Anticoagulation Effect and Safety Observation of Regional Citrate Anticoagulation for Double-Filtration Plasmapheresis in Critical Patients

2020 ◽  
Vol 49 (5) ◽  
pp. 542-549
Author(s):  
Xiaobei Peng ◽  
Xingmin Xie ◽  
Jun Yin ◽  
Saihong Yu ◽  
Chunyan Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Regional Citrate Anticoagulation ◽  
Transmembrane Pressure ◽  
Single Treatment ◽  
Citrate Anticoagulation ◽  
Double Filtration Plasmapheresis ◽  
Significant Difference ◽  
Before And After ◽  
Critical Patients ◽  
Double Filtration

Introduction: Double-filtration plasmapheresis (DFPP) is a semi-selective blood purification method based on dual filtration system. Regional citrate anticoagulation (RCA) is an appealing anticoagulation alternative in DFPP. However, there are still few reports on the safety of RCA in DFPP treatment. Objective: To investigate the anticoagulation effect and safety of RCA for DFPP in critical patients. Methods: A total of 34 critical patients treated with DFPP were retrospectively studied. The incidence of coagulation during extracorporeal circulation after single treatment was compared before and after treatment. Heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, blood routine indexes, blood gas analysis, peripheral ionic calcium (iCa), total peripheral calcium (TCa), TCa/iCa, and complications before and after single treatment were compared. The changes of transmembrane pressure, pressure drop were measured, and the indexes of coagulation before and after treatment were compared. Results: The blood coagulation <III class in plasma separator and vein ampulla after single DFPP procedure were 96.00 and 94.00%, respectively. There were no statistically significant changes regarding above parameters before and after treatment, except PH, base excess (BE), bicarbonate (HCO3–), and TCa. Compared with pretreatment levels, PH, BE, and HCO3– were significantly increased at 5 min and 6 h after treatment (p < 0.05) and restored to the pretreatment levels at 24 h after treatment (p > 0.05). Level of TCa was significantly decreased at 5 min after treatment (p < 0.05), but there was no statistically significant difference at 6 and 24 h (p > 0.05). No treatment-related serious complications were observed in any of the patients. Conclusions: For critical patients who underwent DFPP procedure, RCA is safety and had significant anticoagulation effects, which is worthy of clinical application.

Double Filtration Plasmapheresis in the Treatment of Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis with Severe Kidney Dysfunction

2020 ◽  
Vol 49 (6) ◽  
pp. 713-722 ◽  
Author(s):  
Lu Cheng ◽  
Yue-Qiu Tang ◽  
Jing Yi ◽  
Qian Ren ◽  
Xiao-Yan Yang ◽  
...  
Keyword(s):  
Adverse Events ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Kidney Dysfunction ◽  
Double Filtration Plasmapheresis ◽  
Significant Difference ◽  
Before And After ◽  
The Difference ◽  
Double Filtration

<b><i>Background:</i></b> Therapeutic plasma exchange (TPE) has been recommended by guidelines for the treatment of anti-neutrophil cytoplasmic antibodies-associated vasculitis (AAV) with severe kidney dysfunction. In recent years, some researchers have proposed that double-filtration plasmapheresis (DFPP) can also be used effectively in the treatment of these patients, but the difference between the 2 modalities of plasmapheresis is not clear. <b><i>Methods:</i></b> In this retrospective cohort study of AAV patients with serum creatinine ≥500 μmol/L from March 2013 to July 2018 who received TPE or DFPP treatment, we compared TPE and DFPP in terms of the changes of clinical parameters before and after plasmapheresis, the rates of adverse events during plasmapheresis, and kidney and patient survival during follow-up. <b><i>Results:</i></b> Forty-two AAV patients with kidney injury were included in this study. Twenty patients were treated with TPE and 22 patients were treated with DFPP. All patients were followed up for a median of 22 months. In each group, there were 10 deaths, and 6 patients developed end-stage kidney disease (ESKD). There were no significant differences between TPE and DFPP in terms of the changes of renal function or other laboratory results after treatment. During the plasmapheresis treatment, there was no significant difference in the rate of adverse events (<i>p</i> = 0.67). During the follow-up, there was no difference between the groups regarding the level of serum creatinine for patients with kidney recovery. The hazard ratio (HR) for TPE compared to DFPP for the outcome of ESKD was 0.92 (95% CI 0.45–1.9; <i>p</i> = 0.79) and the HR for death was 1.11 (95% CI 0.45–2.76; <i>p</i> = 0.82). <b><i>Conclusion:</i></b> There were no differences in short-term effectiveness, safety, or long-term outcomes between the 2 modalities of plasmapheresis. Our study suggests that DFPP may be a choice of plasmapheresis for AAV patients with severe kidney injury especially in countries and regions with limited blood resources.

