administration ◽  
Renal Protection ◽  
Cellular Processes ◽  
Main Challenge ◽  
Uncontrolled Diabetes

This literature review aims to highlight the possible causes, complications, and management of this event from previously published studies discussing dehydration in critically-ill patients admitted to the emergency room (ER). In general, the administration of fluids has been used in the ER for critically-ill patients for many purposes. These include the optimization and adjustment of body fluids and electrolytes, increase renal protection against contrast, enhance uric acid, globins, caloric intake, and as an adjuvant to ameliorate the potentiality of certain medications or to dilute them. Many etiologies have been accused to cause dehydration in critically-ill patients. These include the fasting strategy that patients are obliged to whenever undergoing a surgical operation. Kidney, heart, and liver injuries have also been associated with patients’ dehydration. Old age and the presence of other co-morbidities diabetes insipidus and uncontrolled diabetes can also aggravate the condition. Mental affection is the main complication that patients with severe dehydration might complain about. Other complications might include aggravation of heart failure, and skin diseases, and deterioration of the kidney functions and other cellular processes that require adequate nourishment for their daily normal functions. Mortality is also a serious common complication, especially within elderly patients. Although the management of dehydration can be easily achieved by fluid administration, fluid overload can aggravate the underlying complications and develop others. Therefore, the main challenge here would be to frequently monitor patients during fluid administration and resuscitation to prevent this side effect.

scholarly journals Utility of transthoracic echocardiography (TTE) in assessing fluid responsiveness in critically ill patients – a challenge for the bedside sonographer.

2016 ◽  
Vol 18 (4) ◽  
pp. 508 ◽  
Author(s):  
Wojciech Mielnicki ◽  
Agnieszka Dyla ◽  
Tomasz Zawada
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Fluid Responsiveness ◽  
Critically Ill Patients ◽  
Transthoracic Echocardiography ◽  
Diagnostic Tools ◽  
Dynamic Parameters ◽  
Hemodynamic Assessment ◽  
Life Threatening

Transthoracic echocardiography (TTE) has become one of the most important diagnostic tools in the treatment of critically ill patients. It allows clinicians to recognise potentially reversible life-threatening situations and is also very effective in the monitoring of the fluid status of patients, slowly substituting invasive methods in the intensive care unit. Hemodynamic assessment is based on a few static and dynamic parameters. Dynamic parameters change during the respiratory cycle in mechanical ventilation and the level of this change directly corresponds to fluid responsiveness. Most of the parameters cannot be used in spontaneously breathing patients. For these patients the most important test is passive leg raising, which is a good substitute for fluid bolus. Although TTE is very useful in the critical care setting, we should not forget the important limitations, not only technical ones but also caused by the critical illness itself. Unfortunately, this method does not allow continuous monitoring and every change in the patient’s condition requires repeated examination.Keywords: hypovolaemia; non-invasive monitoring; intensive care unit; transthoracic echocardiography

A step-by-step guide to placing a central venous jugular catheter

2020 ◽  
Vol 25 (7) ◽  
pp. 1-4
Author(s):  
Delphine Le Chevallier
Keyword(s):  
Veterinary Medicine ◽  
Parenteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Central Venous Access ◽  
Venous Access ◽  
Blood Sampling ◽  
Seldinger Technique ◽  
Peripheral Vein ◽  
Central Venous

Placing a central venous jugular catheter is a valuable technique. The method used is the modified Seldinger technique (over the wire), which is also used to place chest drains. While intravenous catheterisation of a peripheral vein is common practice in veterinary medicine, critically ill patients may require central venous access if peripheral access is not possible. This is also useful when large volumes of fluid are required, for example for administration of irritant drugs or for parenteral nutrition, or for regular blood sampling.

Fungal Infections

2013 ◽  
Author(s):  
Sara Buckman ◽  
Luis A. Fernandez
Keyword(s):  
Fungal Infection ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Antimicrobial Agents ◽  
Fungal Infections ◽  
Antifungal Prophylaxis ◽  
Diagnostic Methods ◽  
Fungal Colonization ◽  
Surgical Patient ◽  
Candida Infections

Fungal infections remain an important cause of morbidity and mortality in surgical settings, with critically ill patients, transplant patients, and sick neonates all being especially vulnerable. Over the past few decades, technological and scientific advancements have improved physicians’ ability to sustain life in critically ill patients, developments in chemotherapeutics and immune-based therapies have yielded increased survival for many cancer patients, organ transplantation has evolved dramatically, and the use of invasive therapies has increased markedly. With these changes has come an increase in the incidence of serious Candida infections, as well as an increase in the less common but potentially fatal noncandidal infections caused by Aspergillus and the Zygomycetes Mucor and Rhizopus. Antifungal prophylaxis has emerged as a potential means of reducing the occurrence of serious fungal infections. This review covers fungal colonization versus infection, types of fungal infection, epidemiology and risk factors, clinical evaluation, investigative studies, management of acute candidemia and acute disseminated candidiasis, management of nonhematogenous candidiasis, peritonitis and intra-abdominal abscess, management of other fungal infections (Aspergillus, Cryptococcus, Mucor, Rhizopusi), systemic antifungal agents, and the pathogenesis of Candida infection. Tables describe the clinical presentation and diagnostic methods for common fungal infections, antimicrobial agents of choice for candida infections, antifungal chemotherapy, and characteristics of currently available antifungals. Figures show Candida endophthalmitis; superficial candidiasis; biopsy samples of chronic progressive disseminated histoplasmosis and thick-walled, broad-based budding yeasts typical for Blastomyces dermatitidis; and the various forms of Candida. Algorithms demonstrate the approach to the surgical patient at risk for candidiasis, aspergillosis, and other types of fungal infection. This review contains 5 figures, 4 tables, and 189 references.

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