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Hypertonic lactate

Gerald A Dienel, Douglas L Rothman, Carl-Henrik Nordström
Cerebral microdialysis is a widely used clinical tool for monitoring extracellular concentrations of selected metabolites after brain injury and to guide neurocritical care. Extracellular glucose levels and lactate/pyruvate ratios have high diagnostic value because they can detect hypoglycemia and deficits in oxidative metabolism, respectively. In addition, patterns of metabolite concentrations can distinguish between ischemia and mitochondrial dysfunction, and are helpful to choose and evaluate therapy. Increased intracranial pressure can be life-threatening after brain injury, and hypertonic solutions are commonly used for pressure reduction...
September 7, 2016: Journal of Cerebral Blood Flow and Metabolism
Mingtao Chang, Hao Tang, Dong Liu, Yang Li, Lianyang Zhang
A variety of agents may have a beneficial effect in reducing injury-induced intestinal edema of fluid, but studies confirming the efficacy and mechanisms of these agents in secondary intra-abdominal hypertension (IAH) are lacking. This study was to compare the effectiveness of melatonin, 7.5% hypertonic saline (HS), and hydroxyethyl starch 130/0.4 (HES) on the resuscitation of secondary IAH in a rat model. Female SD rats were divided into: sham group, shock group, lactated Ringer solution (LR) group, melatonin group, HS group, and HES group...
2016: PloS One
Fuhong Su, Keliang Xie, Xinrong He, Diego Orbegozo Cortés, Koji Hosokawa, Emiel Hendrik Post, Katia Donadello, Fabio Silvio Taccone, Jacques Creteur, Jean-Louis Vincent
Hypertonic sodium lactate (HTL) expands intravascular volume and may provide an alternative substrate for cellular metabolism in sepsis. We compared the effects of HTL, hypertonic saline (HTS), 0.9% ('normal') saline (NS) and Ringer's lactate (RL) on hemodynamics, sublingual and renal microcirculation, renal, mesenteric and brain perfusion, renal and cerebral metabolism, and survival in anesthetized, mechanically-ventilated, adult female sheep. Animals (7 in each group) were randomized to receive a bolus (over 15-min) of 3 ml/kg 0...
July 7, 2016: Shock
L H Atehortua Lopez, R Mendoza, A Urrego, J F Escobar, F A Jaimes Barragan
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Suneetha Amara, Mu Zheng, Venkataswarup Tiriveedhi
Cancer cells have a proliferative advantage by utilizing intermediates of aerobic glycolysis (Warburg effect) for their macromolecule synthesis. Although the exact causes of this Warburg effect are unclear, high osmotic stress in solid tumor microenvironment is considered one of the important factors. Oleanolic acid (OA) is known to exert anti-inflammatory and anti-cancer effect. In our current studies, using breast cancer cell lines, we determined the protective role of OA in high salt-mediated osmotic stress-induced cancer growth...
September 2016: Cell Biochemistry and Biophysics
Z J Wang, H X Wang, L Li, L Wang, H H Dou
We investigated the influence of different fluid resuscitation techniques on the number of myeloid-derived suppressor cells (MDSCs) in rats. Seventy-two healthy Sprague-Dawley rats were randomly divided into groups that received sham operation (Sham group), hypertonic saline (HRS group), lactated ringer's solution (LRS group), or crystalloid solution (LCRS group). Six rats from each group were sacrificed by cervical dislocation at 12, 24, and 48 h after resuscitation. The spleens were harvested under sterile conditions and spleen cell suspension was prepared...
2016: Genetics and Molecular Research: GMR
Syed Ahmad, Zain Majid, Mehwish Mehdi, Muhammed Mubarak
A 58-year-old male presented with fever, nausea, and vomiting since 15 days along with irritability and confusion since 5 days. His laboratory reports showed low serum sodium, serum osmolality and uric acid. Computerized tomography (CT) scan of brain revealed age-related changes. While on lumbar puncture (LP) and cerebrospinal fluid (CSF) examination, CSF protein, lactate dehydrogenase (LDH) and total leukocyte count (predominant lymphocytes) were all increased. On his 14th day of admission, his serum sodium was 116 mEq/l and he had a high urine output...
