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SCCM Pod-467 PCCM: AHA Guidelines Address Calcium During Pediatric Cardiopulmonary Arrest
The American Heart Association's (AHA) cardiopulmonary resuscitation guidelines recommend against the routine administration of IV calcium during pediatric cardiopulmonary arrest because of its association with worse outcomes. However, IV calcium is routinely used in children with heart disease who have cardiopulmonary arrest. Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Gurpreet S. Dhillon, MD, to discuss the article, Calcium Administration During Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in Children With Heart Disease is Associated With Worse Survival - A Report From the American Heart...
Source: SCCM PodCast - iCritical Care - December 21, 2022 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts

Neurological Complications Acquired During Pediatric Critical Illness: Exploratory “Mixed Graphical Modeling” Analysis Using Serum Biomarker Levels
CONCLUSIONS: Graphical models that include biomarkers in addition to clinical data are promising methods to evaluate direct relationships in the development of neurologic complications in critically ill children. Future work is required to validate and refine these models further, to determine if they can be used to predict which patients are at risk for/or with early neurologic complications.
Source: Pediatric Critical Care Medicine - October 1, 2021 Category: Pediatrics Tags: Neurocritical Care Source Type: research

The Use of Clevidipine for Hypertension in Pediatric Patients Receiving Mechanical Circulatory Support
Conclusions: In this pediatric cardiac cohort, clevidipine infusions were effective at hypertension management and were not associated with hypotensive or code events. This report details the largest cohort and longest duration of clevidipine administration within a pediatric population and did not demonstrate hypotensive events, even among neonatal populations. Clevidipine may be a reasonable cost-effective alternative antihypertensive medication compared to traditional short-acting agents.
Source: Pediatric Critical Care Medicine - December 1, 2020 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

Calcium homeostasis disorder during and after neonatal extracorporeal membrane oxygenation
Conclusions: We confirmed the existence of severe disturbances of calcium homeostasis in neonates on ECMO and supposed the possible damage of calcium regulation. We did not succeed in finding clear explanations of these disturbances.
Source: Indian Journal of Critical Care Medicine - September 8, 2015 Category: Intensive Care Authors: Jerome RambaudIsabelle GuellecJulia GuilbertPierre-Louis LégerSylvain Renolleau Source Type: research

Cardiopulmonary Resuscitation in the Pediatric Cardiac Catheterization Laboratory: A Report From the American Heart Association’s Get With the Guidelines-Resuscitation Registry*
Conclusions: The majority of children experiencing cardiac arrest in the cardiac catheterization laboratory in this large multicenter registry analysis survived to hospital discharge, with no observable difference in outcomes between surgical and medical cardiac patients. Future investigations that focus on stratifying medical complexity in addition to procedural characteristics at the time of catheterization are needed to better identify risks for mortality after cardiac arrest in the cardiac catheterization laboratory.
Source: Pediatric Critical Care Medicine - November 1, 2019 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Contemporary Review in Critical Care Medicine:Mitochondria and Critical Illness.
Abstract Classically, mitochondria have largely been thought to influence the development of illness by modulating cell metabolism and determining the rate of production of high energy phosphate compounds (e.g. ATP). It is now recognized that this is a simplistic view and that mitochondria play key roles in many other processes, including cell signaling, regulating gene expression, modulating cellular calcium levels and influencing the activation of cell death pathways (e.g. caspase activation). Moreover, these multiple mitochondrial functional characteristics are now known to influence the evolution of cellular a...
Source: Chest - September 4, 2019 Category: Respiratory Medicine Authors: Supinski GS, Schroder EA, Callahan LA Tags: Chest Source Type: research

Verapamil as an adjuvant treatment for drug-resistant epilepsy
S Lakshmikanthcharan, Mohamed Hisham, SK Chaitanya Juluri, Sivakumar Mundilipayalam NandakumarIndian Journal of Critical Care Medicine 2018 22(9):680-682 Almost one-third of the people suffering from epilepsy continue to have seizures in spite of using appropriate antiepileptics. Pharmacoresistance is defined as the failure to achieve seizure control with two or more anticonvulsant medications at appropriate daily dosage. Here, we discuss one such gentleman whose seizures had been intractable despite multiple antiepileptic drugs in maximum tolerable doses. Verapamil, a calcium channel blocker, was used for its P-glycoprot...
Source: Indian Journal of Critical Care Medicine - September 17, 2018 Category: Intensive Care Authors: S Lakshmikanthcharan Mohamed Hisham SK Chaitanya Juluri Sivakumar Mundilipayalam Nandakumar Source Type: research

