Hemodynamic Effects of Intravenous Calcium Administration on Septic Shock Patients:A Retrospective Study

We evaluated the hemodynamics and outcomes of septic shock (SS) patients who did not respond to fluid resuscitation, after treatment with or without intravenous calcium. We retrospectively collected information on 154 eligible SS patients who were admitted to Fukuyama City Hospital Emergency Medical Center and did not respond to fluid resuscitation. To compare their degree of hemodynamic impairment, we compared the changes in the vasoactive-inotropic score (VIS) in the calcium-treated group (n＝112) and the noncalcium-treated group (n＝42). We compared the length of stay in the intensive care unit (ICU) and hospital, in-hospital deaths, 28-day deaths, and changes in the Sequential Organ Failure Assessment score within 72h of ICU admission between the 2 groups. Changes in the VIS at 1h after the baseline time were significantly greater in the calcium-treated group than in the noncalcium-treated group (1.41 vs. －1.25, respectively;p＜0.001). However, the changes in the VIS at 3, 6, 24, 48, and 72h did not differ between the 2 groups. The secondary outcomes also did not differ between the groups. Our findings indicate that calcium administered to SS patients might reduce their hemodynamic stabilization, but only for a short time after its administration

Radiotherapy of brain metastases from lung cancer

We studied the results of radiotherapy in 65 patients with brain metastases of lung cancer. In the 34 patients whose treatment consisted of radiotherapy alone, the median survival time was 164 days and the mean survival time was 210 days. Remission was achieved in 29 (85%) of these patients, indicating that radiotherapy was effective. A minimum radiation dose of 30 Gy was necessary to decrease neurological symptoms, and 40 Gy or more was considered to be desirable. Survival after radiotherapy appeared to be dependent largely on factors other than brain metastases such as the effectiveness of management of the primary lesion, the presence or the extent of metastases to other organs, and the patient's general condition. Our study suggests that greater efforts must be made for early detection and early treatment to achieve prolongation of as well as qualitative improvements in the survival time