scholarly journals Effects of Aroma Massage on Home Blood Pressure, Ambulatory Blood Pressure, and Sleep Quality in Middle-Aged Women with Hypertension

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Myeong-Sook Ju ◽  
Sahng Lee ◽  
Ikyul Bae ◽  
Myung-Haeng Hur ◽  
Kayeon Seong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Placebo Group ◽  
Sleep Quality ◽  
Nursing Intervention ◽  
Home Blood Pressure ◽  
Control Group ◽  
Middle Aged ◽  
Significant Difference ◽  
Before And After ◽  
Massage Group

The purpose of this study was to evaluate the effects of aroma massage applied to middle-aged women with hypertension. The research study had a nonequivalent control group, nonsynchronized design to investigate the effect on home blood pressure (BP), ambulatory BP, and sleep. The hypertensive patients were allocated into the aroma massage group (n=28), the placebo group (n=28), and the no-treatment control group (n=27). To evaluate the effects of aroma massage, the experimental group received a massage with essential oils prescribed by an aromatherapist once a week and body cream once a day. The placebo group received a massage using artificial fragrance oil once a week and body cream once a day. BP, pulse rate, sleep conditions, and 24-hour ambulatory BP were monitored before and after the experiment. There was a significant difference in home systolic blood pressure (SBP) (F=6.71,P=0.002) between groups after intervention. There was also a significant difference in SBP (F=13.34,P=0.001) and diastolic blood pressure (DBP) (F=8.46,P=0.005) in the laboratory between aroma massage and placebo groups. In sleep quality, there was a significant difference between groups (F=6.75,P=0.002). In conclusion, aroma massage may help improve patient quality of life and maintain health as a nursing intervention in daily life.

scholarly journals Effect of COVID-19 outbreak on emergency department attendances in an Italian academic hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poletto ◽  
G Perri ◽  
F Malacarne ◽  
B Bianchet ◽  
A Doimo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Initial Phase ◽  
Mainland China ◽  
Hospital Setting ◽  
Academic Hospital ◽  
Significant Difference ◽  
Before And After ◽  
Life Threatening ◽  
The Mean ◽  
Critical Patients