2016: Journal of Renal Injury Prevention
S C Rehberg, M R Raum, S Rammelt, W Schneiders, E A M Neugebauer
INTRODUCTION: Apoptosis, or programmed cell death, seems to play a role in the physiology of shock. The influence of fluid resuscitation on the occurrence of apoptosis during haemorrhage is still unclear. Using an experimental randomised study, the goal of this investigation was to find a relation between different frequently used resuscitation fluids and evidence of apoptosis. MATERIALS AND METHODS: Sixty female pigs with a mean body weight of 20 kg were randomised into six groups, each receiving a different resuscitation fluid therapy: malated Ringer, lactated Ringer, hypertonic saline, hypertonic saline solution/Dextran 60, carbonate/gelatine and a sham group (no shock, no resuscitation)...
August 2013: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
J Nicholas O'Donnell, Anil Gulati, Manish S Lavhale, Shyam S Sharma, Arjun J Patel, Nathaniel J Rhodes, Marc H Scheetz
OBJECTIVE: Centhaquin citrate is a novel agent being developed for use in the treatment of haemorrhagic shock. It has decreased mortality in rat, rabbit and pig models of hypovolaemic shock compared to hypertonic saline and lactated Ringer's resuscitation. The pharmacokinetics of centhaquin citrate have not been described to date. METHODS: Sixteen male Sprague Dawley rats were given an intravenous bolus of 0.45 mg/kg centhaquin citrate. Rats were divided into two groups; plasma concentrations were measured at five time points for each group within 24 h after administration...
January 2016: Journal of Pharmacy and Pharmacology
Shuang Liu, Xiaoxu Ren, Linying Gun, Qi Zhang, Jin Zhang, Yiming Zhu
OBJECTIVE: The mainstay of therapy in patients with septic shock is early and aggressive intravenous fluid resuscitation. However the type of intravenous fluid that would be ideal for managing septic shock has been intensely debated. In this study, the authors observed the effects of 3% hypertonic saline solution compared with normal saline solution as early fluid resuscitation in children with septic shock. METHOD: In this prospective study, 44 septic shock children seen in the intensive care unit (ICU) of the Children's Hospital Affiliated to Capital Institute of Pediatrics were enrolled from January 2012 to January 2014, of whom 33 were male and 11 were female...
August 2015: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Myles Dustin Boone, Achikam Oren-Grinberg, Timothy Matthew Robinson, Clark C Chen, Ekkehard M Kasper
BACKGROUND: Intracranial hypertension, defined as an intracranial pressure (ICP) >20 mmHg for a period of more than 5 min, worsens neurologic outcome in traumatic brain injury (TBI). While several mechanisms contribute to poor outcome, impaired cerebral perfusion appears to be a highly significant common denominator. Management guidelines from the Brain Trauma Foundation recommend measuring ICP to guide therapy. In particular, hyperosmolar therapy, which includes mannitol or hypertonic saline (HTS), is frequently administered to reduce ICP...
2015: Surgical Neurology International
I Aramendi, W Manzanares, A Biestro
Intracranial hypertension (ICH) is the most important modifiable factor with predictive negative value in brain injury patients. Osmotherapy is the most important first level specific measure in the treatment of ICH. Mannitol 20%, and 3, 7.5, 10, and 23% hypertonic sodium chloride are the most commonly used osmotic agents in the neurocritical care setting. Currently, controversy about the best osmotic agent remains elusive. Therefore, over the past few years, half-molar sodium lactate has been introduced as a new osmotic agent to be administered in the critically ill...
March 2016: Medicina Intensiva
Chun-Yu Wu, Kuang-Cheng Chan, Ya-Jung Cheng, Yu-Chang Yeh, Chiang-Ting Chien
INTRODUCTION: Fluid resuscitation is an indispensable procedure in the acute management of hemorrhagic shock for restoring tissue perfusion, particularly microcirculation in splanchnic organs. Resuscitation fluids include crystalloids, hypertonic saline (HTS), and synthetic colloids, and their selection affects the recovery of microcirculatory blood flow and reactive oxygen species (ROS) formation, which is often evident in the kidney, following reperfusion. In this study, the effects of acute resuscitation with 0...
2015: Critical Care: the Official Journal of the Critical Care Forum
Lin-Lin Jiang, Jing-Jing Zhang, Zong-Ze Zhang, Xiang-Hu He, Dong-Ling Chen, Yan-Lin Wang
OBJECTIVE: To determine the effects of intraperitoneal resuscitation (PR) with different concentrations of sodium pyruvate (PY) on intestinal ischemia reperfusion injury in rats hemorrhagic shock (HS). METHODS: Sixty rats were randomly assigned to six groups. These included: group SHAM, intravenous resuscitation only (VR) group, and four PR groups based on resuscitation fluid: glucose-lactate-based peritoneal dialysis solution (LA), and PY-1.1%, PY-1.6%, and PY-2...
