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https://www.readbyqxmd.com/read/28878889/preoperative-fluid-retention-increases-blood-loss-during-major-open-abdominal-surgery
#1
Robert G Hahn, Hans Bahlmann, Lena Nilsson
BACKGROUND: Quantification of renal fluid conservation is possible by urine analysis, and the results can indicate dehydration. The present report sought to determine whether this fluid retention correlates with fluid requirements during major abdominal surgeries that have estimated operating times ≥ 2 h. METHODS: Urine colour, specific weight, osmolality and creatinine concentration were used to calculate a composite "fluid retention index" (FRI) in 97 patients prior to major abdominal surgery...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#2
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28605442/perioperative-goal-directed-therapy-with-uncalibrated-pulse-contour-methods-impact-on-fluid-management-and-postoperative-outcome
#3
F Michard, M T Giglio, N Brienza
Previous meta-analyses suggest that perioperative goal-directed therapy (GDT) is useful to decrease postoperative morbidity. Most GDT studies analysed were done with pulmonary artery catheters, oesophageal Doppler and calibrated pulse contour methods. Uncalibrated pulse contour (uPC) techniques are an appealing alternative but their accuracy has been questioned. The effects of GDT on fluid management (volumes and volume variability) remain unclear. We performed a meta-analysis of randomized controlled trials investigating the effects of GDT with uPC methods on postoperative outcome...
June 11, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28591965/-predictive-value-of-early-changes-in-sublingual-microcirculation-on-organ-failure-of-patients-with-septic-shock
#4
Xue-Ying Zeng, Xue-Lian Liao, Yan Kang, Yao Chen, Wan-Hong Yin, Liang Zhao
OBJECTIVES: To determine the predictive value of early changes in sublingual microcirculation on organ failure of patients with septic shock. METHODS: Side-streamdark field imaging (SDF) videomicroscopy was performed to assess sublingual microcirculation of 34 adult patients at 0 h, 6 h and 24 h after they were diagnosed with septic shock.The patients were subject to sequential organ failure assessment (SOFA24 h-0 h). The patients with ΔSOFA24 h-0 h≥1 (deteriorated conditions) were compared with those with ΔSOFA24 h-0 h<1 in regard to sublingual microcirculation and the traditional hemodynamic indicators such as heart rate, mean arterial pressure, central venous pressure, urine output and lactate...
July 2016: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/28398962/population-based-assessment-of-intraoperative-fluid-administration-practices-across-three-surgical-specialties
#5
COMPARATIVE STUDY
Scott E Regenbogen, Nirav J Shah, Stacey D Collins, Samantha Hendren, Michael J Englesbe, Darrell A Campbell
OBJECTIVE: To assess the variation in hospitals' approaches to intraoperative fluid management and their association with postoperative recovery. BACKGROUND: Despite increasing interest in goal-directed, restricted-volume fluid administration for major surgery, there remains little consensus on optimal strategies, due to the lack of institution-level studies of resuscitation practices. METHODS: Among 64 hospitals in a state-wide surgical collaborative, we profiled fluid administration practices during 8404 intestinal resections, 22,854 hysterectomies, and 1471 abdominopelvic endovascular procedures...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28243006/audit-of-preoperative-fluid-resuscitation-in-perforation-peritonitis-patients-using-physiological-and-operative-severity-score-for-enumeration-of-mortality-and-morbidity
#6
Sunil Kumar
CONTEXT: Debate continues regarding fluid (crystalloid vs. colloid) of choice for resuscitation. Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity (POSSUM) may be used to compare the benefits of preoperative fluid resuscitation with crystalloids and colloids in peritonitis patients. AIMS: The aim of this study is to compare crystalloid and colloid for preoperative resuscitation using morbidity, mortality, length of hospital stay (LOS), and time taken to resuscitate as the outcome parameters...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28211020/goal-directed-fluid-restriction-during-brain-surgery-a-prospective-randomized-controlled-trial
