Podcasts about Mannitol

How does one transform a personal crisis into a groundbreaking business that has the potential to change lives? This question lies at the heart of this episode, as we explore the journey of entrepreneurship through the lens of resilience, innovation, and a relentless drive to make a difference.Our guest, Martha Carlin, transitioned from a career in accounting to founding BiotiQuest after her husband's early Parkinson's diagnosis. Motivated to find solutions outside traditional medicine, Martha uncovered the power of the microbiome and developed specialized probiotics, leveraging years of research and personal investment to help improve lives—including her husband's.This episode provides an inside look at Martha's incredible story, the unique science behind her products, and the significant challenges small health businesses face in the era of digital marketplace giants. It's a must-listen for anyone interested in health, entrepreneurship, or what it truly takes to pursue a mission-driven business in today's digital world. To get the latest from Martha Carlin, you can follow her below!https://www.linkedin.com/in/marthacarlin/https://biotiquest.com/ Sign up for Marcia's newsletter to receive tips and the latest on Angel Investing!Website: www.marciadawood.comLearn more about the documentary Show Her the Money: www.showherthemoneymovie.comAnd don't forget to follow us wherever you are!Apple Podcasts: https://pod.link/1586445642.appleSpotify: https://pod.link/1586445642.spotifyLinkedIn: https://www.linkedin.com/company/angel-next-door-podcast/Instagram: https://www.instagram.com/theangelnextdoorpodcast/TikTok: https://www.tiktok.com/@marciadawood

The JournalFeed podcast for the week of April 18 – May 2, 2025.These are summaries from just 2 of the 5 articles we cover every week! For access to more, please visit JournalFeed.org for details about becoming a member.Monday Spoon Feed:The ALI's first restatement of medical malpractice law shifts from “customary practice” to “reasonable medical care,” integrating evidence-based medicine, clarifying liability standards, discouraging defensive medicine, and promoting transparency while balancing ethical communication and legal accountability.Tuesday Spoon Feed:In children with moderate to severe TBI, 3% hypertonic saline (HTS) was not associated with improved survival or better functional outcomes compared to 20% mannitol.

Show notes at pharmacyjoe.com/episode1015. In this episode, I'll discuss mannitol extravasation. The post 1015: What To Do If Mannitol Extravasates appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode942. In this episode, I'll discuss the administration of mannitol for elevated intracranial pressure. The post 942: Mannitol administration for elevated intracranial pressure appeared first on Pharmacy Joe.

This week's episode was listener/viewer-requested! Do you look at nutrition labels but aren't sure what you're looking at? Or maybe you don't look at nutrition labels at all.  This episode will provide you with the knowledge you need before your next supermarket/grocery store visit.  In this episode, we will cover:The importance of nutrition labelsWhat can be gained from reading nutrition labelsWhat we would be mindful of when looking at nutrition labels11 ingredients to avoid The sugar alcohols mentioned were: Erythritol, Hydrogenated starch hydrolysates (HSH), Isomalt, Lactitol, Maltitol, Mannitol, and SorbitolThe processed oils mentioned were: Canola, Corn, Soybean, Vegetable, and Palm OilWant to WATCH the podcast on YouTube?  Now you can! Watch & listen with this link: https://www.youtube.com/channel/UCvxZW1UUEZoDhyOSKqcZqKw***CHECK THIS OUT!!***Podcast Facebook Community:Have you joined the podcast Facebook community yet?!  If not and you are a woman who is interested in having a place to connect, inspire, and support other like-minded women, this is the place for you! In the Facebook community, we will share our health and wellness journeys to normalize these talks we often shy away from or feel are not welcome. They are welcome here, and I can't wait to see you there!!Use the following link to request to join:https://www.facebook.com/groups/385487936132272/Bi-Weekly Newsletter:Join my bi-weekly email list by sending me an email to kellybholisticwellness@gmail.comProducts I am OBSESSED with:Therasage:Use code KELLYB to save 10% on your portable Infrared Sauna and take your healing to the next level!  Click HERE to shop.Skin Essence Organics:Skin Essence Organics is a fantastic company that makes affordable, non-toxic skin care products that not only smell good but feel good, too!  All of their products are 100% plant-based, organic, cruelty-free, gluten-free, and non-GMO.  To start supporting your body and our environment, head on over to https://www.skinessenceorganics.com/ (if you are in the US) or https://www.skinessence.ca/ (if you are in Canada) to try out these amazing products. You can get 10% off of your order when you use the code: kelly, plus free shipping on orders of $49 or more.Funk It Wellness:Funk It Wellness Seed Cycling Kits and Maca Powder can be found at: https://funkitwellness.com/Use the code: KELLY20 to save 20% on your order!!Finally, if this podcast resonates with you, it would mean the world to me if you could take 20 seconds of your time and leave a review on Apple Podcasts or Spotify.  Reviews help this podcast become more searchable, allowing me to impact more people like you! Feel free to tag me on Instagram @kelly_bluth so that I can personally thank you or reach out to me via email at  kellybholisticwellness@gmail.com. I am so grateful to you and look forward to continuing on this journey together.

This episode is part of my FODMAP mini-series looking at how to handle a negative reaction to the FODMAP diet reintroduction phase. Listen to them all. Listen to hear how to retest after a positive FODMAP reaction to a challenge. I also share HOW mannitol will affect your gut. Foods turn to moderate or high FODMAP for mannitol at these levels:Butternut squash – 60g (also high in GOS)Cauliflower – 75gMange tout – 25g (these are also high in fructans)Sweet potato – 75g Sauerkraut – 30g Mushrooms - button – 10g , portobello – 15g, Shitake – 15gFood additive - E-421If one of the high mannitol foods has affected you, you can retest this FODMAP with a different food. For help managing your IBS diet, including the low FODMAP diet, join the 3 month Gut Reset. LinksGroup Gut Reset - https://www.goodnessme-nutrition.com/group-course-ibsc/1:1 Gut Reset - https://www.goodnessme-nutrition.com/consultations/

