scholarly journals Endotoxin Adsorbent Therapy in Severe COVID-19 Pneumonia

2021 ◽  
pp. 1-8
Author(s):  
Sadudee Peerapornratana ◽  
Phatadon Sirivongrangson ◽  
Somkanya Tungsanga ◽  
Kanitha Tiankanon ◽  
Win Kulvichit ◽  
...  
Keyword(s):  
Chart Review ◽  
Laboratory Data ◽  
Polymyxin B ◽  
Controlled Study ◽  
Mechanically Ventilated ◽  
Randomized Controlled ◽  
Endotoxin Activity ◽  
Attending Physicians ◽  
Polymyxin B Hemoperfusion

<b><i>Introduction:</i></b> Uncontrolled systemic inflammation may occur in severe coronavirus disease 19 (COVID-19). We have previously shown that endotoxemia, presumably from the gut, may complicate COVID-19. However, the role of endotoxin adsorbent (EA) therapy to mitigate organ dysfunction in COVID-19 has not been explored. <b><i>Methods:</i></b> We conducted a retrospective observational study in COVID-19 patients who received EA therapy at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between March 13 and April 17, 2020. Relevant clinical and laboratory data were collected by inpatient chart review. <b><i>Results:</i></b> Among 147 hospitalized COVID-19 patients, 6 patients received EA therapy. All of the 6 patients had severe COVID-19 infection with acute respiratory distress syndrome (ARDS). Among these, 5 of them were mechanically ventilated and 4 had complications of secondary bacterial infection. The endotoxin activity assay (EAA) results of pre-EA therapy ranged from 0.47 to 2.79. The choices of EA therapy were at the discretion of attending physicians. One patient was treated with oXiris® along with continuous renal replacement therapy, and the others received polymyxin B hemoperfusion sessions. All patients have survived and were finally free from the mechanical ventilation as well as had improvement in PaO<sub>2</sub>/FiO<sub>2</sub> ratio and decreased EAA level after EA therapy. <b><i>Conclusions:</i></b> We demonstrated the clinical improvement of severe COVID-19 patients with elevated EAA level upon receiving EA therapy. However, the benefit of EA therapy in COVID-19 ARDS is still unclear and needs to be elucidated with randomized controlled study.

scholarly journals Prospective Randomized Controlled Study to assess the Role of Dexmedetomidine on Perioperative Hemodynamics in Patients with Supratentorial Tumor undergoing Surgery

2017 ◽  
Vol 2 (1) ◽  
pp. 14-17
Author(s):  
Sachin Vaishnav ◽  
Anita Shetty ◽  
Manjula Sarkar
Keyword(s):  
Blood Pressure ◽  
Placebo Group ◽  
Arterial Blood Pressure ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Arterial Blood ◽  
Supratentorial Tumor ◽  
Duration Of Surgery

ABSTRACT The stress response to an intense painful surgical stimulus is characterized by activation of the sympathetic nervous system and an increased secretion of the stress hormones. The ability of the alpha agonist dexmedetomidine (DEX) to decrease heart rate (HR) and arterial blood pressure in perioperative period was tested. One hundred and thirty two patients undergoing craniotomy for supratentorial tumor were randomly distributed to receive either saline (B group) or DEX (A group). The placebo group received saline, whereas the treatment group (A group) received a single bolus dose of DEX (1μg/kg) intravenously over 10 minutes before induction of anesthesia. Hemodynamic parameters, such as HR and arterial blood pressure were measured. Both the groups were comparable with respect to age, sex, American Society for Anesthesiologist grade, and duration of surgery. The arterial blood pressure and HR were found to be lower in the DEX group when compared with the placebo group. How to cite this article Vaishnav S, Shetty A, Sarkar M. Prospective Randomized Controlled Study to assess the Role of Dexmedetomidine on Perioperative Hemodynamics in Patients with Supratentorial Tumor undergoing Surgery. Res Inno in Anesth 2017;2(1):14-17.

scholarly journals Quality of Life in Patients with Dementia with Lewy Bodies

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Chuo-Yu Lee ◽  
Shih-Jung Cheng ◽  
Hui-Chi Lin ◽  
Yu-Lu Liao ◽  
Pei-Hao Chen
Keyword(s):  
Quality Of Life ◽  
Daily Living ◽  
Dementia With Lewy Bodies ◽  
Lewy Bodies ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Specific Instrument ◽  
Pubmed Database

Dementia with Lewy bodies (DLB) is a complex, multisymptom disorder. When making decisions regarding the treatment of DLB, the patient’s quality of life (QoL) should always be the main consideration. To our knowledge, this is the first review article focusing on the QoL in DLB patients. We searched the PubMed database using the keywords “quality of life” and “dementia with Lewy bodies.” Previously, no specific instrument had been developed for assessing the QoL in DLB patients. Patients with DLB have a decreased QoL compared to patients with Alzheimer’s disease, which is reportedly caused by several factors including level of independence in instrumental activities of daily living, whether the patient is living with the caregiver, apathy, delusion, and dysautonomia. The direct effect of visual hallucination, sleep, and movement disorders on the QoL in DLB patients has not been previously studied. The role of cognitive function on the QoL is still controversial. In a randomized controlled study, memantine may improve the QoL in PDD or DLB patients. We concluded that it is important to develop a specific instrument to assess the QoL in DLB patients. Furthermore, there is an urgent need for large clinical trials to identify factors associated with the QoL and how they can be managed.

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