Extracorporeal membrane oxygenation in drug overdose: A clinical case series
We report three patients with cardiovascular medication overdose presenting with profound cardiovascular instability refractory to medical therapy. Venoarterial extracorporeal membrane oxygenation support (VA ECMO) was initiated to provide hemodynamic support. Despite the occurrence of device-associated complications, the outcome was good and all patients survived. VA ECMO may be considered in patients with severe refractory shock due to cardiotoxic medication overdose.
Source: Indian Journal of Critical Care Medicine - February 19, 2018 Category: Intensive Care Authors: C Vignesh Madhan Kumar Ramesh Venkataraman Senthilkumar Rajagopal Nagarajan Ramakrishnan Babu K Abraham Source Type: research

Nutrition management of acute postliver transplant recipients
Conclusion: There are scant data on nutrition management in acute post-LT phase. The present study provides the framework for the formulation of continuous, patient-centric, aggressive nutrition management interventions for acute post-LT recipients.
Source: Indian Journal of Critical Care Medicine - November 19, 2018 Category: Intensive Care Authors: Neha Bakshi Kalyani Singh Source Type: research

Serum Amylase and Lipase for the Prediction of Pancreatic Injury in Critically Ill Children Admitted to the PICU
Objectives: Pancreatic injury is multifactorial and potentially devastating for critically ill children. We aimed to evaluate whether serum amylase and lipase among critically ill children could serve as an independent biomarker to predict pancreatic injury. Design: Retrospective cohort. Setting: PICU of a tertiary, pediatric medical center. Patients: Seventy-nine autopsies. Interventions: None. Measurements and Main Results: A group of 79 children who died of different causes were investigated by autopsy. They were divided into pancreatic injury group and pancreatic noninjury group a...
Source: Pediatric Critical Care Medicine - January 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Calcium Administration During Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in Children With Heart Disease Is Associated With Worse Survival—A Report From the American Heart Association’s Get With The Guidelines-Resuscitation (GWTG-R) Registry*
Objectives: IV calcium administration during cardiopulmonary resuscitation (CPR) for pediatric in-hospital cardiac arrest (IHCA) is associated with worse survival. We evaluated survival to hospital discharge in children with heart disease (HD), where calcium is more frequently administered during CPR. Design: Retrospective study of a multicenter registry database. Setting: Data reported to the American Heart Association’s (AHA) Get With The Guidelines-Resuscitation registry. Patients: Children younger than 18 years with HD experiencing an index IHCA event requiring CPR between January 2000 and Ja...
Source: Pediatric Critical Care Medicine - November 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research

Association of Hypocalcemia With Mortality of Combat Casualties With Brain Injury and Polytrauma Transported by Critical Care Air Transport Teams
CONCLUSION: In-flight hypocalcemia events were common among critically ill combat-wounded polytrauma patients transported by CCATT but were not associated with differences in mortality. Future training should emphasize the need for calcium correction among ERCC patients requiring vasopressors. Future studies with larger sample sizes of patients receiving ERCC are needed to assess the association between in-flight calcium supplementation with clinical outcomes.PMID:35253064 | DOI:10.1093/milmed/usac029
Source: Military Medicine - March 7, 2022 Category: International Medicine & Public Health Authors: William T Davis Patrick C Ng Kimberly L Medellin Julie E Cutright Allyson A Ara ña Richard J Strilka Derek M Sorensen Joseph K Maddry Source Type: research

Heparin-Free Prolonged Intermittent Hemodialysis Using Calcium-Free Citrate Dialysate in Critically Ill Patients
Conclusions: Conclusions:Dialysis anticoagulation with calcium-free citrate-containing dialysate and calcium reinjection according to ionic dialysance is an easy-to-use, efficient, and inexpensive form of heparin-free regional anticoagulation. It allows prolonged hemodialysis sessions in critically ill patients without the need to systemically monitor ionized calcium. Furthermore, sessions can be safely extended according to the hemodynamic tolerance to ensure an adequate dose of dialysis and a negative water balance, a major point in patients with severe acute kidney disease.
Source: Critical Care Medicine - October 17, 2017 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Bone metabolism and fracture risk during and after critical illness
Purpose of review There is growing evidence that bone health is impacted during and after critical illness in multiple ways. In this review, we provide a practical update on postcritical care bone loss with an insight on identification of persons at risk, prevention and treatment strategies. Recent findings Critical illness is associated with an increase in bone turnover and with an uncoupling between bone resorption and bone formation. This results in loss of bone mass, as highlighted by changes in bone marker serum levels and in bone mineral density. Data suggest that ICU survivors are at an increased risk of bone f...
Source: Current Opinion in Critical Care - July 30, 2020 Category: Nursing Tags: METABOLIC SUPPORT: Edited by Karin Amrein and Gennaro Martucci Source Type: research