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Complications of Equine Anesthesia
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Signs of hyperthermic reactions may include: Tachycardia.Hypertension.Sweating.Hard muscles or muscle fasciculations.Metabolic and respiratory acidosis.Increased serum K.Dark-colored urine (myoglobinuria).
Pyrexia Two Weeks after an Attack of Alcohol-Induced Acute Pancreatitis
Published in Savio George Barreto, Shailesh V. Shrikhande, Dilemmas in Abdominal Surgery, 2020
Routine bloods were sent on readmission and this confirmed that serum lipase was elevated at > 4× upper limit of normal, now two weeks after initial admission. He also had a blood alcohol level of 280 mg/dL. Hematology revealed a hemoglobin of 132 g/L, total white blood count of 15.2 × 10-9/L, and a platelet count of 224 × 10-9/L. The hematocrit was 0.45. Electrolytes were normal but his renal function was impaired, with a blood urea nitrogen of 11 mmol/L (Normal range = 2.5–7.1). Liver function tests were normal other than a mildly elevated gamma glutamyl transferase. Random blood glucose was 11.2 mmol/L. An arterial blood gas confirmed hypoxemia and respiratory acidosis (pH 7.32, bicarbonate 30 mEq/L, partial pressure of carbon dioxide of 49 mmHg).
Sedative/Hypnotics
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
Frank A. Barile, Anirudh J. Chintalapati
At the highest doses, blockade of sympathetic ganglia triggers hypotension, bradycardia, and decreased inotropy, with consequent decreased cardiac output. In addition, inhibition of medullary vasomotor centers induces arteriolar and venous dilation, further complicating the cerebral hypoxia and cardiac depression. Respiratory acidosis results from accumulation of carbon dioxide, shifting pH balance to the formation of carbonic acid. The condition resembles alcoholic inebriation as the patient presents with hypoxic shock, rapid but shallow pulse, cold and sweaty skin (hypothermia), and either slow or rapid, shallow breathing. Responsiveness and depth of coma are evaluated according to the guidelines for the four stages of coma (see Chapter 3).
Extracorporeal carbon dioxide removal for patients with acute respiratory failure: a systematic review and meta-analysis
Published in Annals of Medicine, 2023
Zhifeng Zhou, Zhengyan Li, Chen Liu, Fang Wang, Ling Zhang, Ping Fu
ECCO2R, as an experimental adjunct to mechanical ventilation, has been utilized to avoid intubation or tracheotomy, and reduce the length of invasive ventilation. It also has been proven to have advantages in removing carbon dioxide and correcting respiratory acidosis in patients with ARF [29]. Currently, an increasing number of studies support the role of ECCO2R in the treatment of life-threatening critically ill critical illnesses, especially ARF [10,30]. However, there are only a few high-quality studies comparing ECCO2R with other therapies for ARF. Most studies elucidating the efficacy of ECCO2R are case reports or case series with small number [31–33]. Thus, further high-quality prospective controlled studies are urgently needed to compare ECCO2R with other therapies for patients with ARF. And several ongoing randomized clinical trials on ECCO2R treatment for ARF are list in Table 5.
Lethal toxicity induced by combined ingestion of dietary acetic acid and carbamazepine
Published in Drug and Chemical Toxicology, 2023
Iuliu Fulga, Oana-Maria Dragostin, Carmen Chitescu, Ioana Irimia, Alin Pîrăianu, Elena Stamate, Ana Fulga
The 52-year-old female patient is brought to the Emergency Department of the Medical-Social Unit for suspicion of acetic acid ingestion. From the reports of the medical staff, recorded that the patient did not show up at breakfast, being later found in the ward, with an empty bottle of food acetic acid next to her, saying she was feeling unwell. From her personal pathological history, the diagnosis of ‘dementia’ is remembered, being under treatment with carbamazepine. Upon the arrival of the ambulance crew, the patient presents with the Glasgow Score = 3p, Rr = 14 breaths/min, Pulse = 80 bpm, BP left hand = 83/55 mmHg, BP right hand = 60/27 mmHg, SatO2 below 50%, glycemia = 164 mg/dL, the crew intervenes with ALS (advanced life support) maneuvers which are without any result, the patient died shortly after admission. Following the arterial blood gas (ABG) test, an acid–base imbalance is detected, manifested in the form of severe respiratory acidosis with a pH of 6758; P CO2 = 80.3 mmHg, HCO3– = 10.7 mmol/L.
Critical Care Flight Nurses' role within secondary aeromedical services and the inter-hospital transfer of patients with acute spinal cord impairment
Published in Contemporary Nurse, 2023
Respiratory failure and hypoxia are conditions to which patients with SCI are particularly susceptible and that will be exacerbated by transport in the aeromedical environment. Pre-flight assessment of Mr X revealed that he was tachypneic, had increased work of breathing, a paradoxical pattern of breathing in the chest and abdomen and was receiving supplemental oxygen via High Flow Nasal Prongs (HFNP) at 50% Fraction of Inspired Oxygen (FiO2). Arterial blood gas showed an uncompensated respiratory acidosis. Patients with CSI at or above C5, are prone to respiratory failure due to denervation of the phrenic nerve resulting in paralysis or weakness of the diaphragm, intercostal and abdominal muscles (Wang et al., 2021; Life In The Fast Lane (LITFL), 2020). This results in reduced lung and chest wall compliance, hypoventilation and ultimately a mismatch between Ventilation and Perfusion (V/Q) (American College of Surgeons, 2018; Bersten et al., 2019). To optimise patients for transport and to prevent exacerbation of hypoxia and clinical deterioration at altitude, CCFN must have a sound understanding of hypoxia, hypoxemia and how decreased barometric pressure at altitude affects the diffusion of oxygen.