#7
Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu, Guo Chen
BACKGROUND: The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain surgery. METHODS: High-risk patients undergoing brain surgery were randomly assigned to a usual care group (control group) or a GDFR group. In the GDFR group, (1) fluid maintenance was restricted to 3 ml/kg/h of a crystalloid solution and (2) colloid boluses were allowed only in case of hypotension associated with a low cardiac index and a high stroke volume variation...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/27999663/implementation-of-goal-directed-fluid-therapy-during-hip-revision-arthroplasty-a-matched-cohort-study
#8
Marit Habicher, Felix Balzer, Viktor Mezger, Jennifer Niclas, Michael Müller, Carsten Perka, Michael Krämer, Michael Sander
BACKGROUND: Several randomized controlled trials (RCTs) have demonstrated that intraoperative goal-directed fluid therapy (GDFT) can decrease postsurgical complications in patients undergoing major abdominal surgery. However, very few studies have demonstrated the value of goal-directed therapy (GDT) in patients undergoing orthopaedic surgery and confirmed it is as useful in real-life conditions. Therefore, we initiated a GDFT implementation programme in patients undergoing hip revision arthroplasty in order to assess its effects on postoperative complications (e...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27779578/does-small-volume-resuscitation-with-crystalloids-or-colloids-influence-hemostasis-and-survival-of-rabbits-subjected-to-lethal-uncontrolled-hemorrhage
#9
Bijan Shams Kheirabadi, Nahir Miranda, Irasema B Terrazas, Mary D Gonzales, Rose C Grimm, Michael A Dubick
BACKGROUND: Prehospital, small-volume resuscitation of combat casualties with a synthetic colloid (6% hydroxyethyl starch [HES] 670/0.75) has been recommended when blood or blood components are unavailable. We studied hemostatic effects of a newer synthetic colloid (6% HES, 130/0.4) compared with either a natural colloid (albumin) or to crystalloids in an uncontrolled hemorrhage model. METHODS: Spontaneously breathing New Zealand white rabbits (3.4 ± 0.1 kg) were anesthetized, instrumented, and subjected to a splenic injury with uncontrolled bleeding...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27626366/resuscitation-with-pooled-and-pathogen-reduced-plasma-attenuates-the-increase-in-brain-water-content-following-traumatic-brain-injury-and-hemorrhagic-shock-in-rats
#10
Gustav Folmer Genét, Peter Bentzer, Sisse Rye Ostrowski, Pär Ingemar Johansson
Traumatic brain injury and hemorrhagic shock is associated with blood-brain barrier (BBB) breakdown and edema formation. Recent animal studies have shown that fresh frozen plasma (FFP) resuscitation reduces brain swelling and improves endothelial function compared to isotonic NaCl (NS). The aim of this study was to investigate whether pooled and pathogen-reduced plasma (OctaplasLG(®) [OCTA]; Octapharma, Stockholm, Sweden) was comparable to FFP with regard to effects on brain water content, BBB permeability, and plasma biomarkers of endothelial glycocalyx shedding and cell damage...
March 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27625478/phenylephrine-infusion-for-spinal-induced-hypotension-in-elective-cesarean-delivery-does-preload-make-a-difference
#11
Brandi A Bottiger, Dmitri S Bezinover, Berend Mets, Priti G Dalal, Jansie Prozesky, Serdar Ural, Sonia Vaida
BACKGROUND AND AIMS: Patients undergoing elective cesarean delivery (CD) have a high-risk of spinal-induced hypotension (SIH). We hypothesized that a colloid preload would further reduce SIH when compared with a crystalloid preload. MATERIAL AND METHODS: Eighty-two healthy parturients undergoing elective CD were included in the study. Patients were randomly assigned to two groups (41 patients in each group) to receive either Lactated Ringer's solution (1500 ml) or hydroxyethyl starch (6% in normal saline, 500 ml) 30 min prior to placement of spinal anesthesia...
