scholarly journals Case reports of observed significant improvement in patients with ARDS due to COVID-19 and maximum ventilatory support after inhalation of sodium bicarbonate

2020 ◽  
Vol 5 (1) ◽  
pp. 015-019
Author(s):  
A Wardeh ◽  
J Conklin ◽  
M Ko
Keyword(s):  
Sodium Bicarbonate ◽  
Case Reports ◽  
Ventilatory Support

scholarly journals Seizures, Metabolic Acidosis and Coma Resulting from Acute Isoniazid Intoxication

2005 ◽  
Vol 33 (4) ◽  
pp. 518-520 ◽  
Author(s):  
I. Topcu ◽  
E. A. Yentur ◽  
A. Kefi ◽  
N. Z. Ekici ◽  
M. Sakarya
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Metabolic Acidosis ◽  
Sodium Bicarbonate ◽  
Successful Treatment ◽  
Ventilatory Support ◽  
Anticonvulsant Therapy ◽  
Dose Equivalent ◽  
Adult Case ◽  
Clinical Triad

Isoniazid is an anti-tuberculosis drug, used commonly for treatment and prophylaxis of tuberculosis. Acute isoniazid intoxication is characterized by a clinical triad consisting of metabolic acidosis resistant to treatment with sodium bicarbonate, seizures which may be fatal and refractory to standard anticonvulsant therapy, and coma. Treatment requires admission to the intensive care unit for ventilatory support, management of seizures and metabolic acidosis. Pyridoxine, in a dose equivalent to the amount of isoniazid ingested, is the only effective antidote. We report the successful treatment of two isoniazid intoxication cases: the case of a child developing an accidental acute isoniazid intoxication and an adult case of isoniazid intoxication with the intent of suicide.

Prevention of Kidney Injury Following Rhabdomyolysis: A Systematic Review

2013 ◽  
Vol 47 (1) ◽  
pp. 90-105 ◽  
Author(s):  
Elizabeth J Scharman ◽  
William G Troutman
Keyword(s):  
Sodium Bicarbonate ◽  
Urine Output ◽  
Single Case ◽  
Case Reports ◽  
Data Extraction ◽  
Kidney Injury ◽  
Fluid Administration ◽  
Controlled Study ◽  
Fluid Type ◽  
Significant Difference

OBJECTIVE To conduct a systematic literature review to evaluate evidence-based recommendations for the prevention of rhabdomyolysis-associated acute renal failure (ARF). DATA SOURCES PubMed (1966-December 2012), International Pharmaceutical Abstracts, Science Citation Index, and Cochrane databases (1970-December 2012) were searched. There were no language restrictions. STUDY SELECTION AND DATA EXTRACTION Studies selected dealt with treatment of rhabdomyolysis (crush syndrome) or prevention of ARF in patients with rhabdomyolysis. Articles excluded did not present original data or described only the management of ARF after it developed. Single case reports were excluded. Extracted data included study type; population; definitions of rhabdomyolysis and ARF; fluid, sodium bicarbonate, and mannitol dosages; and study findings. DATA SYNTHESIS Twenty-seven studies met the inclusion criteria. No controlled trials compared intravenous fluid administration plus sodium bicarbonate to fluid administration alone. Three concluded that there was no significant difference in the rates of ARF between patients receiving and those not receiving sodium bicarbonate; however, urine alkalinization was not documented. Eight investigations concluded that delayed fluid administration increased the risk of ARF. No controlled study compared volumes of fluid administered or targeted urine output goals. Fluid type, therapy duration, and monitoring parameters varied widely; 4 used a urine output goal in adults of more than 300 mL/h or 300 mL/h or more. No evidence supported a preferred fluid type or that sodium bicarbonate with or without mannitol was superior to fluid therapy alone. CONCLUSIONS Intravenous fluids should be initiated as soon as possible, preferably within the first 6 hours after muscle injury, at a rate that maintains a urine output in adults of 300 mL/h or more for at least the first 24 hours. Sodium bicarbonate should be administered only if necessary to correct systemic acidosis and mannitol only to maintain urine output of 300 mL/h or more despite adequate fluid administration.

scholarly journals Ocorrência de Lesão Pulmonar Aguda relacionada à Transfusão em Hospital de Referência do Ceará: Relato de Caso / Occurrence of Transfusion-related Acute Lung Injury in a Reference Hospital of Ceará: Case Report