Contributor: Travis Barlock MD Education Pearls: The Cushing Reflex is a physiologic response to elevated intracranial pressure (ICP) Cushing's Triad: widened pulse pressure (systolic hypertension), bradycardia, and irregular respirations Increased ICP results from systolic hypertension, which causes a parasympathetic reflex to drop heart rate, leading to Cushing's Triad.  The Cushing Reflex is a sign of herniation Treatment includes: Hypertonic saline is comparable to mannitol and preferable in patients with hypovolemia or hyponatremia Give 250-500mL of 3%NaCl 20% Mannitol - given at a dose of 0.5-1 g/kg Each additional dose of 0.1 g/kg reduces ICP by 1 mm Hg 23.4% hypertonic saline is more often given in the neuro ICU 8.4% Sodium bicarbonate lowers ICP for 6 hours without causing metabolic acidosis Non-pharmacological interventions: Raise the head of the bed to 30-45 degrees Remove the c-collar to improve blood flow to the head Hyperventilation induces hypocapnia, which will vasoconsrict the cerebral arterioles You hyperventilate on the way to the OR. Otherwise, maintain normocapnia. References Alnemari AM, Krafcik BM, Mansour TR, Gaudin D. A Comparison of Pharmacologic Therapeutic Agents Used for the Reduction of Intracranial Pressure After Traumatic Brain Injury. World Neurosurg. 2017;106:509-528. doi:10.1016/j.wneu.2017.07.009 Bourdeaux C, Brown J. Sodium bicarbonate lowers intracranial pressure after traumatic brain injury. Neurocrit Care. 2010;13(1):24-28. doi:10.1007/s12028-010-9368-8 Dinallo S, Waseem M. Cushing Reflex. [Updated 2023 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549801/ Godoy DA, Seifi A, Garza D, Lubillo-Montenegro S, Murillo-Cabezas F. Hyperventilation therapy for control of posttraumatic intracranial hypertension. Front Neurol. 2017;8(JUL):1-13. doi:10.3389/fneur.2017.00250 Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII  

Show notes at pharmacyjoe.com/episode811. In this episode, I'll discuss mannitol extravasation. The post 811: What To Do If Mannitol Extravasates appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode811. In this episode, I ll discuss mannitol extravasation. The post 811: What To Do If Mannitol Extravasates appeared first on Pharmacy Joe.

If you suffer from constipation, sugar cravings, and digestive issues, then this interview is for you!My guest this week is Martha Carlin, founder of the BioCollective, a company specializing in understanding our microbiome. This international team of scientists is in the process of sequencing our microbiome (like experts once sequenced our genes). Martha, in my books, is a modern-day superhero. Motivated by her husband's early diagnosis of Parkinson's, Martha was desperate to find a way to prevent his condition from deteriorating. Her research pointed to the microbiome as a major factor in the onset of his disease. This led, in partnership with other scientists, to the development of a unique probiotic that proved life-saving for her husband (whose Parkinson's dramatically improved and is now stabilized). This probiotic is called SugarShift. In this interview, Martha shares details about how this particular probiotic blend saved her husband and has since been proven to reduce sugar cravings, assist with elimination and help with diabetes. The science is fascinating.How does it work?Martha discovered that we have bacteria in our gut that can convert glucose and fructose into mannitol. Mannitol is a sugar that is not digestible to humans but is food for other friendly bacteria in our gut. This means that certain bacteria (which are in this probiotic blend) can convert some of the fructose - including from healthy whole foods - into a benign substance. It changes fructose into something helpful to our microbiome and reduces the amount heading to the liver to be converted into fat. Please note that taking this product is not a free pass to eat as much sugar as you want. It is intended to help you heal your gut, and that cannot be done if you continue to consume excess sugar.Florence's courses & coaching programs can be found at:www.FlorenceChristophers.comConnect with Florence on:FACEBOOK | TWITTER | INSTAGRAM | YOUTUBE

Download the cheat: https://bit.ly/50-meds  View the lesson: https://bit.ly/MannitolOsmitrolNursingConsiderations    Generic Name mannitol Trade Name Osmitrol Indication increased ICP, oliguric renal failure, edema, increased intraocular pressure Action inhibits reabsorption of water and electrolytes by increasing osmotic pressure, excreted by kidneys Therapeutic Class diuretic Pharmacologic Class osmotic diuretic Nursing Considerations • may cause phlebitis at IV site • may cause dehydration, fluid and electrolyte imbalances • monitor neuro status • administer via a filter

This is a good starting point and probably a pass as per examiners reports, but if you get time then add more detail (e.g. baroreceptor reflexes to volume changes, CVS effects of potential hyperkalaemia)

Trade – OsmitrolClass – Osmotic DiureticMOA – Facilitates the flow of fluid out of tissues including the brain and into interstitial fluid and blood, this causes dehydration of the brain which results in decreased swelling. Reabsorption by the kidneys is limited so increased urine output takes placeIndications – increased ICPContraindications- Active intracranial bleeding, heart failure, pulmonary edema, severe dehydration, use caution with hypovolemia and renal failure.Side effects – Pulmonary edema, headache, blurred vision, dizziness, seizures, hypovolemia, nausea/vomiting, diarrhea, electrolyte imbalance, hypotension/HTN, sinus tachycardia, PVCs, angina, phlebitis DosageAdult: 0.25-1g/kgPediatric: SAA

In this World Shared Practice Forum podcast, Dr. Patrick Kochanek discusses the results of the ADAPT trial, published in JAMA Open Network, which compares intracranial pressure measurements in children with severe traumatic brain injury following administration of hypertonic saline versus mannitol. He outlines the key findings of the ADAPT trial, describes some of the challenges and limitations that accompanied the study, and provides insight into the potential impact on the management of pediatric traumatic brain injury. Publication date: April 25, 2022. Citation: Kochanek P, Daniel D, Burns JP. Results of a Clinical Trial of Hypertonic Saline or Mannitol in the Treatment of Children With Severe Traumatic Brain Injury. 04/2022. Online Podcast. OPENPediatrics. https://youtu.be/ZdnaccURMVQ. Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

Mannitol is a common medication you are likely to see on nursing school exams, NCLEX, and in the clinical setting. Because it requires careful administration, assessment, and follow-up, you will most likely see it utilized in the critical care environment. In this episode, we'll go through mannitol using the Straight A Nursing DRRUGS framework. Want to maximize your learning by reading this information, too? Check out the article and references here. Learn some of the most common root/suffix conventions used in pharmacology to make studying and understanding easier than ever! Grab the FREE pharmacology cheatsheet! RATE, REVIEW AND FOLLOW! If this episode helped you, please take a moment to rate and review the show! This helps others find the podcast, which helps me help even more people :-) Click here, scroll to the bottom, then simply tap to rate with 5 stars and select, "write a review." I'd love to hear how the podcast has helped you! If you're not following yet, what are you waiting for? It takes just a quick moment and the episodes show up like magic every Thursday. And, when I release a bonus episode, those show up, too! You'll never miss a thing! In Apple Podcasts, just click on the three little dots in the upper right corner here. Know someone who would also love to study with me? Share the show or share specific episodes with your classmates...when we all work together, we all succeed! On Apple Podcasts, the SHARE link is in the same drop-down as the follow link. Spread the love! Thanks for studying with me! Nurse Mo

Show notes at pharmacyjoe.com/episode701. In this episode, I'll discuss the administration of mannitol for elevated intracranial pressure. The post Episode 701: Mannitol administration for elevated intracranial pressure appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode701. In this episode, I ll discuss the administration of mannitol for elevated intracranial pressure. The post Episode 701: Mannitol administration for elevated intracranial pressure appeared first on Pharmacy Joe.

