Refractory status epilepticus describes continuing seizures despite adequate initial pharmacologic treatment. This situation is common in children, but few data are available to guide management. We review the literature related to the pharmacologic treatment and overall management of refractory status epilepticus, including midazolam, pentobarbital, phenobarbital, propofol, inhaled anesthetics...

REBOA has been recently adopted for trauma patients with refractory hypotension or in traumatic arrest from hemorrhage below the diaphragm. REBOA has shown improved physiologic parameters, coronary and cerebral blood flow, and survival in hemorrhage models. The National Trauma Care System (NTCS) goal to achieve zero preventable deaths after injury may benefit with advances in REBOA. Non-compres...

We report the case of a 38-week gestational age neonate, with isolated congenital diaphragmatic hernia presenting with refractory persistent pulmonary hypertension, systemic hypotension, and hypoxemia, resistant to usual therapeutics. Arginine vasopressin is responsible for systemic vasoconstriction and decreases pulmonary hypertension. We theorized that terlipressin, its long-acting analogue, ...

Arginine vasopressin (AVP), also known as antidiuretic hormone, is a peptide endogenously secreted by the posterior pituitary in response to hyperosmolar plasma or systemic hypoperfusion states. When administered intravenously, it causes an intense peripheral vasoconstriction through stimulation of V1 receptors on the vascular smooth muscle. Patients in refractory shock associated with severe s...

HYPOTENSION, SOMETIMES REFRACTORY, is a well-recognized phenomenon associated with the administration of general anesthesia in patients who have angiotensin-axis blockade (AAB) because of the administration of either angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs).1 Hypotension in such patients usually occurs within 30 minutes of the induction of anesthe...

context the occurrence of intradialytic hypotension (idh) during hemodialysis (hd) continues to be a main problem in patients with esrd (end-stage kidney disease). it also negatively affects health-related quality of life. we aimed to determine vasopressin effect in decreasing idh. evidence acquisition we reviewed clinical and experimental literature in a variety of sources, including pubmed, c...

conclusions in intervertebral herniated disc surgery, aprotinin and controlled hypotension treatments yielded similar results in terms of reducing blood loss and surgeon satisfaction with the field of operation. results 70 patients were identical in terms of demographics and the length of surgery. the two groups were not statistically different in terms of mean change in systolic, diastolic and...

conclusions intrathecal midazolam 2 mg provides significantly longer and effective postoperative analgesia with no side effects. results postoperative analgesia was significantly longer in the midazolam group compared to the control group (201.5 minutes vs. 357.6 minutes). the mean onset times of the sensory and motor blocks were significantly faster (p < 0.01) in the midazolam group compared t...