2021 ◽  
Vol 15 (58) ◽  
pp. 410-426
Author(s):  
Hermínia Moreira Coelho da Costa
Keyword(s):  
Acute Lung Injury ◽  
Case Report ◽  
Blood Transfusion ◽  
Lung Injury ◽  
Health Professionals ◽  
Case Reports ◽  
Ventilatory Support ◽  
Exploratory Laparotomy ◽  
High Morbidity ◽  
Reference Hospital

Lesão pulmonar aguda relacionada à transfusão (TRALI –Transfusion Related Acute Lung Injury) é uma complicação grave da transfusão sanguínea que cursa essencialmente com desconforto respiratório durante ou dentro de 6 horas depois de completada a transfusão. Apesar de ser considerada rara e a lesão pulmonar ser geralmente transitória, traz preocupação aos profissionais da área da saúde, visto que está associada à alta morbidade dos pacientes que necessitaram de suporte ventilatório, assim como a alta mortalidade. Sua incidência não está bem estabelecida, muito devido à falta de preparo para identificar os casos suspeitos. Assim, os relatos de casos ganham relevância tanto para contribuir que o diagnóstico desta patologia seja alcançado com mais facilidade quanto para estimular que os casos sejam notificados. O presente relato descreve a ocorrência de TRALI em paciente no segundo dia de pós-operatório de cesárea por pré- eclâmpsia e síndrome Hellp que evoluiu com suspeita de hemoperitônio sendo submetida a laparotomia exploratória (LE).---Transfusion related acute lung injury (TRALI) is a serious complication of blood transfusion that evolves mainly with respiratory distress during or within 6 hours after transfusion. Although considered rare and is usually transient lung injury, she brings concern to health professionals, as it is associated with high morbidity of patients requiring ventilatory support, as well as the high mortality. Its incidence is not well established, much due to lack of preparation to identify suspected cases. Thus, case reports gain relevance to contribute to the diagnosis of this condition is more easily achieved as to stimulate the cases are reported. This report describes the occurrence of TRALI in a patient on the second day after surgery by cesarean preeclampsia and HELLP syndrome who developed suspected hemoperitoneum and underwent exploratory laparotomy (LE).

scholarly journals Myasthenia gravis and COVID-19: a systematic review of case reports and case series

2021 ◽  
Vol 50 (2) ◽  
pp. 87-106
Author(s):  
Débora Lilian Roveron ◽  
Ivan Luiz Gonçalves dos Santos ◽  
Julio Luiz Gonçalves dos Santos ◽  
Najila Fernandes Alem ◽  
João Gabriel Pacetti Capobianco
Keyword(s):  
Systematic Review ◽  
Respiratory Failure ◽  
Myasthenia Gravis ◽  
Corticosteroid Therapy ◽  
Neuromuscular Transmission ◽  
Case Reports ◽  
Ventilatory Support ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Main Factor

Myasthenia gravis (MG) is an autoimmune disease involving neuromuscular transmission and possible respiratory failure when concomitant with COVID-19. The aim of this study was to analyze the need for ventilatory support (VS), length of hospital stay (LOS) and mortality in patients diagnosed with MG and COVID-19. In this systematic review, PubMed, SciELO, LILACS, MEDLINE and IBECS databases were searched for primary studies published from January 2010 to March 2021, with no language restrictions. Fourteen eligible studies were identified. The main factor associated with the need for VS was the use of antibiotics other than azithromycin (AZM) for the treatment of COVID-19 (RR 1.60; 95% CI 1.20–2.91; p = 0.009). Patients who used hydroxychloroquine (HCQ)  and AZM had almost twice the risk of needing invasive ventilatory support (IVS) (RR 1.94; 95% CI 1.07-3.52; p = 0.16). There were nonsignificant trends towards less need for IVS in patients who used intravenous immunoglobulin (IVIg) and corticosteroid therapy (RR 0.54; 95% CI 0.09–3.26; p = 0.60). There was a trend towards shorter LOS in patients who received therapy with IVIg and corticosteroid therapy [8 (5 - 8) vs 19 (12.2–23.7); p = 0.007]. 10.3% (n = 4/39) died and 100% did not use IVIg or IVIg and prednisone. There was a non-significant trend towards higher mortality in patients who used AZM (RR 2.55; 95% CI 0.26–30.02; p = 0.60).  IVIg and corticotherapy presented themselves as a favorable alternative in relation to the outcomes.KEY WORDS: Coronavirus infections; length of stay; Myasthenia gravis; Respiratory insufficiency.

