Assessment of volume status in patients with end-stage renal disease has long been a problem. Objective tools for estimating dry weight are necessary. The present study was designed to determine if better assessment of volume status could be achieved by measuring brain natriuretic peptide (BNP) and thoracic fluid content (TFC) by bioimpedance. We prospectively surveyed 51 medically stable perit...

INTRODUCTION The recognition and management of hypovolemic shock still remain an important task during initial trauma assessment. Recently, we have questioned the validity of the Advanced Trauma Life Support (ATLS) classification of hypovolemic shock by demonstrating that the suggested combination of heart rate, systolic blood pressure and Glasgow Coma Scale displays substantial deficits in ref...

Hyponatremia, a common clinical problem, may result from a wide variety of causes. Treatment can vary from fluid restriction to rehydration, depending on the pathogenesis of the disorder. Essential to evaluation of hyponatremic patients is correct estimation of the status of the extracellular fluid volume, because this determines the type of therapy: a patient who is hypovolemic will not benefi...

Schochl and co-authors have described a 5-year retrospective study that outlines a novel, important and controversial transfusion concept in seriously injured trauma patients. Traditionally, clinicians have been taught to use a serial approach, resuscitating hypovolemic trauma patients with a form of crystalloid or colloid, followed by red blood cells (RBCs), then fresh frozen plasma (FFP), and...

The Postural Tachycardia Syndrome (POTS) is the most common disorder seen in autonomic clinics. Cardinal hemodynamic feature of this chronic and debilitating disorder of orthostatic tolerance is an exaggerated orthostatic tachycardia (≥30 bpm increase in HR with standing) in the absence of orthostatic hypotension. There are multiple pathophysiological mechanisms that underlie POTS. Some patient...

Background: Different techniques are employed to assess the endpoint of fluid therapy in hypovolemic patients. Lung ultrasound (US) is increasingly becoming a diagnostic tool critical care s...

The effects of increasing oxygen delivery (DO2) on oxygen consumption (VO2) in eight patients with septic shock and five patients with hypovolemic shock were studied during fluid resuscitation. In the septic shock group, DO2 increased from 315 +/- 29 to 424 +/- 25 ml/min/m2 (p less than 0.01) and VO2 increased from 134 +/- 8 to 151 +/- 7 ml/min/m2 (p less than 0.01). In the hypovolemic shock gr...

results we performed rush on 77 patients. kappa index was 0.71 (p value = 0.000), reflecting acceptable general agreement between initial impression and final diagnosis. for hypovolemic, cardiogenic and obstructive shock, the protocol had an npv above 97% yet it had a lower ppv. for shock with distributive or mixed etiology, rush showed a ppv of 100% but it had low sensitivity. subgroup analysi...