Today, I am blessed to have here with me Martha Carlin. She is a Citizen Scientist that takes a systems approach to looking at Parkinson's disease and finds the answers to PD and many chronic diseases may be in our poop. Free 7 Day Keto Challenge: http://www.ketokampchallenge.com When doctors said her husband's Parkinson's would eventually kill him, Martha Carlin said, “no it won't.” She stepped out of a successful career as a systems expert and into the new role of Citizen Scientist. After years of re-learning the sciences, pouring over research (and commissioning work at the University of Chicago), Martha is now a leading source of deep data on the human biome to unlock preventions and cures for many of our most complex health conditions. Her company, The BioCollective, links personal health history, metagenomics and microbiome analysis to uncover previously unknown links between chronic disease and diet, stress, and environment. She lives with her (thriving) husband John in Lone Tree, Colorado. In this episode, Martha speaks about her obsession with the gut microbiome and how her research helped her husband's Parkinson's diagnosis. We talk about the differences between a healthy gut and an unhealthy gut. Martha reveals the top three things you need to avoid to improve your gut health. Later, we chat all about the products that Martha has developed as a result of her research. If you're interested in improving your gut health, you can find those formulas here: https://biotiquest.com/ (Use Code: KETOK15). Free 7 Day Keto Challenge: http://www.ketokampchallenge.com 90 Day Detox Program: http://www.ketokampdetox.com Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E   S P ON S O R S  PureForm Omega Plant Based Oils (Best Alternative to Fish Oil): http://www.purelifescience.com Use ben4 for $4.00 off. Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list.  [00:30] Why Martha Is So Obsessed With The Gut Microbiome and The Research She's Doing In Her Company Martha's 44-year-old otherwise healthy husband was diagnosed with Parkinson's disease. So, Martha started to teach herself about science and the human body. Food and water are the main inputs in the human body. Martha threw out all the food that wasn't organic. After ditching highly refined carbohydrates, Martha's husband started to do much better than most people with Parkinson's. Martha recommends reading Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues: https://www.amazon.com/Missing-Microbes-Overuse-Antibiotics-Fueling/dp/1250069270/benazadi-20 [12:05] Comparing A Healthy Gut To An Unhealthy Gut People who have a relative abundance of streptococcus are in some disease category. Streptococcus loves glucose. Elevated proteobacteria is another sign of an unhealthy gut. There's a study suggesting that people who drink skim milk have a statistically significant increase in Parkinson's risk. [18:30] Glyphosate: The Main Problem That Is Disrupting Your Microbiome The number one thing disrupting the gut microbiome is glyphosate. Most people do not understand how much the use of glyphosate has increased in the last thirty years. Glyphosate changes the biochemistry of the plant. Also, it changes the biochemistry of the soil, which changes the nutritional uptake of a plant. So, you need to eat as organic as possible. Also, make your legislators aware of the glyphosate problems. [23:55] Other Things You Should Avoid To Improve Your Gut Health Avoid high fructose corn syrup. Highly processed sugars will have a significant impact on your microbiome and overall health. The highest consumption of high fructose corn syrup is usually in poor populations. Also, avoid antibiotics to improve your gut health. [28:00] All About The BioCollective and How Martha Wants To Help People Improve Their Health Martha uses the concept of collect, connect, and correct. She collects poop samples, connects the dots, and corrects the problem. Martha has worked with researchers all over the globe using their samples. Now, they formulate different products to help people. Sugar Shift is something that will help you address cravings. BiotiQuest's Sugar Shift helps your gut microbiome transform the unneeded accumulation of sugars (glucose and fructose) into mannitol. Mannitol is a sugar that isn't stored in the body, so it is naturally eliminated. Get Sugar Shift here: https://biotiquest.com/pages/sugar-shift (Use Code: “KETOK15”) [36:05] Help Your Gut By Using Ideal Immunity and Heart Centered    Ideal Immunity is similar to Sugar Shift. However, this particular formula will kill foodborne pathogens. Plus, it works to restore mucosal surfaces in the gut to support your immune system. If you're traveling, Ideal Immunity is great for your gut. Get Ideal Immunity here: https://biotiquest.com/pages/ideal-immunity (Use Code: “KETOK15”) Lastly, Heart Centered is focused on cardiovascular health and lowering blood pressure. Get Martha's products here: https://biotiquest.com/ (Use Code: “KETOK15”) AND MUCH MORE!  Resources from this episode: Check out Martha's Website: https://www.marthasquest.com/ The BioCollective: https://www.thebiocollective.com/ Get Martha's products here: https://biotiquest.com/ (Use Code: “KETOK15”) Follow Martha Carlin LinkedIn: https://www.linkedin.com/in/marthacarlin/ Twitter: https://twitter.com/tbcmicrobes BioCollective on LinkedIn: https://www.linkedin.com/company/the-biocollective/about/ Check out Martha speak at the White House: https://www.youtube.com/watch?v=ZXq1oOjO_Kg Watch Do Gut Microbes Predict or Cause Diseases like Parkinson's? | Martha Carlin | TEDxBoulder: https://www.youtube.com/watch?v=Ph4L_JHeB3I Join theKeto Kamp Academy: https://ketokampacademy.com/7-day-trial-a Watch Keto Kamp on YouTube: https://www.youtube.com/channel/UCUh_MOM621MvpW_HLtfkLyQ Free 7 Day Keto Challenge: http://www.ketokampchallenge.com Order Keto Flex: http://www.ketoflexbook.com -------------------------------------------------------- / / E P I S O D E   S P ON S O R S  PureForm Omega Plant Based Oils (Best Alternative to Fish Oil): http://www.purelifescience.com Use ben4 for $4.00 off. Paleo Valley beef sticks, apple cider vinegar complex, organ meat complex & more. Use the coupon code KETOKAMP15 over at https://paleovalley.com/ to receive 15% off your entire order. Text me the words "Podcast" +1 (786) 364-5002 to be added to my contacts list.  *Some Links Are Affiliates* // F O L L O W ▸ instagram | @thebenazadi | http://bit.ly/2B1NXKW ▸ facebook | /thebenazadi | http://bit.ly/2BVvvW6 ▸ twitter | @thebenazadi http://bit.ly/2USE0so ▸clubhouse | @thebenazadi Disclaimer: This podcast is for information purposes only. Statements and views expressed on this podcast are not medical advice. This podcast including Ben Azadi disclaim responsibility from any possible adverse effects from the use of information contained herein. Opinions of guests are their own, and this podcast does not accept responsibility of statements made by guests. This podcast does not make any representations or warranties about guests qualifications or credibility. Individuals on this podcast may have a direct or non-direct interest in products or services referred to herein. If you think you have a medical problem, consult a licensed physician.

This the last episode of 2021. What is chromogenic agar? In this episode I go over chromogenic agar used to detect MRSA. I also talk about Mannitol salt agar and how it aids in the isolation of Staphylococcus aureus.