Abstract Background Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was discovered during the 2019 outbreak in Mainland China and the first cases were reported in Italy on February 21, 2020. This study evaluates the emergency department (ED) attendances of an academic hospital in northern Italy before and after media reported the news of the first infected patients in Italy. Methods Adult attendances in ED in February 2020 were analysed dividing the period into 4 weeks (days 1-7, 8-14, 15-21, 22-28) compared with the same periods in 2019. The visits were analysed separately according to the Italian colour code of triage: white (non-critical), green (low-critical), yellow (medium critical), red (life-threatening). The mean weekly number of attendances was compared with t-test. Results February 2020 total ED attendances compared with February 2019 were 4865 vs 5029 (-3.3%), of which white codes were 834 vs 762 (+9.4%), green 2450 vs 2580 (-5.0%), yellow 1427 vs 1536 (-7.1%), red 154 vs 151 (+2.0%). February 2020 weekly mean ED attendances compared with February 2019 had statistically significant difference only in the fourth week (days 22-28) for green codes (75 vs 92, p = 0.007) and yellow codes (41 vs 52, p = 0.047), not for white (27 vs 26, p = 0.760) and red codes (5 vs 5, p = 0.817). The first three weeks of February 2020 compared with 2019 showed no statistically significant difference in weekly mean ED attendances. Conclusions There was a significant reduction of green and yellow codes attendances at ED in the fourth week of February 2020, corresponding to the initial phase of Italian COVID-19 outbreak. The fear of contracting SARS-CoV-2 by attending the ED probably acted as a significant deterrent in visits, especially for low and medium critical patients. Additional data are required to better understand the phenomenon, including the behaviour of non-critical attendances. Key messages A reduction of green and yellow codes attendances was reported during initial phase of COVID-19 outbreak in an Italian academic hospital. Fear of contracting COVID-19 infection in a hospital setting could impact on emergency department attendances.

scholarly journals Perubahan antropometri, kalsium darah, tekanan darah, dan kebugaran fisik akibat asupan susu kambing pada olahragawan

2021 ◽  
Vol 17 (3) ◽  
pp. 133
Author(s):  
Yusni Yusni ◽  
Amiruddin Amiruddin
Keyword(s):  
Blood Pressure ◽  
Physical Fitness ◽  
Intervention Group ◽  
Goat Milk ◽  
Sports Nutrition ◽  
T Test ◽  
Muscle Endurance ◽  
Blood Calcium ◽  
Significant Difference ◽  
Before And After

Changes in anthropometry, blood calcium, blood pressure, and physical fitness due to goat's milk intake in athletesBackground: The intake of healthy-balanced nutrition is needed by athletes. The complex nutritional content of goat milk such as protein, fat, carbohydrate, vitamin, and mineral acts as sports nutrition during and after training. Objective: This study aims to analyze the effects of goat milk on physical fitness, anthropometrics, blood calcium, and blood pressure in athletes. Methods: A clinical trial was conducted using healthy human subjects. Subjects were runners (n=10 people) as the control group and gymnasts (n=19 people) as the treatment group, male, age 21-27 years, and healthy. Bodyweight (BW), Height, and Body Mass Index (BMI), blood calcium, Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and physical fitness were examined two times, before and after consuming goat milk. Intervention: fresh goat milk, 250 mg/day (after dinner), and given for 90 days. Data were analyzed using a paired sample t-test and independent sample t-test. Results: There was no difference between BW (p=0.07), BMI (p=0.08), and DBP (p=0.24), but instead there was a significant difference in SBP (p=0.00) before and after goat milk intervention in the experimental group. Blood calcium was significantly increased (p=0.00) in the intervention group, whereas reverse decreased significantly (p=0.02) in controls. A significant difference before and after therapy was found in speed (p=0.00), arm muscle endurance (p=0.01), an-aerobic endurance (p=0.00), agility (p=0.02), however, there was no significant difference between leg muscle power (p=0.13), flexibility (p=0.23), an endurance of abdominal muscles (p=0.26), VO2 max (p=1.15) in the intervention group. Conclusions: Regular consumption of goat milk can reduce SBP, increase blood calcium levels, and improve physical fitness (speed, arm muscle endurance, anaerobic endurance, and agility) in athletes. Goat milk is an essential role in sports nutrition for physical fitness and athlete's health.

scholarly journals Dental anxiety in patients undergoing oral surgery and its effects on blood pressure and heart rate

2020 ◽  
Vol 9 (8) ◽  
pp. e316985536
Author(s):  
Jaqueline Oliveira Barreto ◽  
Julliana Cariry Palhano Freire ◽  
Arthur Willian de Lima Brasil ◽  
Cristian Statkievicz ◽  
Francisley Ávila Souza ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Oral Surgery ◽  
Dental Anxiety ◽  
Waiting Room ◽  
Demographic Questionnaire ◽  
Significant Difference ◽  
Before And After ◽  
Evaluation Anxiety

