44 research outputs found
High rate ultrafiltration in anasarca: 33 liters of net negative fluid balance in 52 hours!
info:eu-repo/semantics/publishe
Inducible metabolic pathway for citrate metabolism in case of major liver dysfunction: fact or fiction?
SCOPUS: le.jinfo:eu-repo/semantics/publishe
Effective Treatment of Acute Tricyclic Antidepressant Poisoning with Cardiogenic Shock and Severe Rhabdomyolysis Using ECMO and CytoSorb® Adsorber.
BACKGROUND Tricyclic antidepressant (TCA) drugs are a common cause of fatal poisoning because of their cardiotoxic and arrhythmogenic effects. Classic supportive management includes sodium bicarbonate, gastrointestinal chelating agents, and vasopressors. Recently, intravenous lipid emulsion (supported by a low evidence level) has also been used. CASE REPORT We report the case of a 55-year-old woman admitted to our Intensive Care Unit (ICU) with acute imipramine self-poisoning. She arrived at the emergency department 7 hours after imipramine ingestion; she had severe rhabdomyolysis upon admission, with creatine phosphokinase levels at about 52 500 IU/L (normal, <200 IU/L). She quickly developed cardiogenic shock and malign arrhythmia requiring veno-arterial extra corporeal membrane oxygenation (VA-ECMO). Continuous renal replacement therapy (CRRT) with CytoSorb® (CytoSorbents, Monmouth Junction, New York, United Sates of America) was started 19 hours after admission. We performed serial blood measurements of imipramine and its active metabolite desipramine as well as viewing the levels on the CRRT-circuit monitor. Cardiac function improved and ECMO was explanted after 4 days. She also had severe acute respiratory distress syndrome, which resolved spontaneously. The neurologic outcome was favorable despite early myoclonus. The patient regained consciousness on the fifth day. Her clinical evolution was marked by acute ischemia of the lower left limb due to the arterial ECMO cannula. CONCLUSIONS These measurements document the efficacy of the CytoSorb® adsorber in removing a lipophilic drug from a patient's bloodstream. To our knowledge, this is the first published case of CytoSorb® extracorporeal blood purification therapy for acute TCA poisoning
Endovascular cooling is superior to surface cooling in terms of effectiveness by improving the neurological prognosis, but what about the safety?
SCOPUS: le.jinfo:eu-repo/semantics/publishe
Treatment of influenza virus-related critical illness during continuous renal replacement therapy: Take caution with dosing
SCOPUS: le.jinfo:eu-repo/semantics/publishe
Risk of harlequin syndrome during bi-femoral peripheral VA-ECMO: Should we pay more attention to the watershed or try to change the venous cannulation site?
SCOPUS: le.jinfo:eu-repo/semantics/publishe
Hepcidin is described as the master regulator of iron: Could its removal by CRRT lead to iron dysmetabolism in the critically ill?
SCOPUS: le.jinfo:eu-repo/semantics/publishe
The causal link between hyperchloremia and acute kidney injury is yet to be conclusively established: We are not sure
SCOPUS: le.jinfo:eu-repo/semantics/publishe
Clostridioides difficile infection in the critically ill: What kind of therapy for refractory cases
SCOPUS: le.jinfo:eu-repo/semantics/publishe
Liver injury without liver failure in COVID-19 patients: how to explain, in some cases, elevated ammonia without hepatic decompensation
SCOPUS: le.jinfo:eu-repo/semantics/publishe