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Dr. Marylene KyriazisDr. Marylene is a Doctor of Pharmacy and has served as a community and consultant clinical pharmacist for more than 25 years. Since 2010, she has focused on palliative care and pain management. Her roles include consultant, mentor, product and program developer, public speaker, researcher and philanthropist. She developed a CCCEP accredited certificate program in pain management and mentored community pharmacists across the province of BC. She was involved in the research and development of QR Cream™. She has volunteered in numerous capacities as a committee and board member for professional and philanthropic organizations. She is currently the Co-Founder, President and CEO of the Paul Sugar Palliative Support Foundation, providing supportive care to patients with a serious illness and their families. As a Director of MaryHelene Enterprises Inc., she is responsible for the manufacturing, marketing and distribution of QR Cream™. Dr. Helene BertrandMain interest is relieving pain. To provide pain relief she uses prolotherapy. She has published a paper on using prolotherapy for shoulder pain (PM&R 2016 January 2016). She also uses perineural injections and has invented a cream for topical pain treatment. A randomized controlled study has proven the effectiveness of this cream for pain relief (PM&R November 7 2015). She has completed a pilot study on using this cream for postherpetic neuralgia: 16 of the 20 people suffering from pain following a bout the shingles, on average five years previously, found relief from this cream. She is conducting a randomized placebo-controlled study using it for painful diabetic peripheral neuropathy. The study is underway with, currently, 81 of the 90 participants needed. As she has started selling the cream, the principal investigator is Dr. François Louw from Kelowna. The cream provides on average 53% pain relief (narcotics, 36%, anti-inflammatories, 23%, Tylenol 13%). To find out more about the cream, called QR cream, go to www.qrcream.com. She has developed a new way to examine for and treat low back pain which provides 78% of those examined with pain relief using a two-minute exercise, see https://www.youtube.com/watch?v=NXNS6PNKRPo. She is about to start a randomized controlled study to assess the long-term effectiveness of this technique.

Elevated intracranial pressure (ICP) was just discussed in our last podcast on head injuries.  However, we briefly mentioned how there is a certain amount of controversy on this subject.  This separate podcast is to act as a supplement to the Chapter 6 ATLS podcast on head trauma that was just covered.  We find this particularly important given how long our ATLS podcasts run in general.

Vermutlich spielen verschiedene Faktoren bei der Entstehung von Reizdarm eine Rolle. Als recht sicher gilt die Überempfindlichkeit der Schleimhaut gegenüber Dehnung. Eine vermehrten Gasbildung im Darm kann daher zu Probleme führen. Neben Intoleranzen oder fehlenden Verdauungssäften, kann eine veränderte Darmbewegung zu Gasbildung führen. Es kann hierdurch eine Dünndarmfehlbesiedelung entstehen (Bakterien an einem Ort, wo sie nicht hingehören) und es kann zu einer Veränderung der Darmflora kommen. Bakterien produzieren nunmal gerne Luft bei der Verdauung. Auch kann eine erhöhte Durchlässigkeit durch Einwirkung von fremden Erregern oder Toxinen auf die Darmschleimhaut Leaky Gut verursachen. Wie können wir die Gasbildung beeinflussen? - Zeit nehmen zum Essen - Ausreichend Kauen, optimal 30-40 mal - Warme, gekochte Speisen sind leichter zu verdauen Es gibt außerdem Stoffe, die zu Blähungen führen können - die FODMAPs. Diese fermentierbaren Oligosaccharide, Dissacharide, Monosaccharide und Polyole werden im Darm durch unsere Bakterien unter Produktionen von Gasen, wie CO2, verdaut. Dazu zählen Laktose, Fruktose oder Sorbit und kurzkettige, fermentierbare Kohlenhydrate wie Fruktane. Durch die Gasbildung wird der Darm gedehnt. Es kann zu krampfartigen Bauchschmerzen kommen. Zudem können Gase die Darmschleimhaut angreifen und die Durchlässigkeit erhöhen (Leaky Gut). FODMAPs werden z.T. als Präbiotikum eingesetzt, sind also für einen gesunden Darm nützlich. Die Summe macht das Gift bei empfindlichen Menschen. Studien konnten zeigen, dass es 75 % der Patienten damit besser geht und 80% die Ernährung über die Studiendauer hinweg fortsetzten. Der komplette Verzicht auf Kohlenhydrate und Ballaststoffe ist dauerhaft nicht sinnvoll. Unsere Bakterien bilden daraus wichtige kurzkettige Fettsäuren (Butyrate). Diese dienen der Schleimhaut als Pflege und Nahrung und wirken antientzündlich. 3 Phasen der FODMAP Ernährung: 1. Restriktion 4-6 Wochen alle FODMAPs weglassen 2. Wiedereinführung 3. Dauerhafte Ernährung !! Wichtig!!! Ernährungsumstellung mit einem Therapeuten Tipps für die FODMAP-Ernährung: Im Voraus planen, Einkaufsliste schreiben, selbst kochen. Zutatenliste der Lebensmittel studieren: Problemstoffe sind süße Zusatzstoffe wie Fructose, Laktose, Honig, Agavendicksaft, Fructose-Glucosesirup und verschiedene Zuckeralkohole wie Xylitol, Mannitol, Sorbitol. Besonders beliebt ist Inulin. Wichtig ist, bei gegebener Verträglichkeit, faserreiche Lebensmittel zu essen: Nüsse, Samen, low FODMAP Gemüse/Früchte, Leinsamen, Quinoa, Buchweizen, Haferbrei. Da bei der FODMA-Diät häufig kalziumreiche Lebensmittel rausfliegen, sollten sie durch Pflanzenmilch, Cheddarkäse, Sardinen, grünes Blattgemüse (Spinat, Grünkohl) etc. ersetzt werden. Generell ist selber kochen besonders wichtig. Du weißt so, was in deiner Nahrung drin ist. Beim Brot gibt es einen weiteren Vorteil: Bei Gehzeit von bis zu 20 Stunden, können die enthaltenen FODMAPs zum Großteil durch Bakterien und Hefen fermentiert und so unproblematisch gemacht werden. Disclaimer: Die Nutzung der Inhalte erfolgt auf eigene Gefahr für den Benutzer und ist zur allgemeinen Information bestimmt. Sollte ein Benutzer an einer Störung der Gesundheit leiden, ist ein Arztbesuch unerlässlich. Die auf diesem Podcast zusammengestellten Informationen stellen in keiner Weise Ersatz für professionelle Beratungen und/oder Behandlungen durch ausgebildete und anerkannte Fachärzte dar. Wir stellen keine Diagnosen und erteilen ausdrücklich keine Ratschläge oder Empfehlungen hinsichtlich der Therapie konkreter Erkrankungen. Für etwaige Angaben über Verfahrensweisen und Anwendungsformen wird von uns keine Gewähr übernommen und jede Anwendung erfolgt auf eigene Gefahr des Benutzers. Wir sind in keiner Weise verantwortlich für etwaige Schädigungen, die durch den Gebrauch oder Missbrauch der dargestellten Inhalte entstehen.

Mannitol is a commonly used osmotherapy agent in raised intracranial pressure (ICP) but the side effects are significant.

Mannitol is a commonly used osmotherapy agent in raised intracranial pressure (ICP) but the side effects are significant.

