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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

ECG, arterial flow and pressure were recorded during external cardiac compression (ECC) in a patient whose heart had ceased beating. The patient was a 68-year-old female who remained comatose for 2 weeks after an emergency laparotomy for perforated diverticulitis of the colon. She developed sepsis, renal failure, and cardiopulmonary failure. During ECC, the pressure on the sternum was maintained for about 0.5 sec (sustained pressure technique), flow and mean arterial pressure were improved by 32 and 20%, respectively, as compared with flow and pressure obtained with a quick and more jerky compression. During spontaneous heart activity with a low blood pressure, a superimposed ECC improved both flow and mean arterial pressure. Calcium chloride and adrenaline injected into the right atrium increased the tone and contractile power of the heart and greatly improved flow and pressure when the heart was subsequently compressed during asystole.
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PMID:On the technique of external cardiac compression. 65 21

Calcium chloride is administered frequently to critically ill patients to improve cardiac output and BP. However, Ca has been implicated in the pathophysiology of shock and ischemic disorders. To test the hypothesis that Ca may be deleterious to shock outcome, we studied the effects of CaCl and Ca chelator (EGTA) infusions on mean arterial pressure (MAP) responses to endotoxin and 24-h survival in rats. Increasing ionized Ca from 4.1 +/- 0.06 to 4.9 +/- 0.20 and 8.5 +/- 0.52 mg/dl progressively increased endotoxin lethality from 20% to 37% and 80%, respectively. This occurred despite slight improvements in MAP in hypercalcemic rats. Conversely, hypocalcemia (3.6 +/- 0.08 mg/dl) lowered endotoxin-induced mortality to 0 without significant effects on MAP. Ca and EGTA infusions alone were not associated with any mortality. Although Ca administration may improve MAP, it significantly increases mortality associated with endotoxic shock in rats. Based on these observations, we advise caution when using Ca in patients with sepsis.
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PMID:Calcium administration increases the mortality of endotoxic shock in rats. 250 40