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Intravenous Mannitol reduces intracompartmental pressure following tibia fractures: A randomized controlled trial

Chinese Journal of Traumatology 2021年第2期24卷 109-112页

作者： Jerry Nesaraj Viju Daniel Varghese P.R.Boopalan Manasseh Nithyananth thambu David sudarsanam Thilak Samuel Jepegnanam Christian Medical College Vellore 632004Tamil NaduIndia Royal Darwin Hospital Darwin 0810Northern TerritoryAustralia

Purpose:Impending compartment syndrome is a common event following closed tibia fractures,which can progress to sinister compartment *** is the only definitive treatment available,though it has its own drawbacks and *** management at present consists of limb elevation and adequate *** study aims at determining whether intravenous administration of Mannitol reduced the intracompartmental pressure in patients with closed tibial ***:This is a double blinded,randomized control trial done in a single tertiary care center in ***-five patients were recruited between February 2012 and October *** patients who presented to the emergency department with isolated,closed,high velocity,and proximal 2/3 tibia fractures were included in this *** with contraindication to Mannitol were *** were allocated into 2 groups by the investigator using computer generated *** pressure in the anterior compartment of the leg was measured with a handheld Stryker pressure *** either 20%Mannitol or 0.9%normal saline as given intravenously in a blinded manner,based on the *** intracompartmental pressure was measured at 0,1 and 3 h after the *** participant,investigator and statistician were masked to the group ***:There was no difference in intracompartmental pressures at 1 or 3 h,between the ***,in patients with the baseline of compartmental pressures30 mmHg,Mannitol showed a marked reduction in pressure of 8.5 mmHg at 1 h compared to almost no change in pressure in the saline *** were no adverse events with the use of ***:This preliminary study appears to show that Mannitol is useful in the management of the increased compartment *** limitations of this study were that it only involved a small group of patients and the baseline pressures in both the groups were not *** studies are requi

关键词： Mannitol Compartment pressures Acute tibial fractures

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Spectrum of cardiac manifestations and its relationship to outcomes in patients admitted with scrub typhus infection

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World Journal of Critical Care Medicine 2018年第1期7卷 16-23页

作者： Gunasekaran Karthik Thomas Isaiah Sudarsan John Victor Peter thambu sudarsanam George M Varghese Paul Kundavaram Sowmya Sathyendra Ramya Iyyadurai Kishore Pichamuthu Department of Medicine Christian Medical College Medical Intensive Care Unit Christian Medical College Department of Infectious Diseases Christian Medical College

AIM To study the spectrum of cardiac manifestations in scrub typhus infection and assess its relationship to *** Demographic data, electrocardiographic(ECG) changes, left ventricular (LV) systolic and diastolic function, myocardial injury (defined as troponin T > 14 pg/mL), and pericardial effusion were documented. Myocarditis was diagnosed when myocardial injury was associated with global LV systolic dysfunction. The relationship between myocarditis and outcomes was assessed using logistic regression analysis and expressed as odds ratio(OR) with 95%*** The cohort(n = 81; 35 males) aged 49.4 ± 16.1 years(mean, SD) presented 8.1 ± 3.1 d after symptom onset. The APACHE-Ⅱ score was 15.7 ± 7.0. Fortyeight (59%) patients were ventilated, and 46 (56%) required vasoactive agents. Mortality was 9.9%. ECG changes were non-specific; sinus tachycardia was the most common finding. Myocardial injury was evident in 61.7% of patients and LV systolic dysfunction in 30.9%. A diagnosis of myocarditis was made in 12.3%. In addition, seven patients with regional wall motion abnormalities had LV systolic dysfunction and elevated cardiac enzymes. Mild diastolic dysfunction was observed in 18 (22%) patients. Mild to moderate pericardial effusion was seen in 51%. On multivariate logistic regression analysis, patients with myocarditis tended to be older (OR = 1.04, 95%CI: 0.99-1.09), had shorter symptom duration (OR = 0.69, 95%CI: 0.49-0.98), and tended to stay longer in hospital(OR = 1.17, 95%CI: 0.98-1.40). Myocarditis was not associated with increased *** In scrub typhus infection, cardiac manifestations are frequent and associated with increased morbidity but not mortality.

关键词： Scrub typhus Myocarditis Outcome

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