It’s the JournalFeed Podcast for the week of Nov 23-37, 2020. We cover seat belt sign and CT sensitivity, PT for sciatica, 3% saline or mannitol for pediatric CNS infection with increased ICP, reducing pediatric critical care transport risk, and POCUS for emergency airway management.

Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2020.10.30.362137v1?rss=1 Authors: Suda, N., Cendejas-Hernandez, J., Poulton, J., Jones, J. P., Konsoula, Z., Smith, C., Parker, W. Abstract: Based on several lines of evidence, numerous investigators have suggested that paracetamol exposure during early development can induce neurological disorders. We had previously postulated that paracetamol exposure early in life, if combined with antioxidants that prevent accumulation of NAPQI, the toxic metabolite of paracetamol, might be innocuous. In this study, we administered paracetamol at or below the currently recommended therapeutic dose to male laboratory rat pups aged 4-10 days. The antioxidants cysteine and mannitol were included to prevent accumulation of NAPQI. In addition, animals were exposed to a cassette of common stress factors: an inflammatory diet, psychological stress, antibiotics, and mock infections using killed bacteria. At age 37-49 days, observation during introduction to a novel conspecific revealed increased rearing behavior, an asocial behavior, in animals treated with paracetamol plus antioxidants, regardless of their exposure to oxidative stress factors (2-way ANOVA; P < 0.0001). This observation would suggest that the initial hypothesis is incorrect, and that oxidative stress mediators do not entirely eliminate the effects of paracetamol on neurodevelopment. This study provides additional cause for caution when considering the use of paracetamol in the pediatric population, and provides evidence that the effects of paracetamol on neurodevelopment need to be considered both in the presence and in the absence of oxidative stress. Copy rights belong to original authors. Visit the link for more info

Show notes at pharmacyjoe.com/episode514. In this episode, I ll discuss mannitol extravasation. The post 514: Mannitol Extravasation appeared first on Pharmacy Joe.

In this episode, we discuss hypertonic saline solutions and mannitol for the treatment of cerebral edema in a variety of clinical settings. Please remember to subscribe to our podcast and leave us a comment to enter a drawing for your chance to win a gift!References:Cook, AM, et al. Guidelines for the acute treatment of cerebral edema in neurocritical care patients. Neurocrit care. 2020. https://doi.org/10.1007/s12028-020-00959-7Mesghali E, at al. Safety of peripheral line administration of 3% hypertonic saline and mannitol in the emergency department. J Emerg Med. 2019; 4: 431-436Perez, CA, et al. Complication rates of 3% hypertonic saline infusion through peripheral intravenous access. J Neurosci Nurs. 2017; 49(3): 191-195Mannitol [prescribing information] Lake Forest, IL: Hospira; 2019 

Cerebral Edema TreatmentSpecial Guest: Aaron Cook, PharmD, BCCCP, BCPS, FCCP, FKSHP, FNCS Show Notes: https://pharmacytodose.files.wordpress.com/2020/04/treatment-of-cerebral-edema-show-notes.pdf Guideline Development06:18 – How did the content and the chairs for this guideline get chosen?; 08:40 – How long were you working on these guidelines?; 09:40 – How are panel members chosen for the guidelines?; 11:20 – Is the research librarian underrated?; 13:31 – GRADE methodology and PICO formatting; 17:24 – Has this changed your research habits or ideas?; 21:40 – Challenges from meeting virtually when developing the guidelines; 23:53 – How were disagreements settled within the working group?Management of Cerebral Edema 27:45 – Cerebral edema and elevated ICP; 29:22 – Refractory cerebral edema management; 31:59 – How long was the initial question list?; 35:03 – Quality of evidence; 37:58 – Patient subgroup with the most evidence; 40:10 – Should we be driving up patients’ sodium levels?; 44:56 – Is there a preferred hyperosmolar agent?; 47:45 – Mannitol in acute ischemic stroke; 49:00 – Osmolar therapy and neurologic outcomes; 51:16 – HTS administration; 54:30 – HTS ADE and monitoring; 57:10 – Mannitol osmolality monitoring; 58:20 – Hyperosmolar therapy ADE prevention; 61:00 – Guideline key take-aways; 62:20 – Common research issuesPharmacyToDose.Com@PharmacyToDose on Twitter/InstagramPharmacyToDose@Gmail.com

Does Lasix work to control your ICP? Is it synergistic with mannitol? No. Oh, you want evidence? Fine... ech... Todd, M., Cutkomp, J., Brian, J. (2006). Influence of Mannitol and Furosemide, Alone and in Combination, on Brain Water Content after Fluid Percussion Injury Anesthesiology 105(6), 1176-1181. https://dx.doi.org/10.1097/00000542-200612000-00017

Contributor: Charleen Gnisci, PharmD Educational Pearls: Causes of increased intracranial pressure may include intracranial hemorrhage, malignancy, and trauma.  While definite treatment is to remove the offending cause, there are emergency medicine   Non-pharmacologic methods include elevating head of bed and removing noxious stimuli Pharmacologic options include mannitol and hypertonic saline Hypertonic saline is best delivered through a central line but not required Both these agents benefit from adequate renal function Before using mannitol, be sure to inspect the bag to ensure that it has not precipitated. If it has, try warming the bag before administration.  References https://pulmccm.org/critical-care-review/hyperosmolar-therapy-for-increased-intracranial-pressure-review-nejm/ Burgess S, Abu-Laban RB, Slavik RS, Vu EN, Zed PJ. A Systematic Review of Randomized Controlled Trials Comparing Hypertonic Sodium Solutions and Mannitol for Traumatic Brain Injury: Implications for Emergency Department Management. Ann Pharmacother. 2016 Apr;50(4):291-300. doi: 10.1177/1060028016628893. Epub 2016 Jan 29. Review. PubMed PMID: 26825644. Summarized by Will Dewispelaere, MS4 | Edited by Erik Verzemnieks, MD

