• Title/Summary/Keyword: Fluid Therapy

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Meta-analysis of Inline Filtration Effects on Post-infusion Phlebitis Caused by Particulate Contamination of Intravenous Administration

  • Ku, Hye-Min;Kim, Ji-Yeon;Kang, Suk-Hyun;Lee, Eui-Kyung
    • Journal of Pharmaceutical Investigation
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    • v.40 no.4
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    • pp.225-230
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    • 2010
  • The particulate contamination of intravenously administered fluid has been of major concern. One of the most common complications associated with long term i.v. therapy is post-infusion phlebitis (PIP). We undertook a systematic review and meta-analysis of the effect of inline filters on PIP. An electronic search of Medline, KoreaMed, and KRIST was conducted to identify randomized controlled trials evaluating the effect of inline filters. Meta-analysis was undertaken using STATA 10. A total of 62 literatures were retrieved, of which 7 were included in meta-analysis. Inline filtration for intravenous infusion significantly reduced by 39% of the incidence of phlebitis, with a relative risk of 0.61 (95% CI 0.41-0.90, p=0.012). Therefore, inline filtration is a highly effective means of decreasing the incidence of infusion phlebitis and should be considered as a part of intravenous therapy.

Is Postoperative Isoniazid Therapy Necessary for Regional Lymphadenitis Following BCG Vaccination? (BCG 접종후 발생한 림프선염의 외과적 치료후 Isoniazid 투여의 필요여부)

  • Shin, Kwan-Soo;Lee, Nam-Hyuk;Kim, Sang-Youn
    • Advances in pediatric surgery
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    • v.3 no.1
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    • pp.1-5
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    • 1997
  • Regional lymphadenitis is the most common complication following BCG vaccination in this country. The literature describes controversial results with medical, surgical and combined therpy. The purpose of this study is to clarify the therapeutic effect of isoniazid(INH) after surgical procedures. The early and late postoperative complications of 136 children with lymphadenitis following BCG vaccination at the Taegu Fatima Hospital between March 1985 and February 1996 were reviewed. In 90 children, INH was given for 3-4 days before operation and for 3 months after surgery. In the other 46 cases, INH was not given during the pre- or postoperative period. Surgical procedures were excision or incision and currettage according to the states of lesions. Postoperative complications were fluid accumulation, wound infection, sinus formation and others. Complication rates were 14.4 % in INH-treated group and 13.0% of INH-nontreated group. The difference was not significant. There was no recurrence or other late complication in either groups. The result suggest that surgical excision or incision and currettage are sufficient for the treatment of regional lymphadenitis following BCG vaccination and postoperative INH therapy is not necessary.

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A case of hypothyroidism concurrent with myxedema coma in a Cocker spaniel dog

  • Kim, Yun-Hye;Kim, Jun-Hwan;Lee, Hyun-Seok;Cho, Ho-Seong;Park, Jin-Ho;Park, Chul
    • Korean Journal of Veterinary Service
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    • v.35 no.2
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    • pp.159-163
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    • 2012
  • A 4-year-old female Cocker spaniel weighing 7.74 kg was presented with a seven-month history of lethargy and skin problems. On the basis of clinical history, physical examination, laboratory tests, electrocardiogram, radiography, ultrasonography, and thyroid function tests, the dog was diagnosed as hypothyroidism. The dog was administered levothyroxine and presented a good response to the therapy. However, uncontrolled for about 6 months, the dog was re-admitted to hospital with depression and three seizure episodes. The dog was diagnosed as hypothyroidism with concurrent myxedema coma and gallbladder mucocele. With fluid therapy and administration of levothyroxine, the dog was successfully controlled for 3 months after starting treatment. This report describes the clinical features and successful treatment of a Cocker spaniel dog with concurrent hypothyroidism and myxedema coma.

Endoscopic vacuum therapy for treatment of spontaneous and iatrogenic upper gastrointestinal defects

