Incidence of hyponatremia with different postoperative intravenous maintenance fluids: a single-center, prospective, randomized trial.2018 · PURPOSE: Patients undergoing surgery are prone to postoperative hyponatremia, which can lead to delirium. However, the optimal sodium concentration for postoperative maintenance fluids in adult patients is still unclear. Therefore, this study examined the incidence of hyponatremia and delirium in postoperative patients. METHODS: This was a single-center, non-blinded, randomized trial. The inclusion criteria for this study were age 20 years or older and elective head and neck cancer or esophageal cancer surgery between April 2018 and June 2023. Patients were randomly assigned to one of three groups based on the sodium concentration in the intravenous fluids administered after surgery: the 140 mmol/L sodium (Na140) group, the 77 mmol/L sodium (Na77) group, and the 35 mmol/L sodium (Na35) group. RESULTS: A total of 105 patients had complete data at the end of the study: Na140 group (n = 35), Na77 group (n = 32), and Na35 group (n = 38). The incidence of postoperative hyponatremia was 22.9% (8/35) in the Na140 group, significantly lower than in the Na77 group [56.3% (18/32)] and the Na35 group [60.5% (23/38)] (both p
Hemodynamic Changes Following Landiolol Initiation in Patients With Critical Illness Who Developed Tachycardia During Dobutamine Infusion: A Retrospective Observational Study.2014 · Background and objective Dobutamine, a β1-adrenergic agonist, is frequently used to enhance myocardial contractility in patients with critical illness. However, it also increases tachyarrhythmia and myocardial oxygen consumption. Landiolol, an ultra-short-acting and highly β1-selective β-blocker, is used to manage tachycardia in patients with critical illness; however, the combination of a β-agonist and β-blocker seems contradictory at first glance. Previous studies have examined this combination in healthy subjects; however, its effects on patients with critical illness have not been fully elucidated. Hence, this study aimed to address that gap in the literature. Methods This single-center, retrospective, observational study included adult ICU patients who received combination therapy with dobutamine and landiolol between January 1, 2014, and December 31, 2023. Patients who received combination therapy for less than 24 hours or who required extracorporeal circulatory support were excluded. Continuous hemodynamic data were extracted from electronic medical records. Primary outcomes were changes in heart rate (HR) and mean arterial pressure (MAP) after initiation of landiolol administration. Secondary outcomes were achievement of HR
