190 research outputs found
A cardiopulmonary resuscitation guide for healthcare providers
No full textCardiopulmonary resuscitation or CPR is the term used to describe a series of action that comprises of artificial respiration and chest compressions to patients in cardiorespiratory arrest. It has to be initiated promptly to improve the chance of survival before advanced medical care is available. CPR is an important clinical skill, almost mandatory for every healthcare personnel. The CPR procedure is an essential component of Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS).
This book covers the important aspects of Basic Life Support (BLS) and serves as a guide to participants of the CPR course. Participants are required to read this book before attending the course. Its main objective is to provide a simple and comprehensive reference to participants of our CPR workshops. It follows the standardised 2010 guideline published by recognised bodies such as The International Liaison Committee on Resuscitation (ILCOR), and the American Heart Association (AHA). We have also incorporated a chapter on Islamic Ethics, in line with the IIICE (Integration, Islamisation, Internationalisation and Comprehensive Excellence) mission of our university.
A cardiopulmonary resuscitation guide for healthcare providers
No full textCardiopulmonary resuscitation or CPR is the term used to describe a series of action that comprises of artificial respiration and chest compressions to patients in cardiorespiratory arrest. It has to be initiated promptly to improve the chance of survival before advanced medical care is available. CPR is an important clinical skill, almost mandatory for every healthcare personnel. The CPR procedure is an essential component of Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS). This book covers the important aspects of Basic Life Support (BLS) and serves as a guide to participants of the CPR course. Participants are required to read this book before attending the course. Its main objective is to provide a simple and comprehensive reference to participants of our CPR workshops. It has been updated according to the latest 2015 guidelines published by recognised bodies such as The International Liaison Committee on Resuscitation (ILCOR), and the American Heart Association (AHA). We have also incorporated a chapter on Islamic Ethics, in line with the IIICE (Integration, Islamisation, Internationalisation and Comprehensive Excellence) mission of our university
Estimates of Glomerular filtration rate by the chronic kidney disease epidemiology collaboration equations best correlates with kinetic estimates of Glomerular filtration rates in the critically ill
No full textKinetic estimate of GFR (keGFR) is a more accurate estimate of GFR in the
acute settings with rapidly changing kidney functions. It takes into account the changes
of creatinine over time, creatinine production rate, and the volume of distribution,
however needs serial measurement of creatinine. We evaluated which methods of the
conventional eGFR measurement best correlates with keGFR. This could assist clinicians
in using a simpler method of calculation and is useful in the absence of serial plasma
creatinine. (Copied from article)
Plasma Cystatin C and estimates of Glomerular filtration rate using Cystatin C independently diagnose acute kidney injury in critically ill patients with Sepsis
No full textPlasma Cystatin C (CysC) is as an early functional marker for acute kidney
injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in
some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing acute
kidney injury (AKI) and predicting death in critically ill patients with sepsis. (Copied from article)
Validating a Lower Urine Output Criteria in predicting death in Critically Ill Patients
No full textUrine output provides a rapid estimate for kidney function, and its use has been incorporated in the diagnosis of acute kidney injury. However, not many studies had validated its use compared to the plasma creatinine. It has been showed that the ideal urine output threshold for prediction of death or the need for dialysis was 0.3 ml/kg/h. We aim to assess this threshold in our local ICU population
Malaysian Society of Anaesthesiologists Year Book 2013/2014
No full textWe would like to thank the Malaysian Society of Anaesthesiologists (MSA) for the trust given to us as Editors for this 6th edition of MSA Year Book for the year of 2013/2014.
The theme for this edition is mainly related on the management of critically ill patients. The articles contained in this yearbook are a compilation of review articles written by experts covering a diverse range of topics of each system of the body. It is our hope that these articles could update clinicians with the latest evidences in managing critically ill patients as a whole.