  • Kavea Panneerselvam;Jake S. Jacob;Ronald E. Samuel;Andy Tau;Gyanprakash A. Ketwaroo;Wasif M. Abidi;Robert J. Sealock
    • Clinical Endoscopy
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    • v.56 no.6
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    • pp.754-760
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    • 2023
  • Background/Aims: Endoscopic vacuum therapy (EVT) can heal a variety of defects within the gastrointestinal (GI) tract via applying negative pressure, which reduces the defect size, aspirates the infected fluid, and promotes granulation tissue. Here we present our experience with EVT as it relates to both spontaneous and iatrogenic upper GI tract perforations, leaks, and fistulas. Methods: This retrospective study was conducted at four large hospital centers. All patients who underwent EVT between June 2018 and March 2021 were included. Data on multiple variables were collected, including demographics, defect size and location, number and intervals of EVT exchanges, technical success, and hospital length of stay. Student t-test and the chi-squared test were used to analyze the data. Results: Twenty patients underwent EVT. The most common defect cause was spontaneous esophageal perforation (50%). The most common defect location was the distal esophagus (55%). The success rate was 80%. Seven patients were treated with EVT as the primary closure method. The mean number of exchanges was five with a mean interval of 4.3 days between exchanges. The mean length of hospital stay was 55.8 days. Conclusions: EVT is a safe and effective initial management option for esophageal leaks and perforations.

Tumor Interstitial Fluid Pressure in Patients with Head and Neck Cancer (두경부 악성 종양 조직내 간질액 압력)

  • Cho Moon-June;Kim Jae-Sung;Lee In-Tae;Kim Jun-Sang;Jang Ji-Young;Kim Ki-Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.16 no.1
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    • pp.9-13
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    • 2000
  • Objectives: To determine the tumor interstitial fluid pressure(TIFP) in patients with head and neck cancerand predict radiotherapy outcome.Materials and Methods: In 12 biopsy proven primary head and neck cancer patients with accessible by direct inspection and palpation, and of sufficient thickness(>1cm) to permit accurate needle placement, we measured TIFP at cervical lymph node before and during radiotherapy using a modified wick-in-needle technique. Tumor size was measured clinically and radiologically. Results: The mean preradiotherapy TIFP was 23.4mmHg. Preradiotherapy TIFP had significant relationship with tumor size(p=0.0009). Preradiotherapy TIFP was not different between complete response group and partial or less response group(p=0.114). Radiotherapy outcome was not different between group with above and group with below average TIFP(p=0.09). Conclusion: The mean TIFP was elevated with 23.4mmHg before radiation therapy. Preradiotherapy TIFP had significant relationship with tumor size. It is not definitive that TIFP could be prognostic indicator of radiation response.

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Assessment of Body Fluid Alteration Using Bioelectrical Impedance in Stroke Patients with Hemiplegia Caused by Cerebral Hemorrhage and Cerebral Infarction

  • Shin, Yong Il;Kim, Gun Ho;Hwang, Young Jun;Baik, Seung Wan;Kim, Jae Hyung;Jeon, Gye Rok
    • Journal of Sensor Science and Technology
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    • v.26 no.3
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    • pp.160-167
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    • 2017
  • Many stroke patients undergoing rehabilitation therapy require a quantitative indicator for the evaluation of body composition in paretic and non-paretic regions. In this study, the body fluid alteration in the paretic and non-paretic regions of stroke patients with hemiplegia caused by cerebral hemorrhage and cerebral infarction was analyzed using bioelectrical impedance analysis (BIA). Alterations in body fluids were investigated to assess the physical status of the paretic and non-paretic regions of 20 stroke patients with hemiplegia caused by cerebral hemorrhage (7 patients) and cerebral infarction (13 patients). Extracellular water (ECW), intracellular water (ICW), ICW/ECW, total body water (TBW), ECW/TBW, and TBW/fat-free mass were utilized to evaluate the functional status of the paretic and non-paretic regions. Compared with the non-paretic region, the paretic region had high ECW and low ICW. Due to the loss of motor function and nutritional imbalance caused by the stroke, the amount of fat increased while the muscle quantity and quality significantly decreased in the paretic region. Thus, BIA can be a useful tool for quantitatively assessing paretic and non-paretic regions in stroke patients with hemiplegia.

Role of Cerebrospinal Fluid Biomarkers in Clinical Trials for Alzheimer's Disease Modifying Therapies

