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Hospital Resources
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
The macronutrient components. This is the most important component. It is based on your estimate of the patient’s calorie and protein requirements. You will be deciding if you are giving the full complement of nutrients or a pre-determined percentage of requirements. You will select the quantity and concentration of dextrose based on the patient’s physiology and medical conditions. You will determine the quantity and type of lipids, i.e., Intralipid™, SMOF™, etc.). You will determine the quantity, type and concentration of amino acids.
Candida spp.
Published in Rossana de Aguiar Cordeiro, Pocket Guide to Mycological Diagnosis, 2019
Silviane Praciano Bandeira, Glaucia Morgana de Melo Guedes, Débora de Souza Colares Maia Castelo-Branco
The ability to ferment different carbohydrates is also evaluated to identify Candida species. Fermentation tests are performed by inoculating a yeast suspension into test tubes containing culture medium with different sugars such as maltose, sucrose, galactose, lactose, and trehalose, and an inverted Durham tube is added to the test tubes (Figure 3.1F). Dextrose is used as positive control for sugar fermentation. Fermentation is observed through the production of carbon dioxide and pH change after incubation at 25°C–30°C for up to 28 days (Neppelenbroek et al., 2014).
Pediatric neurotrauma
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Anesthesia for Neurotrauma, 2018
Ankur Khandelwal, Hemanshu Prabhakar
Hyperglycemia worsens outcome after pediatric TBI.45,67,68 Causes of hyperglycemia after TBI include an increase in gluconeogenesis and glycogenolysis from catecholamine response, cortisol release, and glucose intolerance.69–71 As such, dextrose containing fluids should ideally be avoided except in cases of established hypoglycaemia. However, aggressive treatment of hyperglycemia should also be performed cautiously due to the potential for an increased risk of hypoglycemia and its potentially devastating neurologic consequences if unrecognized and untreated.72 Given the potential impact of both hyperglycemia and hypoglycemia, intermittent monitoring of blood glucose concentrations during intraoperative care is suggested.
Efficacy comparison between ultrasound-guided injections of 5% dextrose with corticosteroids in carpal tunnel syndrome patients
Published in Neurological Research, 2023
Aref Nasiri, Farzaneh Rezaei Motlagh, Mohammad Amin Vafaei
Another finding of our study was that 5% dextrose was thoroughly safe without any adverse events. Similar finding has been reported by in-line studies as well [32,46]. Hypertonic dextrose (up to 25%) have been used in most old studies (deep injections in tendon-bone attachments) [47,48]. Some of the patients reported severe pain, discomfort, and fatigue after the injections [48–51]. According to an animal study, prolotherapy injections with hypertonic dextrose can induce inflammation and thickening of transverse carpal ligament in rabbits; they showed that lower concentrations of dextrose provided proliferation without an inflammatory reaction. ‘Nowadays, lower concentrations of dextrose have been increasingly used in clinical practice, especially for perineural injections. 5% Dextrose perineural prolotherapy targets sensory peptidergic C fibers, decreasing TRPV1 activity and neurogenic pain’ [52]. Further, it is shown that higher volumes of 5% dextrose do not lead to severe adverse events [46].
A new mathematical mixed effect model was used for analysing the influencing factors of hypoglycaemia of newborns from women with gestational diabetes mellitus
Published in Journal of Obstetrics and Gynaecology, 2022
Yin Ying, Lijun Bei, Lili Sun, Junhua Ye, Mengyan Xu
In some study, it has been reported that about 21% of the GDM in utero foetuses were dead (Ducarme et al. 2018). The main cause of death was neonatal respiratory distress syndrome (Rashid et al. 2017). However, the influencing factors of the changes of 24-hour blood glucose level in GDM newborns within 24 hours after birth, still maintain unclear. Also it was suggest that treatment with dextrose gel is safe and effective and may help support breast feeding (Harding et al. 2017) and may improve breastfeeding quality(Weston et al. 2017). Further clinical researches need to be done. At present, some epidemiological survey method has already carried out about GDM (Egbe et al. 2018; Bower et al. 2019; Sosa-Rubi et al. 2019), but there are still some problems, such as the analysis effect is not enough, the data is difficult to be convincing and so on. In this study, we aim to utilise a mathematical method to study hypoglycaemia of GDM newborn within 24 hours after birth, and to investigate the influence factors of hypoglycaemia.
Utility of Glucose Testing and Treatment of Hypoglycemia in Patients with Out-of-Hospital Cardiac Arrest
Published in Prehospital Emergency Care, 2022
Tiffany M. Abramson, Nichole Bosson, Angelica Loza-Gomez, Marc Eckstein, Marianne Gausche-Hill
POC testing should drive treatment. In a recent study by Wang et al., glucose ≤150mg/dl was associated with worse outcomes from in-hospital cardiac arrest. However, treatment with dextrose did not improve outcomes (16). Further, empiric dextrose administration may be harmful. There is evidence that dextrose administration during in-hospital cardiac arrest may be detrimental and can worsen cerebral ischemia (4, 17). Our data suggests that POC glucose testing in OHCA is not associated with improved outcome; the documented treatment rate for hypoglycemia in this cohort was only 41%, despite the fact that LAC treatment protocols at the time of the study dictated treatment for a measured glucose <60 mg/dL. It is unclear why a large percentage of patients did not receive this treatment. While in some cases, this may be due to documentation error, it is also possible that prioritization of interventions resulted in treatment delays even after hypoglycemia was identified. Further, a very large number of patients would need to be tested for hypoglycemia, though few would be identified as requiring treatment, and even fewer would have a positive outcome. In our cohort, treatment of hypoglycemia was not associated with improvement in outcome. It is possible that POC testing may actually worsen outcomes, given the potential to delay other interventions. Once ROSC is achieved, POC glucose testing and treatment of documented hypoglycemia may be considered.