Objective: To assess dental anxiety in patients undergoing oral surgery, as well as its impact on blood pressure and heart rate. Material and Methods: A total of 233 patients answered a socio-demographic questionnaire and another one based on the Corah dental anxiety scale. Blood pressure and heart rate were assessed at three moments while: patients were in the waiting room, immediately before and after the procedure. Results: This study revealed a prevalence of anxiety of 77.3%. There was a statistically significant difference in mean systolic blood pressure and heart rate at the three moments of the evaluation. Anxiety was prevalent in the sample and was observed from the time in the waiting room until the time when local anesthesia was performed, causing variations in systolic blood pressure and heart rate, anxiety levels decreased after the end of the service. In conclusion, we observed that oral surgery is directly related to increased anxiety, and anxiety is mainly related to the change in heart rate.

scholarly journals Efficacy and Complications of Regional Citrate Anticoagulation During Continuous Renal Replacement Therapy in Critically Ill Patients with COVID-19

2021 ◽  
Author(s):  
Dmytro Khadzhynov ◽  
Uwe von dem Berge ◽  
Frédéric Muench ◽  
Stoyan Karaivanov ◽  
Roland Koerner ◽  
...  
Keyword(s):  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
University Hospital ◽  
Regional Citrate Anticoagulation ◽  
Close Monitoring ◽  
Acid Base Balance ◽  
Metabolic Disturbances ◽  
Citrate Anticoagulation ◽  
Significant Difference

Abstract Background: Enhanced coagulation in coronavirus disease 2019 (COVID-19) patients is considered a major obstacle for continuous renal replacement therapy (CRRT), but systematic analyses are sparse. We compared filter survival and citrate-induced complications during CRRT with regional citrate anticoagulation (RCA) in COVID-19 and Non-COVID-19 patients.Methods: In this retrospective study we included all consecutive adult patients (n=97) with acute kidney injury (AKI) treated with RCA-CRRT at seven ICUs of a tertiary university hospital over the tree month period. Medical data were collected to compare the efficacy and complications of RCA-CRRT between COVID-19 (n=44) and Non-COVID-19 patients (n=53).Results: There was no significant difference in the number of CRRT filters used per patient in COVID-19 vs. Non-COVID-19 patients (median 5 vs 3 filters, p=0.103). Mean filter run-time was significantly higher in COVID-19 patients compared to Non-COVID-19 patients (68.4 (95%CI 67.0-69.9) vs. 65.2 (95%CI 63.2-67.2) hours, respectively; log-rank 0.014). COVID-19 patients showed significantly higher activated partial thromboplastin time (aPTT) throughout the CRRT due to systemic anticoagulation compared to Non-COVID-19 patients (54 (IQR 45 – 61) vs. 47 (IQR 41 - 58) seconds, respectively; p<0.001). A significantly higher incidence of combined metabolic disturbances (metabolic alkalosis, hypercalcemia and hypernatremia), consistent with reduced filter patency and citrate overload during RCA, was observed in COVID-19 patients compared to Non-COVID-19 patients (19.1% vs. 12.7%, respectively; p=0.04). These metabolic disarrangements were resistant to per-protocol adjustments and disappeared after replacement of the CRRT-filter. Conclusions: In contrast to initial concerns, adequate filter life-span can be achieved with RCA during CRRT in COVID-19 patients. However, close monitoring of the acid-base balance appears warranted, as these patients tend to develop reduced filter patency leading to a higher incidence of citrate overload and metabolic disturbances. Trial Registration (local authority): EA1/285/20 (Ethikkommission der Charité - Universitätsmedizin Berlin); date of registration 08.10.2020.

scholarly journals Cardiovascular, lactate and appetite response to light and spicy music tempo after an endurance swimming protocol in young girls