  • Kang, Ju-Hee;Ryoo, Na-Young;Shin, Dong Wun;Trojanowski, John Q.;Shaw, Leslie M.
    • The Korean Journal of Physiology and Pharmacology
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    • v.18 no.6
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    • pp.447-456
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    • 2014
  • Until now, a disease-modifying therapy (DMT) that has an ability to slow or arrest Alzheimer's disease (AD) progression has not been developed, and all clinical trials involving AD patients enrolled by clinical assessment alone also have not been successful. Given the growing consensus that the DMT is likely to require treatment initiation well before full-blown dementia emerges, the early detection of AD will provide opportunities to successfully identify new drugs that slow the course of AD pathology. Recent advances in early detection of AD and prediction of progression of the disease using various biomarkers, including cerebrospinal fluid (CSF) $A{\beta}_{1-42}$, total tau and p-tau181 levels, and imagining biomarkers, are now being actively integrated into the designs of AD clinical trials. In terms of therapeutic mechanisms, monitoring these markers may be helpful for go/no-go decision making as well as surrogate markers for disease severity or progression. Furthermore, CSF biomarkers can be used as a tool to enrich patients for clinical trials with prospect of increasing statistical power and reducing costs in drug development. However, the standardization of technical aspects of analysis of these biomarkers is an essential prerequisite to the clinical uses. To accomplish this, global efforts are underway to standardize CSF biomarker measurements and a quality control program supported by the Alzheimer's Association. The current review summarizes therapeutic targets of developing drugs in AD pathophysiology, and provides the most recent advances in the clinical utility of CSF biomarkers and the integration of CSF biomarkers in current clinical trials.

Epidural Fluid Collection after Cranioplasty : Fate and Predictive Factors

  • Lee, Jung-Won;Kim, Jae-Hoon;Kang, Hee-In;Moon, Byung-Gwan;Lee, Seung-Jin;Kim, Joo-Seung
    • Journal of Korean Neurosurgical Society
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    • v.50 no.3
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    • pp.231-234
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    • 2011
  • Objective : Infection and bone resorption are major complications of cranioplasty and have been well recognized. However, there are few clinical series describing the epidural fluid collection (EFC) as complication of cranioplasty. This study was planned to identify the predictive factors and fate of EFC after cranioplasty. Methods : We reviewed retrospectively the demographic, clinical, and radiographic data in 59 patients who underwent a first cranioplsty following decompressive craniectomy during a period of 6 years, from January 2004 to December 2009. We compared demographic, clinical, and radiographic factors between EFC group and no EFC group. The predictive factors associated with the development of EFC were assessed by logistic regression analysis. Results : Overall, 22 of 59 patients (37.3%) suffered from EFC following cranioplasty. EFC had disappeared (n=6, 31.8%) or regressed (n=6, 31.8%) over time on follow up brain computed tomographic (CT) scans. However, 5 patients (22.7%) required reoperation due to symptomatic and persistent EFC. Predictive factors for EFC were male [odds ratio (OR), 5.48; 95% CI, 1.26-23.79], air bubbles in the epidural space (OR, 12.52; 95% CI, 2.26-69.28), and dural calcification on postoperative brain CT scan (OR, 4.21; 95% CI, 1.12-15.84). Conclusion : The most of EFCs could be treated by conservative therapy. Air bubble in the epidural space and dural calcification are proposed to be the predictive factors in the formation of EFC after cranioplasty.

Vacuum Assisted Closure Therapy in Snake Bite Wound: Preliminary Report (독사 교상 환자에서의 음압요법: 예비보고)

  • Song, Woo-Jin;Choi, Hwan-Jun;Kang, Sang-Gue
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.121-126
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    • 2011
  • Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

Comparison of Blood Glucose Levels from the Fingertips of Both Patients with and without Diabetes Who are Receiving Dextrose Fluid Therapy (포도당 수액요법을 받는 당뇨병 환자와 비당뇨병 환자의 양쪽 손가락 끝 혈당치 비교)

  • Park, Suk Hyun;Lee, Chang Kwan;Kim, Yeon Woo;Kwon, Chi Hye
    • Korean Journal of Adult Nursing
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    • v.28 no.2
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    • pp.127-135
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    • 2016
  • Purpose: The aim of this study was to identify the effect of dextrose intravenous fluid (IVF) on the blood glucose levels taken from both fingertips of patients with diabetes mellitus (DM) and those without DM. Methods: From October 2012 to February 2013, 21 DM and 25 non-DM patients were recruited. Blood glucose levels taken from the both fingertips of patients at 7AM while IVF was not infusing and at 11AM, 5PM, and 9PM while IVF was infusing. Results: The differences between the mean values of blood glucose from the fingertips at four different times was not statistically significant in DM patients as well as non-DM patients. Also intra-class correlation for blood glucose levels from the fingertips with and without IVF infusion in both groups was shown over about 0.95 at each time (p<.001). Conclusion: Blood glucose levels measured in the same fingertips of both arms were the same regardless of dextrose IVF infusion. The results indicated that IVF with dextrose may not have any significant effect on the fingertip results of blood glucose level. This study may suggest that patients' both arms and any fingertips can be used for blood glucose monitoring even when the patients are on dextrose IVF infusion.