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/27546766/a-change-of-colloid-from-hydroxyethyl-starch-to-gelatin-does-not-reduce-rate-of-renal-failure-or-mortality-in-surgical-critical-care-patients-results-of-a-retrospective-cohort-study
#12
COMPARATIVE STUDY
Frederic W Albrecht, Michael Glas, Hauke Rensing, Detlef Kindgen-Milles, Thomas Volk, Alexander M Mathes
PURPOSE: Hydroxyethyl starch (HES) may compromise renal function in critically ill patients. As an alternative, gelatin (GEL) was suggested. This study investigated whether GEL (4%) may have advantages over HES (6%, 130/0.4) with respect to acute renal failure (ARF), length of intensive care unit /hospital stay, and 30-day mortality and evaluated dose-dependent effects. MATERIAL AND METHODS: We performed a retrospective cohort analysis of 1522 surgical intensive care patients in a single university hospital where HES was changed to GEL in June 2006...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27481739/how-safe-is-gelatin-a-systematic-review-and-meta-analysis-of-gelatin-containing-plasma-expanders-vs-crystalloids-and-albumin
#13
REVIEW
Claudia Moeller, Carolin Fleischmann, Daniel Thomas-Rueddel, Vlasislav Vlasakov, Bram Rochwerg, Philip Theurer, Luciano Gattinoni, Konrad Reinhart, Christiane S Hartog
Gelatin is a widely used synthetic colloid resuscitation fluid. We undertook a systematic review and meta-analysis of adverse effects in randomized and nonrandomized studies comparing gelatin with crystalloid or albumin for treatment of hypovolemia. Multiple databases were searched systematically without language restrictions until August 2015. We assessed risk of bias of individual studies and certainty in evidence assessment by the Grading of Recommendations Assessment, Development, and Evaluation approach...
October 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27113691/fluid-as-a-drug-balancing-resuscitation-and-fluid-overload-in-the-intensive-care-setting
#14
REVIEW
Matthew D McGuire, Michael Heung
Intravenous fluid resuscitation is ubiquitous throughout medicine and is often considered a benign procedure. Yet, there is now clear recognition of the potential harms of fluid overload after initial resuscitation. In recent years, there has also been an increasing focus on comparing various resuscitation fluids with respect to both benefits and risks. Studies have examined colloids, such as albumin and starches, against the clinical standard of crystalloids. In addition, evidence has emerged to suggest that outcomes may be different between resuscitation with chloride-rich vs balanced crystalloid solutions...
May 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/26976366/perioperative-fluid-volume-optimization-following-proximal-femoral-fracture
#15
REVIEW
Sharon R Lewis, Andrew R Butler, Andrew Brammar, Amanda Nicholson, Andrew F Smith
BACKGROUND: Proximal femoral fracture (PFF) is a common orthopaedic emergency that affects mainly elderly people at high risk of complications. Advanced methods for managing fluid therapy during treatment for PFF are available, but their role in reducing risk is unclear. OBJECTIVES: To compare the safety and effectiveness of the following methods of perioperative fluid optimization in adult participants undergoing surgical repair of hip fracture: advanced invasive haemodynamic monitoring, such as transoesophageal Doppler and pulse contour analysis; a protocol using standard measures, such as blood pressure, urine output and central venous pressure; and usual care...
March 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26945358/impact-of-albumin-on-coagulation-competence-and-hemorrhage-during-major-surgery-a-randomized-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Kirsten C Rasmussen, Michael Højskov, Pär I Johansson, Irina Kridina, Thomas Kistorp, Lisbeth Salling, Henning B Nielsen, Birgitte Ruhnau, Tom Pedersen, Niels H Secher
For patients exposed to a massive blood loss during surgery, maintained coagulation competence is important. It is less obvious whether coagulation competence influences bleeding during elective surgery where patients are exposed to infusion of a crystalloid or a colloid. This randomized controlled trial evaluates whether administration of 5% human albumin (HA) or lactated Ringer solution (LR) affects coagulation competence and in turn blood loss during cystectomy due to bladder cancer. Forty patients undergoing radical cystectomy were included to receive either 5% HA (n = 20) or LR (n = 20)...