2020 ◽  
Vol 24 (4) ◽  
pp. 195-202
Author(s):  
Javad Mehrabani ◽  
Soodabeh Bagherzadeh ◽  
Abuzar Jorbonian ◽  
Eisa Khaleghi-Mamaghani ◽  
Maryam Taghdiri ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Recovery Period ◽  
Young Girls ◽  
Significant Difference ◽  
Before And After ◽  
Lactate Levels ◽  
The Impact

Background and Study Aim. During exercise, the effects of music on the performance have been previously evaluated. However, the superiority of the type of music and during recovery is not yet clear. Therefore the aim of this study was to determine the impact of music with a spicy and light beat on changes in lactate levels, blood pressure, heart rate, and appetite during the recovery period after the endurance swimming. Material and Methods. Thirteen healthy young girls participate in three control and experimental sessions. The participants performed a swimming. Immediately after swimming, they listened to music. Also, evaluations before and after (several times) swimming were performed.Results. Five minutes after swimming there was also a significant difference between the non-sound group with the music groups (p<0.05). Two and 5 minutes after swimming, there was a significant difference between the spicy and light music groups compared to the non-sound group. There was a significant difference between spicy and light music groups at time 10, 15 and 25 minutes. In the 25 minutes after the swim, reducing the heart rate in light music was more than spicy. Also, 10 minutes after swimming, the spicy music group could not cope with the increase in heart rate (p<0.05). There was a significant difference between the two music groups in minutes 5, 10 and 15 after swimming (p<0.05).Conclusions. listening to light music during recovery from endurance swimming was associated with decreased lactate levels and heart rate, but listening to spicy music increased heart rate and desire for food.

Evaluation of the effects of the national diabetes control and prevention program on a sample of iranian people with type 2 diabetes

2021 ◽  
pp. 1-13
Author(s):  
Simin Haghravan ◽  
Fatemeh Mohammadi-Nasrabadi ◽  
Maryam Rafraf ◽  
Mohammad Asghari Jafarabadi
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Prevention Program ◽  
Time Effect ◽  
Anthropometric Indices ◽  
Hba1 C ◽  
Significant Difference ◽  
Before And After ◽  
Control And Prevention

Diabetes prevention programs have been developed in the different countries and it is therefore necessary to gain a better understanding of factors affecting the effectiveness of these programs for each society. Accordingly, the purpose of this study was to evaluate the effect of the National Diabetes Control and Prevention Program (NDCPP) on the biochemical and anthropometric indices among a sample of Iranian patients with type 2 diabetes mellitus (T2DM). A total of 384 patients with T2DM from the primary health care system of Tehran and Tabriz cities during January to June 2020, were included in the study. A two-part questionnaire consisting of items related to socio-economic and demographic characteristics was used and biochemical and anthropometric indices were measured at the beginning and the end of the 3-month intervention period. There was a significant difference in fasting blood sugar (FBS), hemoglobin glycosides (HbA1 C), systolic blood pressure (SBP) and weight before and after the NDCPP (P <  0.001). Also, there was significant improvement in carbohydrate (P = 0.015) and protein intake (P = 0.027) after the NDCPP compared to before the study. No significant difference was observed in waist circumference (WC) (P = 0.689), body mass index (P = 0.784), diastolic blood pressure (P = 0.647), and other dietary nutrient intake before and after the NDCPP. Repeated measure ANOVA revealed a significant decrease in FBS (Time effect P = 0.019) and weight (Time effect P = 0.006) after the NDCPP. Also, residing in different cities had a significant effect on FBS (time×city effect P <  0.001), HbA1 C (time×city effect P <  0.001), and SBP (time×city effect P = 0.037) after the NDCPP. The NDCPP resulted in weight loss, improved HbA1 C, and FBS. These findings suggested that NDCPP had a positive effect on controlling T2DM among Iranian population and can be considered as a way to prevent complications of T2DM.