Dr. Warren Gasper is the Chief of Vascular Surgery at the San Francisco VA, an assistant professor of vascular surgery at UCSF, and the president of the Northern California Vascular Society. He did his general surgery residency and vascular surgery fellowship at UCSF. He is the principal investigator in multiple NIH-funded clinical trials studying interventions for PAD, broadening the application of MRA imaging in vascular surgery, and treatment of para-visceral and thoracic aortic aneurysms with fenestrated endografts. Dr. Ahmed Shalabi (Ahmed.Shalabi@ucsf.edu, LinkedIn) is the Chief of Vascular Anesthesia at UCSF, where he is an associate professor of anesthesia and perioperative care. He did his residency in anesthesia at the Alexandria University Hospital in Egypt and has pursued advanced training in pediatric anesthesia at the University of Lille in France, in transplantation anesthesia at UCSF, and in transesophageal echocardiography at UCLA. He discovered his passion for doing anesthesia for complex open and endovascular cases and is a member of the Center for Aortic Excellence at UCSF, where he has developed a Vascular Anesthesia Quality Improvement Database. Dr. Leigh Ann O'Banion (lobanion@fresno.ucsf.edu) is an assistant professor of Vascular Surgery at UCSF Fresno, where she also completed her general surgery residency. She did her fellowship in vascular surgery at UCSF, graduated in 2017 and then returned to UCSF Fresno as an attending. She has a busy clinical practice with a focus on mentoring the next generation of vascular trainees. She is currently enrolling patients in a prospective study focused on improving the multidisciplinary system of care for patients who undergo amputations. Anesthesia in acute aortic syndrome: Review Article: Anesthesia for vascular emergencies. Ellard L and Djaiani G. Anaesthesia. 68 (Suppl. 1), 72-83. 2013 Outcomes for EVAR under sedation / local: Observations from the IMPROVE trial concerning the clinical care of patients with ruptured abdominal aortic aneurysm. IMPROVE trial investigators. British Journal of Surgery. 101(3): 216-224. 2014 Decreased mortality with local versus general anesthesia in endovascular aneurysm repair for ruptured abdominal aortic aneurysm in the Vascular Quality Initiative database. Faizer R et al. Journal of Vascular Surgery. S0741-5214(18)32551-5. 2019 Local anesthesia for percutaneous endovascular abdominal aneurysm repair is associated with fewer pulmonary complications. Van Orden K et. al. Journal of Vascular Surgery. 68(4) 1023-1029. 2018 Type of Anesthesia for Endovascular Abdominal Aortic Aneurysm Repair. Armstrong RA et. al. Journal of Cardiothoracic and Vascular Anesthesia. 33: 462-471. 2019 Renoprotection: Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine. Weisbord SD et. al. New England Journal of Medicine. 378(7): 603-614. 2018 Mannitol for the Prevention of Peri-Operative Acute Kidney Injury: Systematic Review. Waskowski J et. al. European Journal of Vascular and Endovascular Surgery. In press. 2019 Spinal cord protection guidelines for thoracic aortic work: 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease. Hiratzka LF et. al. Circulation. 121(13): e266-369. 2010 Contemporary spinal cord protection during thoracic and thoracoabdominal aortic surgery and endovascular aortic repair: a position paper of the vascular domain of the European Association for Cardio-Thoracic Surgery. Etz CD et. al. European Journal of Cardio-Thoracic Surgery. 47: 943-957. 2015 Perioperative coronary artery revascularization and antiplatelet bridging: Coronary-Artery Revascularization before Elective Major Vascular Surgery. McFalls EO et. al. New England Journal of Medicine. 351(27) 2795-804. 2004 Bridging antiplatelet therapy with cangrelor in patients with recent intracranial stenting undergoing invasive procedures: a prospective case series. Godier A. British Journal of Anaesthesia. In press. 2019 Rapid ventricular pacing for aortic arch work: Rapid Ventricular Pacing for Landing Zone Precision During Thoracic Endovascular Aortic Arch Repair: A Case Series. Bokoch MP et. al. Journal of Cardiothoracic and Vascular Anesthesia. 31: 2141-2146. 2017

The post Mannitol (Osmitrol) Nursing Pharmacology Considerations appeared first on NURSING.com.

Head injury worldwide is a significant cause of morbidity and mortality. Besides prevention there isn't anything that can be done to improve the results from the primary brain injury, there is however a phenomenal amount that can be done to reduce the secondary brain injury that patients suffer, both from a prehospital and in hospital point of view. In the podcast we run through head injuries, all the way from initial classification and investigation, to specifics of treatment including neuro protective anaesthesia and hyperosmolar therapy, to give a sound overview of the management of these patients. As always we welcome feedback via the website or on Twitter and we look forward to hearing from you. Enjoy! Simon, Rob & James References & Further Reading Risk of Delayed Intracranial Hemorrhage in Anticoagulated Patients with Mild Traumatic Brain Injury: Systematic Review and Meta-Analysis. Chauny JM. J Emerg Med. Jul 26 2016 Mannitol or hypertonic saline in the setting of traumatic brain injury: What have we learned? Boone MD. Surg Neurol Int. 2015 Life in the fast lane; hypertonic saline Life in the fast lane; Traumatic brain injury Traumatic brain injury in England and Wales: prospective audit of epidemiology, complications and standardised mortality. T Lawrence. BMJ Open. 2016 Epidemiology of traumatic brain injuries in Europe: a cross-sectional analysis. M.Majdan. The Lancet. 2016 The inefficiency of plain radiography to evaluate the cervical spine after blunt trauma. Gale SC. J Trauma. 2005 What is the relationship between the Glasgow coma scale and airway protective reflexes in the Chinese population? Rotheray KR. Resuscitation. 2012 NICE Head Injury Guidelines 2014 MDCALC Canadian Head Injury TheResusRoom; The AHEAD Study TheResusRoom; Anticoagulation, head injury & delayed bleeds Management of Perceived Devastating Brain Injury After Hospital Admission; A consensus statement  A case for stopping the early withdrawal of life sustaining therapies in patients with devastating brain injuries. Manara AR. J Intensive Care Soc. 2016

Join the EM GuideWire team as they discuss some simple strategies to manage increased intracranial pressure (ICP). From intubation to administration of hypertonic saline, the group will discuss the basic steps to help your most critical patients.

Today I answer questions and address topics listeners have asked me to discuss. Here is a short list of some of the questions and topics I address:  Using a nutritional approach to healing Parkinson's I now have a healing crisis every 4 days followed by good days.What does this mean?More about LDN for treating symptoms please.What about Mannitol as a treatment for Parkinson's symptoms?How can I reduce tremors in my left hand and foot and in the upper, inner and left side of my head?When will the 2017 updated Road to Recovery from Parkinsons Disease be available? What about amino acid acid therapy as a therapy?  Additional Resources discussed: The second Jump Start to Recovery Course convenes August 1st for 8 consecutive Tuesdays. 2017 Updated Road to Recovery from Parkinsons Disease Consultations with Robert Rodgers PhD