March 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26849439/differences-between-total-intravenous-anesthesia-and-inhalation-anesthesia-in-free-flap-surgery-of-head-and-neck-cancer
#17
Yi-Ting Chang, Chih-Chen Wu, Tsung-Yung Tang, Chun-Te Lu, Chih-Sheng Lai, Ching-Hui Shen
BACKGROUND: Many studies have evaluated risk factors associated with complications after free flap surgery, but these studies did not evaluate the impact of anesthesia management. The goal of the current study was to evaluate the differences between patients who received inhalation and total intravenous anesthesia (TIVA) in free flap surgery. METHODS: One hundred and fifty-six patients who underwent free flap surgery for head and neck cancer were retrospectively divided into the TIVA (96 patients) and the inhalation group (87 patients)...
2016: PloS One
https://www.readbyqxmd.com/read/26722660/perioperative-effects-of-high-doses-of-intraoperative-thymoglobulin-induction-in-liver-transplantation
#18
Lesley De Pietri, Valentina Serra, Giuseppe Preziosi, Gianluca Rompianesi, Bruno Begliomini
AIM: To describe our single-centre experience in liver transplantation (LT) with the infusion of high perioperative thymoglobulin doses. The optimal dosage and timing of thymoglobulin(®) [antithymocyte globulin (ATG)] administration during LT remains controversial. Cytokine release syndrome, haemolytic anaemia, thrombocytopenia, neutropenia, fever and serum sickness are potential adverse effects associated with ATG infusion. METHODS: Between December 2009 and December 2010, 16 adult non-randomized patients (ATG group), receiving a liver graft from a deceased donor, received an intraoperative infusion (4-6 h infusion) of thymoglobulin (3 mg/kg, ATG: Thymoglobuline(®))...
December 24, 2015: World Journal of Transplantation
https://www.readbyqxmd.com/read/26475802/effects-of-acute-plasma-volume-expansion-on-renal-perfusion-filtration-and-oxygenation-after-cardiac-surgery-a-randomized-study-on-crystalloid-vs-colloid
#19
RANDOMIZED CONTROLLED TRIAL
J Skytte Larsson, G Bragadottir, V Krumbholz, B Redfors, J Sellgren, S E Ricksten
BACKGROUND: In the present randomized study, we evaluated the differential effects of a colloid and a crystalloid fluid on renal oxygen delivery (RD(O2)), glomerular filtration (GFR), renal oxygen consumption ((RV(O2))), and the renal oxygen supply-demand relationship (i.e., renal oxygenation) after cardiac surgery with cardiopulmonary bypass. METHODS: Thirty patients with normal preoperative renal function, undergoing uncomplicated cardiac surgery, were studied in the intensive care unit in the early postoperative period...
November 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26445090/preferential-effects-of-low-volume-versus-high-volume-replacement-with-crystalloid-fluid-in-a-hemorrhagic-shock-model-in-pigs
#20
COMPARATIVE STUDY
Martin Ponschab, Herbert Schöchl, Claudia Keibl, Henrik Fischer, Heinz Redl, Christoph J Schlimp
BACKGROUND: Fluid resuscitation is a core stone of hemorrhagic shock therapy, and crystalloid fluids seem to be associated with lower mortality compared to colloids. However, as redistribution starts within minutes, it has been suggested to replace blood loss with a minimum of a three-fold amount of crystalloids. The hypothesis was that in comparison to high volume (HV), a lower crystalloid volume (LV) achieves a favorable coagulation profile and exerts sufficient haemodynamics in the acute phase of resuscitation...
2015: BMC Anesthesiology
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