Continuous Veno-Venous Hemofiltration During Intercontinental Aeromedical Evacuation.

Continuous Veno-Venous Hemofiltration During Intercontinental Aeromedical Evacuation. Mil Med. 2018 Mar 01;183(suppl_1):189-192 Authors: Driscoll IR, Wallace A, Rosario FA, Hensley S, Cline KD, Chung KK Abstract Overseas contingency operations which occur in areas lacking medical infrastructure pose challenges to the stabilization and transportation of critically ill patients. In particular, metabolic derangements resulting from acute kidney injury (AKI) make long-distance aeromedical evacuation risky. Here, we report the first modern use of in-flight continuous veno-venous hemofiltration (CVVH) for intercontinental aeromedical evacuation. Hospital and transport records were reviewed for a 31-yr-old male active duty service member who sustained 40% total body surface area full thickness burns after high-voltage electrical exposure in the southern Philippines. He was evacuated to the Burns Centre at Singapore General Hospital, where CVVH was initiated for anuric AKI secondary to rhabdomyolysis. The United States Army Institute of Surgical Research (USAISR) Burn Flight Team transported the patient to the USAISR Burn Center at Fort Sam Houston, TX, USA. CVVH was performed in-flight for 15 h out of 19.5 h of total flight time. CVVH settings were maintained as follows: blood flow 250 mL/min; replacement fluid rate 3,500 mL/h; and no ultra-filtrate removal. Unfractionated heparin at 500 units/h was utilized for regional anticoagulation. No filter clotting was e...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research

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ConclusionPatients with electrical injuries have several unique acute manifestations that differ from other burns. Prognosticating outcomes is difficult, as the full scale of damage is seldom immediately evident. Multiple organ systems are often affected, which makes the treatment of such patients exceptionally challenging, multi-disciplinary and resource-intensive.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionsFirst, patients admitted to our burn unit with electrical injury accompanied by significant skin and muscle injury rarely exhibit hyperkalemia. Secondly, the presence of hyperkalemia is independent of the severity of rhabdomyolysis or the extent of the burn.
Source: Burns - Category: Dermatology Source Type: research
​Compartment syndrome made it on our weird and wild list not only because it is uncommon but also because it is difficult to identify. It presents in strange ways, and is often missed the first time a patient seeks care. This rare but serious condition may result in permanent contractures or even loss of a limb. Complications from compartment syndrome escalate quickly if they're not treated promptly. Early recognition and treatment of this problem is imperative.The increased pressure in the space around certain muscles that creates compartment syndrome can be caused by fractures, bleeding, recent surgeries, burns, rhabdo...
Source: The Procedural Pause - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
We present a review of the published data of acute foot compartment syndrome and pedal frostbite, with pathogenesis, treatment, and subsequent sequelae. A case report illustrating 1 example of bilateral foot, atraumatic compartment syndrome, is highlighted in the present report. The patient presented with changes consistent with distal bilateral forefoot frostbite, along with gangrenous changes to the distal tuft of each hallux. At admission and evaluation, the patient had increasing rhabdomyolysis with no other clear etiology. Compartment pressures were measured in the emergency room and were >100 mm Hg in the med...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
Amelia Burns, 30, from Berkshire, returned home from her daily session at the gym to find her arms swollen and she passed out. She was diagnosed with life-threatening condition rhabdomyolysis.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
Amelia Burns, 30, from Berkshire, returned home from her daily session at the gym to find her arms swollen and she passed out. She was diagnosed with life-threatening condition rhabdomyolysis.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
BY SHANNON BROWNLEE On Wednesday, October 25, 2017 I was at the inaugural Society for Participatory Medicine conference. It was a fantastic day and the ending keynote was the superb Shannon Brownlee. It was great to catch up with her and I’m grateful that she agreed to let THCB publish her speech. Settle back with a cup of coffee (or as it’s Thanksgiving, perhaps something stronger), and enjoy–Matthew Holt George Burns once said, the secret to a good sermon is to have a good beginning and a good ending—and to have the two as close together as possible. I think the same is true of final keynotes aft...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: OP-ED Patients Physicians Lown Institute Overtreatment Right Choice Alliance Shannon Brownlee Society for Participatory Medicine Source Type: blogs
Discussion Hypernatremia is a serum sodium of> 150 mEq/L. Basic causes are too much sodium or too little free water. If body weight is normal or increased, there is an increase in total body sodium without an appropriate increase in total body water. Normally when the serum sodium is increased there is transient hypertonicity of the plasma which causes the thirst center to be stimulated and antidiuretic hormone (ADH) to be released. The thirst center tells the person to drink more water and ADH causes the kidney to retain free water. This normally will allow the plasma tonicity to go back to normal. Treatment is by tr...
Source: - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Conclusion: This study reports a possible mechanism for RM-induced AKI and suggests that reductions in TTR could increase the generation of ROS and induce apoptosis. TTR may be a potentially valuable target for RM-induced AKI.Cell Physiol Biochem 2017;43:1673 –1688
Source: Cellular Physiology and Biochemistry - Category: Cytology Source Type: research
Conclusions In acute and critically ill major burn patients, ECMO could be considered as a salvage therapy, particularly in those with inhalation injury and burn-related acute respiratory distress syndrome. However, ECMO does not seem to provide benefits for circulatory support in those with hemodynamic compromise. The use of ECMO in these patients is still investigational, as our data provided no benefit in terms of the outcomes or survival, particularly in those with more than 90% TBSA burns.
Source: Burns - Category: Dermatology Source Type: research
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