We're talking to Dr. Harry Adelson who is an expert at stem cell therapy and the founder of Docere Clinics in Park City, Utah. Dr. Adelson is one of the most experienced practitioners in the world with use of autologous stem cells for the treatment of musculoskeletal pain conditions. He’s deeply knowledgeable about various aspects of stem cell therapy and we discuss various uses for stem cells, whether and how to bank them for the future, and the strengths and limitations of stem cell therapy. Find Out More About Harry Here: Docere ClinicsAbout Harry Adelson In This Episode: [02:09] - Harry talks about the stem cell injections he has done on Dave Asprey. He also discusses Mannitol and its impact on the blood-brain barrier. [05:15] - We learn more about the anesthesia involved in Harry’s processes. [07:09] - Harry clarifies the two types of approaches to getting stem cells. He then explains the sensation and experience of having the procedures done. He talks about his experiences with using both, and the benefits he’s found in combining them. [13:56] - Harry explains how he got involved in stem cell therapy, which came from a personal experience with a shoulder injury. He then explains some different uses of stem cell therapy, and clarifies which ones he treats. [15:45] - Are you still a candidate for stem cell therapy if, for example, you’ve had a knee replacement? [16:48] - Should people who are about to get joint surgery consider stem cell therapy instead? [17:44] - Harry discusses the use of stem cells in a joint where the cartilage has been damaged. [22:49] - Why isn’t everybody running to get stem cell therapy? Because “medicine moves at a glacial rate,” Harry explains. [26:11] - Harry shares his thoughts on the role of stem cell therapy in elderly people who have broken their hips. He isn’t aware of any research around stem cells and osteoporosis. [27:26] - What are some surprising things that stem cell therapy can be good for? [28:18] - Harry talks about the role of stem cell therapy in impotence and erectile dysfunction. He then talks about the link between erectile dysfunction and dementia. [30:24] - What would be the stem cell approach toward dealing with dementia? [31:16] - We learn about the advantages of harvesting stem cells at a young age and banking them for future use, as well as Harry’s suggestions for how to do this. [32:32] - Banking stem cells from cord blood is a good idea, and the stem cells collected this way have a shelf life as long as a human life. [33:34] - What do you do if you’re in a foreign country and need stem cell treatment, but your banked stem cells are in another part of the world? As part of his answer, Harry talks about embryonic stem cells. [36:13] - Harry talks about FDA regulations for stem cell procedures in the United States. [38:32] - What is the role of age in the stem cell therapy process? [40:46] - Harry discusses going offshore for stem cell therapy, and why he suggested South America in particular. [42:50] - We hear Harry’s thoughts on facial stem cell injections. [44:30] - Harry talks about the use of stem cell therapy for acne and diabetes. [45:20] - Stephan returns to the topic of stem cells for sexual performance. Harry clarifies that they do both the O-shot (for women) and the P-shot (for men) at his clinic, but he doesn’t do them personally. He then talks about what people can expect from these procedures. [48:23] - Where does stem cell therapy fit into the broad topic of inflammation? [50:37] - How would somebody who wants to work with Harry get in touch? He answers, then talks about the price range you can expect. Get Optimized! If I choose to have a stem cell procedure done, opt for one that combines bone marrow stem cells with those from fat for best results. Make a list of the parts of my body that experience pain. If any of these are musculoskeletal pain, get in touch with Docere Clinics. Look into the possibility of stem cell therapy before agreeing to joint replacement. This may not be the right choice for me, but it’s worth looking into. Links and Resources: Docere ClinicsAbout Harry AdelsonBulletproof ConferenceDave Asprey on the Optimized GeekAdipose-derived stem cellsAutologous stem cell transplantMannitolBlood-brain barrierKaiser PermanenteAngiogenesisKristin ComellaEmbryonic stem cellsThe Healing Power of Stem Cells with Dr. Harry Adelson

Do you chew gum while you're training/racing? You may want to think twice about that habit and ditch the “artificial junk” Typical sugar free gum ingredients: Sorbitol, Gum Base, Glycerol, Natural and Artificial Flavors, Hydrogenated Starch Hydrolysate, Aspartame, Mannitol, Acesulfame K, Soy Lecithin, Xylitol, Colors (Beta-Carotene, Blue 1 Lake), BHT (to Maintain Freshness). Artificial sweeteners […] The post ATC 223: Spit Out That Gum, Recovery From Overtraining, Healthy Mindset to Body Shape, and More first appeared on Endurance Planet.

ORIGINAL AIRDATE: November 18th, 2016 --- The team are pinned down at the Latvian embassy, bringing a terrorist to justice. MISSION: After catching a Latvian terrorist, Mac, Jack, and Riley are trapped in an embassy under siege waiting for reinforcements to relieve them. This week's highlights include: Richard was right. This footage is crazy. Andrea Seitz caught this screenshot mentioned in a tweet from @AVRicher. Mannitol hexanitrate (Chemistry) Mannitol hexanitrate is a powerful explosive. Physically, it is a powdery solid at normal temperature ranges, with density of 1.73 g/cm3. The chemical name is hexanitromannitol and it is also known as nitromannite, MHN, and nitromannitol, and by the trademarks Nitranitol and Mannitrin. It is more stable than nitroglycerin, and it is used in detonators. Check out the article on wikipedia: https://en.wikipedia.org/wiki/Mannitol_hexanitrate.

This week we discuss how to aggressively resuscitate patients with DKA as well as dispelling some dogmatic teachings on the topic. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_60_0_Final_Cut.m4a Download Leave a Comment Tags: Cerebral Edema, DKA, Hypokalemia, Insulin, Resuscitation Show Notes Take Home Points DKA should be suspected in any patient with altered mental status and hyperglycemia. Get a VBG (ABG not necessary) to confirm the diagnosis. Hypokalemia kills in DKA. Aggresively replete potassium and consider holding insulin, which drops serum potassium, until K is greater than 3.5 The insulin bolus isn't necessary and appears to cause more episodes of hypokalemia. Just start insulin as an infusion at 0.14 units/kg Be vigilant about cerebral edema. Any change or deterioration in mental status should prompt treatment and evaluation. Mannitol in the euvolemic, normotensive patient and 3% hypertonic saline in the hypotensive/hypovolemic patient Finally, don't forge to always hunt down the underlying cause of the DKA. Infection and non-compliance is the most common so liberally administer broad spectrum antibiotics if you've got even a hint of infection brewing

This week we discuss how to aggressively resuscitate patients with DKA as well as dispelling some dogmatic teachings on the topic. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_60_0_Final_Cut.m4a Download Leave a Comment Tags: Cerebral Edema, DKA, Hypokalemia, Insulin, Resuscitation Show Notes Take Home Points DKA should be suspected in any patient with altered mental status and hyperglycemia. Get a VBG (ABG not necessary) to confirm the diagnosis. Hypokalemia kills in DKA. Aggresively replete potassium and consider holding insulin, which drops serum potassium, until K is greater than 3.5 The insulin bolus isn't necessary and appears to cause more episodes of hypokalemia. Just start insulin as an infusion at 0.14 units/kg Be vigilant about cerebral edema. Any change or deterioration in mental status should prompt treatment and evaluation. Mannitol in the euvolemic, normotensive patient and 3% hypertonic saline in the hypotensive/hypovolemic patient Finally, don't forge to always hunt down the underlying cause of the DKA. Infection and non-compliance is the most common so liberally administer broad spectrum antibiotics if you've got even a hint of infection brewing