We would like to thank all authors and reviewers for their valuable time and effort in writing and reviewing the papers. We hope that this effort could be an impetus for future writings in more esteemed peer-reviewed journals. In addition, we hope this would serve as an avenue in developing the skills of the Society members in writing more scientific papers in the future
Malaysian society of anaesthesiologists year book 2020/2021
No full textOur theme for this year is ‘Evolution and Revolution’. We look upon the past and how it has evolved or revolved to the current practice and the future prospect. We cover specific domains in our specialty which include Clinical Anaesthesiology, Critical Care, and Pain Medicine. In the era of rapid progress of technology in our life, its contribution to our daily clinical practice and to the teaching and learning in our specialty are discussed. Last but not least, ethics, safety and social issues that impact our daily clinical life are dealt with in the final three articles. It is our hope that these articles could enrich our esteemed colleagues on the specific topics covered that could help our clinical practice. Finally, our thanks go to the MSA secretariat who has provided excellent logistics that make this publication possible
High-dose intravenous epoetin does not increase blood pressure in critically ill patients with acute kidney injury
No full textTreatment of renal anemia with erythropoietic stimulating agents sometimes increases blood pressure. It is uncertain whether this is due to direct vasoconstriction and/or increased red blood cell mass. We conducted a post-hoc analysis of 160 critically ill patients in the EARLYARF trial with elevated urinary γ-glutamyltranspeptidase and alkaline phosphatase, indicating acute kidney injury. Patients received two doses of intravenous epoetin (500 U/kg), 24 hours apart, or placebo, in a randomized, double-blind study design. Hourly mean arterial pressure (MAP), and norepinephrine equivalent dose (NED: determined using equipotency conversion factors for doses of epinephrine, vasopressin, phenlyephrine, or dopamine) were extracted from clinical records. The differences between baseline and maximum MAP and NED (∆MAP and ∆NED) over 4, 24, 72-hour, and 30-day periods following study drug administration were compared between groups. At baseline, MAP was 78±14 mmHg in the epoetin group and 81±15 mmHg in the placebo group (p=0.22). There were no differences between groups in ∆MAP (6±14 versus 7±14 mmHg; p=0.53), in ∆NED, or in ∆MAP adjusted for ∆NED at 4 hours, or at any time points. A subgroup analysis of only those patients not requiring vasopressor support (n=71) also showed no differences between epoetin and placebo for all outcomes. We concluded that intravenous high dose epoetin does not acutely increase blood pressure, suggesting no acute vasoconstrictor effect in this setting
Perioperative strategies for renal protection
No full textAcute Kidney Injury (AKI) is common, occurring in 10 to 30% perioperatively, and this can lead to increased morbidity and mortality. Currently, there is no therapeutic intervention available, hence perioperative renal protection strategies are important to reduce the consequences of AKI. Current consensus of AKI definition was based on serum creatinine and urine output criteria as in the Kidney Disease in Improving Global Outcome (KDIGO) 2012 guideline. However, both have limitations in the perioperative settings, and this present a diagnostic challenge that precludes good interventional study that impede development of novel pharmacologic therapy. Newer biomarkers offer a better diagnostic opportunity and provide more insight of functional verses injury paradigm, however, is limited by cost and availability. It is important for us to understand the pathophysiology and risk factors for early identification of high-risk patients, so that appropriate strategies could be carefully implemented. Risk assessment prior to surgery is crucial to optimize strategies to prevent AKI and to determine which patients might require more intense monitorization after surgery. The KDIGO guideline proposes to implement a bundle of preventive measures in patients at high risk for AKI. Application of this bundle in high risk patients identified by new biomarker has been shown to reduce overall AKI incidence in cardiac and non-cardiac surgery. Appropriate strategies to deliver optimal amount and type of fluid management perioperatively is important to prevent AKI. Various pharmacological therapies has been studied, of these dexmedetomidine and statin has shown a promising result
Biomarkers of acute kidney injury in the intensive care unit
No full textAcute Kidney Injury (AKI) is common in critical
illness, and contributes to high mortality. Current
consensus AKI definition is mainly based on
functional biomarkers, plasma creatinine and urine
output. Emerging studies showed the utility of
structural biomarkers for earlier detection of AKI,
and stratification of injury severity. A combination
of these functional and structural biomarkers is
of utility for risk stratification and prediction of
outcome. This paper provides an overview of AKI
with emphasis on critically ill patients. The major
focus is on the early detection of AKI and prediction
of outcome by functional and structural biomarkers.
The future advances in the use of AKI biomarkers
are explored
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