scholarly journals DIAPHRAGMATIC ULTRASONOGRAPHY AS A PREDICTOR OF VENTILATORY WEANING: A SYSTEMATIC REVIEW

2021 ◽  
Author(s):  
André Luiz Lisboa Cordeiro ◽  
Lucas Soares ◽  
Késsia Oliveira ◽  
Amanda Maria Jesus
Keyword(s):  
Artificial Respiration ◽  
Case Reports ◽  
Ventilatory Support ◽  
Ventilator Weaning ◽  
Inclusion Criteria ◽  
Cutoff Value ◽  
Predicting Success ◽  
Literature Reviews ◽  
Predictor Of Success ◽  
Definition Of

Objectives: To review the evidence on Diaphragmatic Ultrasonography as a predictor of success in ventilatory weaning. Methodology:Systematically review using the PICO methodology and keywords: Ultrasound, Ultrasound, Diagnostic imaging, Diaphragm, Weaning, Intensive Care Unit, Artificial Respiration, Mechanical Ventilation, Ventilator Weaning. Published cohort studies were used without language and year restrictions that addressed the use of ultrasound to predict success in weaning and ventilatory extubation. Studies with patients under 18 years of age, case reports, literature reviews, results that do not bring a cutoff value for thickness and diaphragmatic excursion and the definition of failure in the weaning and extubation process were excluded. In addition, the Boolean operators “and” and “or” were used. Results:459 were found, which after exclusion due to duplication and reading of titles and abstract, only 11 were selected by the inclusion criteria. The samples ranged from 34 to 193 individuals. We can evidence that the use of USG to assess the thickness and excursion of the diaphragm in patients undergoing invasive ventilatory support is effective in predicting success in the weaning and extubation process. Conclusion: It is concluded that Diaphragmatic Ultrasonography has great applicability to assess the ability to predict success or failure in removing invasive ventilatory support.

scholarly journals The Role of Sodium Bicarbonate in the Management of Some Toxic Ingestions

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Aibek E. Mirrakhimov ◽  
Taha Ayach ◽  
Aram Barbaryan ◽  
Goutham Talari ◽  
Romil Chadha ◽  
...  
Keyword(s):  
Sodium Bicarbonate ◽  
Metabolic Alkalosis ◽  
Case Reports ◽  
Toxic Substance ◽  
Case Series ◽  
Decompensated Heart Failure ◽  
The United States ◽  
Severe Toxicity ◽  
High Sodium ◽  
The Impact

Adverse reactions to commonly prescribed medications and to substances of abuse may result in severe toxicity associated with increased morbidity and mortality. According to the Center for Disease Control, in 2013, at least 2113 human fatalities attributed to poisonings occurred in the United States of America. In this article, we review the data regarding the impact of systemic sodium bicarbonate administration in the management of certain poisonings including sodium channel blocker toxicities, salicylate overdose, and ingestion of some toxic alcohols and in various pharmacological toxicities. Based on the available literature and empiric experience, the administration of sodium bicarbonate appears to be beneficial in the management of a patient with the above-mentioned toxidromes. However, most of the available evidence originates from case reports, case series, and expert consensus recommendations. The potential mechanisms of sodium bicarbonate include high sodium load and the development of metabolic alkalosis with resultant decreased tissue penetration of the toxic substance with subsequent increased urinary excretion. While receiving sodium bicarbonate, patients must be monitored for the development of associated side effects including electrolyte abnormalities, the progression of metabolic alkalosis, volume overload, worsening respiratory status, and/or worsening metabolic acidosis. Patients with oliguric/anuric renal failure and advanced decompensated heart failure should not receive sodium bicarbonate.

scholarly journals Fulminant myocarditis as an early presentation of SARS-CoV-2

2020 ◽  
Vol 13 (9) ◽  
pp. e237553 ◽  
Author(s):  
Tamara Naneishvili ◽  
Arsalan Khalil ◽  
Ryan O'Leary ◽  
Neeraj Prasad
Keyword(s):  
Viral Infections ◽  
Case Reports ◽  
Parvovirus B19 ◽  
Ventilatory Support ◽  
Coxsackie Virus ◽  
Fulminant Myocarditis ◽  
Caucasian Woman ◽  
Myocardial Inflammation ◽  
Second Phase ◽  
Early Presentation