Comparing the effects of cold compress and Xyla-p cream on hemodynamic changes in hemodialysis patients during venipuncture

2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Ziba Ghoreyshi ◽  
Monireh Amerian ◽  
Farzaneh Amanpour ◽  
Reza Mohammadpourhodki ◽  
Hossein Ebrahimi
Keyword(s):  
Blood Pressure ◽  
Physiological State ◽  
Vital Signs ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Intermittent Hemodialysis ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
The Difference

AbstractBackgroundThe vital signs reflect the physiological state of patients in various clinical conditions. The purpose of this study was to compare the effects of cold compress and Xyla-P cream on hemodynamical changes during venipuncture in hemodialysis patients.Methods and MaterialIn this clinical trial study, 50 patients under hemodialysis were selected by simple random sampling. The patients were then randomly assigned to either Xyla-P cream, cold compress or placebo groups. The vital signs (blood pressure and pulse) were measured upon two intermittent hemodialysis sessions before and after venipuncture. Data were analyzed using repeated measures analysis of variance.ResultsThe mean alternation in systolic blood pressure was significantly different comparing the placebo and cold compress groups before and after intervention (p<0.001). However, the difference was not significant between the Xyla-P cream group and either placebo (p=0.402) or ice compress (p=0.698) groups. The difference of the mean diastolic blood pressure was significant comparing the placebo group with either the Xyla-P cream group (p=0.003) or cold compress group (p<0.001) before and after intervention. In addition, there was a significant difference in the mean number of heartbeats comparing the control group with either the Xyla-P cream group (p<0.001) or cold compress group (p<0.001) before and after the intervention.ConclusionsConsidering the beneficial effects of ice compress and the Xyla-P cream on reduction of cardiovascular parameters, it is recommended to use these methods in hemodialysis patients during venipuncture.

scholarly journals Clinical Impact of after-consult clinic blood pressure: comparison with automated office blood pressure

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Cheol Ho Lee ◽  
Ji Hun Ahn ◽  
Joon Ha Ryu ◽  
Woong Gil Choi
Keyword(s):  
Blood Pressure ◽  
Rest Period ◽  
Office Blood Pressure ◽  
Community Based ◽  
Measure Blood Pressure ◽  
Significant Difference ◽  
Before And After ◽  
Study Population ◽  
Alternative Measurement ◽  
Automated Office Blood Pressure

Abstract Background It is most important to measure blood pressure (BP) exactly in treating hypertension. Recent recommendations for diagnosing hypertension clearly acknowledge that an increase in BP attributable to the “whitecoat response” is frequently associated with manual BP recordings performed in community-based practice. However, there was no data about after-consult (AC) BP that could reduce whitecoat effect. So we evaluated before-consult (BC) and AC routine clinic BP and research based automated office blood pressure (AOBP) measured. Methods The study population consisted of 82 consecutive patients with hypertension between April 2019 and December 2019. We measured routine clinic BP and AOBP before and after see a doctor, respectively. Seated blood pressure and pulse are measured at each time after a rest period using an automated device as it offers reduced potential for observer biases. AOBP was measured and measuring BP 3 times un-observed. We compared each BP parameter for identifying exact resting BP state. Results There was significant difference between BC and AC systolic BP (135.37 ± 16.90 vs. 131.95 ± 16.40 mmHg, p = 0.015). However there was no difference in the BC and AC diastolic blood pressure (73.75 ± 11.85 vs. 74.42 ± 11.71 mmHg, p = 0.415). In the AOBP comparison, there was also significant difference (BC systolic AOBP vs. AC systolic AOBP, 125.17 ± 14.41 vs. 122.98 ± 14.09 mmHg, p = 0.006; BC diastolic ABOB vs. AC diastolic AOBP, 71.99 ± 10.49 vs. 70.99 ± 9.83, p = 0.038). Conclusions In our study, AC AOBP was most lowest representing resting state. Although AC BP was higher than BC AOBP, it might be used as alternative measurement for reducing whitecoat effect in the routine clinical practice.

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