This week we discuss how to aggressively resuscitate patients with DKA as well as dispelling some dogmatic teachings on the topic. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_60_0_Final_Cut.m4a Download Leave a Comment Tags: Cerebral Edema, DKA, Hypokalemia, Insulin, Resuscitation Show Notes Take Home Points DKA should be suspected in any patient with altered mental status and hyperglycemia. Get a VBG (ABG not necessary) to confirm the diagnosis. Hypokalemia kills in DKA. Aggresively replete potassium and consider holding insulin, which drops serum potassium, until K is greater than 3.5 The insulin bolus isn’t necessary and appears to cause more episodes of hypokalemia. Just start insulin as an infusion at 0.14 units/kg Be vigilant about cerebral edema. Any change or deterioration in mental status should prompt treatment and evaluation. Mannitol in the euvolemic, normotensive patient and 3% hypertonic saline in the hypotensive/hypovolemic patient Finally, don’t forge to always hunt down the underlying cause of the DKA. Infection and non-compliance is the most common so liberally administer broad spectrum antibiotics if you’ve got even a hint of infection brewing

Ep #31 Hypertonic Saline vs. Mannitol in the Transport Environment with Dr. Drew Cathers @DrewCathers AMPA – Air Medical Physicians Association https://www.ampa.org/ #CCTMC17 Training Announcement – Critical Care Transport Medicine Conference http://www.iafccp.org/events/EventDetails.aspx?id=177507 4/10/2017 to 4/12/2017 When: April 10 - 12, 2017 Where: Map this event » Wyndam River Walk Hotel 111 E. Pecan St. San Antonio, Texas  78205 United States Contact: Pat Petersen ppeter1111@aol.com     Sponsored by @PerfectCPR Apple Watch App with Audio and Haptic Feedback to Optimize Cardiac Arrest Training and Improve Quality of CPR Delivery PerfectCPR.com     Query us on Twitter: www.twitter.com/EMS_Nation Like us on Facebook: www.facebook.com/prehospitalnation   Wishing Everyone a safe tour! ~Faizan H. Arshad, MD @emscritcare www.emsnation.org  

Diagnosed with Parkinson's disease three years ago. Don McCammon developed his own compound to treat his symptoms. He has been symptom free for 2 1/2 years.  Don wrote an article describing his discovery. The name of the compound he developed is Syncolein. It is a natural product that does not require a medical prescription. What is the main ingredient in his forumlation? It is Mannitol. What in the world is Mannitol? Listen to the show to find out!  For further information and to get your questions answered, email Don at: donmccammon@gmail.com

John Myburgh on the misunderstood craniectomy. The management of raised ICP and what we do when our options run out.

Hintergrund der vorliegenden Studie war, ein Behandlungskonzept für die unmittelbar nach einer Subarachnoidalblutung einsetzenden Pathomechanismen zu entwickeln. Dabei bilden das post-hämorrhagische Hirnödem neben der akut einsetzenden Erhöhung des intrakraniellen Drucks (ICP) und dem Abfall der zerebralen Perfusion (CBF) die wesentlichen kausalen Pathomechanismen für die hohe Frühmorbidität und –letalität der Patienten. Zu diesem Zweck wurde das therapeutische Konzept der Small Volume Resuscitation – einer neuen Primärtherapie des traumatisch-hämorrhagischen Schocks und des Schädel-Hirn-Traumas - evaluiert, bei der die intravenöse Bolusinjektion eines kleinen Volumens (250 ml) einer stark hyperosmolaren (7,5 %) Kochsalzlösung genutzt wird, um intraendotheliales und intraparenchymales Wasser zu mobilisieren und dadurch das intravaskuläre Volumen wiederherzustellen. Die erzielte Hämodilution zusammen mit dem hyperosmolaritätsbedingten Schrumpfen des endothelial-perivaskulären Volumens führt zu einer verbesserten Mikrozirkulation und einem Auswa-schen potentiell gefährlicher Metaboliten – es kommt zur Reduktion des perivaskulären Ödems mit Reperfusion der mikrozirkulatorischen Strombahn. Ziel der vorliegenden Untersuchung war es, verschiedene klinisch gebräuchliche hyperton-hyperonkotische Lösungen hinsichtlich ihrer therapeutischen Wirksamkeit nach experimenteller Subarachnoidalblutung der Ratte zu vergleichen. Diese Untersuchung sollte anhand von definierten Zielparametern, sowohl hinsichtlich kurzfristiger Wirkungen nach SAB (Verlauf von ICP und CBF während der ersten 90min nach SAB) als auch hinsichtlich längerfristiger Effekte (Neuro-score für 7 posthämorrhagische Tage und quantitative histologische Auswertung) durchgeführt werden. 60 männliche dextranresistente Wistarratten wurden in vier Gruppen à 15 Tiere randomi-siert um dann entweder mit 0,9% NaCl- Lösung (Kontrollgruppe), 7,5% NaCl- Lösung mit 6% Dextran 70 (Rescue FlowTM), 7,2% NaCl- Lösung mit 200.000 HAES (HyperHAES®) oder 20% Mannitol 30 min nach Induktion der SAB intravenös therapiert zu werden. Nach Beendigung der Messung der kontinuierlich aufgezeichneten Parameter wurden die Tiere 7 Tage lang nachbeo-bachtet und ihre neurologische Erholung dokumentiert; dann wurden die Gehirne entnommen und histologisch aufgearbeitet. Mit Hilfe dieses experimentellen Setups konnte nachgewiesen werden, dass der Hirndruck nach experimenteller SAB bei Ratten durch die Applikation der untersuchten hypertonen Lösungen (7,5% NaCl- Lösung mit 6% Dextran 70 [Rescue FlowTM], 7,2% NaCl- Lösung mit 200.000 - 75 - HAES [HyperHAES®] und 20% Mannitol in vergleichbarer Weise unmittelbar und anhaltend signifikant gegenüber der Kontrollgruppe gesenkt werden konnte. Die Kontrolllösung konnte den ICP nicht senken. Nur die Applikation von 7,5 % NaCl/ Dextran – Lösung konnte den zerebralen Blutfluss auf der von der Blutung betroffenen Seite für 20 min steigern. Die mit den verwendeten Tests beschriebene neurologische Erholung konnte durch Therapie mit den getesteten Lösungen nicht signifikant im Vergleich zur Kontrollgruppe verbessert werden; es ergaben sich auch zwischen den anderen Gruppen keine signifikanten Unterschiede. Eine signifikante Steigerung der Leistungen während des Beobachtungszeitraums konnte allerdings innerhalb der 7,5 % NaCl/ Dextrantherapiegruppe gezeigt werden. Nur in der mit 7,5 % NaCl/ Dextran therapierten Gruppe zeigten sich zudem signifikante protektive Effekte im Motorkortex und Kaudoputamen im Hinblick auf die Zahl intakter Neurone. Allein die Therapie mit 7,5 % NaCl/ Dextranlösung konnte, wenn auch nur als statistischer Trend, die Frühletalität nach SAB senken. Bei keinem der Versu-che kam es nach Applikation der Therapielösungen zu einer erneuten SAB. Die vorhandene klinische Zulassung von 7,5% + 6% Dextran 70 (RescueFlow™) für die initiale Behandlung von hämorrhagischem Schock würde eine rasche Umsetzung der experimentellen Ergebnisse im Rahmen einer klinischen Studie bei Patienten mit schwerer SAB erleichtern.