Myocarditis is well known to be caused by viral infections such as Coxsackie virus group B, human herpes virus 6 and parvovirus B19. However, during the current emerging outbreak of SARS-CoV-2, there have been few case reports describing myocarditis as a possible presentation. In our case report we describe, early cardiac manifestations of SARS-CoV-2 in a UK District General Hospital. A 44-year-old Caucasian woman without any comorbidities presented with SARS-CoV-2 related fulminant myocarditis without initial respiratory symptoms. Patient underwent treatment with milrinone and methylprednisolone that showed reduction in myocardial inflammation and significantly improved myocardial contractility. This was then followed by a second phase of SARS-CoV-2 associated pneumonia and renal failure requiring ventilatory support and haemofiltration. Although, not described in the literature, we have found conjunctive use of milrinone and methylprednisolone effective in patient with SARS-CoV-2 fulminant myocarditis.

scholarly journals Mucormycosis-induced upper gastrointestinal ulcer perforation in immunocompetent patients: a report of two cases

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongyun Huang ◽  
Lang Xie ◽  
Zheng Zheng ◽  
Hanhui Yu ◽  
Lingjing Tu ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Bacterial Infection ◽  
Fungal Infection ◽  
Clinical Symptoms ◽  
Case Reports ◽  
Ventilatory Support ◽  
Young Patients ◽  
Good Prognosis ◽  
Pathological Examination ◽  
First Case

Abstract Background Gastrointestinal mucormycosis (GIM) is a rare, opportunistic fungal infection with poor prognosis. Clinically, it is difficult to diagnose GIM owing to its nonspecific clinical symptoms and poor suspicion. The estimated incidence of GIM is inaccurate, and most cases are diagnosed accidentally during surgery or upon postmortem examination. GIM usually occurs in patients with immune deficiencies or diabetes. Here, we report two cases of immunocompetent young patients with GIM who had good prognosis after treatment. Compared to other case reports on GIM, our cases had unusual infection sites and no obvious predisposing factors, which make it important to highlight these cases. Case presentation The first case was that of a 16-year-old immunocompetent boy who was admitted with gastrointestinal bleeding and perforation due to a gastric ulcer. Strategies used to arrest bleeding during emergency gastroscopy were unsuccessful. An adhesive mass was then discovered through laparoscopy. The patient underwent type II gastric resection. Pathological examination of the mass revealed bacterial infection and GIM. The second case was of a 33-year-old immunocompetent woman with a recent history of a lower leg sprain. The patient subsequently became critically ill and required ventilatory support. After hemodynamic stabilization and extubation, she presented with hematemesis due to exfoliation and necrosis of the stomach wall. The patient underwent total gastrectomy plus jejunostomy. The pathology results revealed severe bacterial infection and fungal infection that was confirmed as GIM. The patient fully recovered after receiving anti-infective and antifungal treatments. Conclusions Neither patient was immunosuppressed, and both patients presented with gastrointestinal bleeding. GIM was confirmed via pathological examination. GIM is not limited to immunocompromised patients, and its diagnosis mainly relies on pathological examination. Early diagnosis, timely surgical treatment, and early administration of systemic drug treatment are fundamental to improving its prognosis.

Ultrastructure of the basal body apparatus in epidermal cells of a sponge larva (Aplysilla SP: Demospongiae)

1992 ◽  
Vol 50 (1) ◽  
pp. 928-929
Author(s):  
R.L. Pinto ◽  
R.M. Woollacott
Keyword(s):  
Sodium Bicarbonate ◽  
Epoxy Resin ◽  
Basal Body ◽  
Phosphate Buffer ◽  
Similar Data ◽  
Basal Apparatus ◽  
Striated Rootlet ◽  
The Common ◽  
Basal Foot ◽  
Sexually Mature

The basal body and its associated rootlet are the organelles responsible for anchoring the flagellum or cilium in the cytoplasm. Structurally, the common denominators of the basal apparatus are the basal body, a basal foot from which microtubules or microfilaments emanate, and a striated rootlet. A study of the basal apparatus from cells of the epidermis of a sponge larva was initiated to provide a comparison with similar data on adult sponges.Sexually mature colonies of Aplysillasp were collected from Keehi Lagoon Marina, Honolulu, Hawaii. Larvae were fixed in 2.5% glutaraldehyde and 0.14 M NaCl in 0.2 M Millonig’s phosphate buffer (pH 7.4). Specimens were postfixed in 1% OsO4 in 1.25% sodium bicarbonate (pH 7.2) and embedded in epoxy resin. The larva ofAplysilla sp was previously described (as Dendrilla cactus) based on live observations and SEM by Woollacott and Hadfield.

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