April 2016: Shock
Hervé Quintard, Camille Patet, Jean-Baptiste Zerlauth, Tamarah Suys, Pierre Bouzat, Luc Pellerin, Reto Meuli, Pierre J Magistretti, Mauro Oddo
Energy dysfunction is associated with worse prognosis after traumatic brain injury (TBI). Recent data suggest that hypertonic sodium lactate infusion (HL) improves energy metabolism after TBI. Here, we specifically examined whether the efficacy of HL (3h infusion, 30-40 μmol/kg/min) in improving brain energetics (using cerebral microdialysis [CMD] glucose as a main therapeutic end-point) was dependent on baseline cerebral metabolic state (assessed by CMD lactate/pyruvate ratio [LPR]) and cerebral blood flow (CBF, measured with perfusion computed tomography [PCT])...
April 1, 2016: Journal of Neurotrauma
Dhuleep S Wijayatilake, Suyogi V Jigajinni, Peter B Sherren
PURPOSE OF REVIEW: Over many years, understanding of the pathophysiology in traumatic brain injury (TBI) has resulted in the development of core physiological targets and therapies to preserve cerebral oxygenation, and in doing so prevent secondary insult. The present review revisits the evidence for these targets and therapies. RECENT FINDINGS: Achieving oxygen, carbon dioxide, blood pressure, temperature and glucose targets remain a key goal of therapy in TBI, as does the role of effective prehospital care...
October 2015: Current Opinion in Anaesthesiology
Jing-xiang Zhao, Bo Wang, Guo-xing You, Ying Wang, Gan Chen, Quan Wang, Xi-gang Zhang, Lian Zhao, Hong Zhou, Yue-zhong He
OBJECTIVE: The goal of this study was to investigate the effect of hypertonic saline with 6% Dextran-70 (HSD) resuscitation on organ damage and the resuscitation efficiency of the combination of HSD and lactated ringers (LR) in a model of hemorrhage shock in dogs. METHODS: Beagles were bled to hold their mean arterial pressure (MAP) at 50 ± 5 mmHg for 1 h. After hemorrhage, beagles were divided into three groups (n = 7) to receive pre-hospital resuscitation for 1 h (R1): HSD (4 ml/kg), LR (40 ml/kg), and HSD+LR (a combination of 4 ml/kg HSD and 40 ml/kg LR)...
2015: PloS One
Diya Sharma, Marie K Holowaychuk
OBJECTIVE: To investigate the prognostic value of clinical and laboratory variables and scoring systems in dogs with head trauma. DESIGN: Retrospective study (January-March, 2011). SETTING: University teaching hospital. ANIMALS: Seventy-two client-owned dogs with a history of head trauma occurring ≤5 days prior to hospital admission. Dogs were excluded if they had an unconfirmed history of trauma, preexisting neurologic disease, or insufficient data available in the medical record...
September 2015: Journal of Veterinary Emergency and Critical Care
Juan Han, Hui-Qin Ren, Qing-Bo Zhao, You-Liang Wu, Zhuo-Yi Qiao
Hypertonic saline solutions (HSSs) (7.5%) are useful in the resuscitation of patients with hypovolemic shock because they provide immediate intravascular volume expansion via the delivery of a small volume of fluid, improving cardiac function. However, the effects of using 3% HSS in hypovolemic shock resuscitation are not well known. This study was designed to compare the effects of and complications associated with 3% HSS, 7.5% HSS, and standard fluid in resuscitation. In total, 294 severe trauma patients were enrolled from December 2008 to February 2012 and subjected to a double-blind randomized clinical trial...
March 2015: Shock
Fernando Campos Gomes Pinto, Matheus Fernandes de Oliveira, Ricardo Prist, Maurício Rocha E Silva, Luiz Fernando Ferraz da Silva, Antonio Capone Neto
Traumatic brain injury (TBI) is the main cause of trauma-related deaths. Systemic hypotension and intracranial hypertension causes cerebral ischemia by altering metabolism of prostanoids. We describe prostanoid, pupilar and pathological response during resuscitation with hypertonic saline solution (HSS) in TBI. Method Fifteen dogs were randomized in three groups according to resuscitation after TBI (control group; lactated Ringer's (LR) group and HSS group), with measurement of thromboxane, prostaglandin, macroscopic and microscopic pathological evaluation and pupil evaluation...
June 2015: Arquivos de Neuro-psiquiatria
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