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Bhavisha Bakrania, Joey P Granger, Romain Harmancey
The mammalian heart is a major consumer of ATP and requires a constant supply of energy substrates for contraction. Not surprisingly, alterations of myocardial metabolism have been linked to the development of contractile dysfunction and heart failure. Therefore, unraveling the link between metabolism and contraction should shed light on some of the mechanisms governing cardiac adaptation or maladaptation in disease states. The isolated working rat heart preparation can be used to follow, simultaneously and in real time, cardiac contractile function and flux of energy providing substrates into oxidative metabolic pathways...
September 28, 2016: Journal of Visualized Experiments: JoVE
Robert G Hahn
BACKGROUND: A recent review article suggests that elimination of infused crystalloid fluid might occur faster in females than in males. To study this question, a population kinetic analysis was performed to compare the turnover of buffered Ringer's solution when infused at different rates in males and females. METHODS: Data were retrieved from seven series of experiments where 44 intravenous infusions of Ringer's acetate had been given to female volunteers and 67 to male volunteers...
2016: Biology of Sex Differences
Lakshmi Kumar, Murukesh Seetharaman, Nisha Rajmohan, Pavithra Ramamurthi, Sunil Rajan, Rekha Varghese
BACKGROUND AND AIMS: Lactate levels predict outcomes after hepatectomy. We compared metabolic effects of lactated versus lactate free solutions in living donor hepatectomy. METHODS: Consecutive right lobe donors (n = 53) were alternatively allotted to lactated Ringer's solution and normal saline (Group L-control) or acetated crystalloid (Sterofundin B Braun(®) Group S -study group) in an observational prospective randomised study. The primary outcome measure was lactate level, and secondary outcomes were base excess, bicarbonate, glucose and chloride intra- and post-operatively...
October 2016: Indian Journal of Anaesthesia
P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
Christopher Varga, Isaac Luria, Nikolaus Gravenstein
BACKGROUND: Air injection is carefully avoided during IV solution administration; however, ambient air is dissolved in all liquids used for intravenous (IV) therapy. A portion of this gas will come out of solution in the form of bubbles as the solution is warmed to body temperature in a fluid warming system and/or within the body. We sought to quantify the proportion of the gas theoretically dissolved in room temperature crystalloid and 4°C blood products that comes out of solution in the IV tubing on warming to 37°C...
October 3, 2016: Anesthesia and Analgesia
David A Berlin, Harrison Peprah-Mensah, Seth Manoach, Paul M Heerdt
OBJECTIVE: The study tests the hypothesis that noninvasive cardiac output monitoring based upon bioreactance (Cheetah Medical, Portland, OR) has acceptable agreement with intermittent bolus thermodilution over a wide range of cardiac output in an adult porcine model of hemorrhagic shock and resuscitation. DESIGN: Prospective laboratory animal investigation. SETTING: Preclinical university laboratory. SUBJECTS: Eight ~ 50 kg Yorkshire swine with a femoral artery catheter for blood pressure measurement and a pulmonary artery catheter for bolus thermodilution...
October 3, 2016: Critical Care Medicine
Matthew W Semler, Jonathan P Wanderer, Jesse M Ehrenfeld, Joanna L Stollings, Wesley H Self, Edward D Siew, Li Wang, Daniel W Byrne, Andrew D Shaw, Gordon R Bernard, Todd W Rice
RATIONALE: Saline is the intravenous fluid most commonly administered to critically ill adults, but may be associated with acute kidney injury and death. Whether use of balanced crystalloids rather than saline affects patient outcomes remains unknown. OBJECTIVES: To pilot a cluster-randomized, multiple-crossover trial using software tools within the electronic health record to compare saline to balanced crystalloids. METHODS: Cluster-randomized, multiple-crossover trial among 974 adults admitted to a tertiary medical intensive care unit from February 3, 2015 through May 31, 2015...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
Robert Sümpelmann, Karin Becke, Sebastian Brenner, Christian Breschan, Christoph Eich, Claudia Höhne, Martin Jöhr, Franz-Josef Kretz, Gernot Marx, Lars Pape, Markus Schreiber, Jochen Strauss, Markus Weiss
This consensus- based S1 Guideline for perioperative infusion therapy in children is focused on safety and efficacy. The objective is to maintain or re-establish the child's normal physiological state (normovolemia, normal tissue perfusion, normal metabolic function, normal acid- base- electrolyte status). Therefore, the perioperative fasting times should be as short as possible to prevent patient discomfort, dehydration, and ketoacidosis. A physiologically composed balanced isotonic electrolyte solution (BS) with 1-2...
October 17, 2016: Paediatric Anaesthesia
Kalpana Rajendra Kulkarni, Amruta Girish Naik, Sunetra Girish Deshpande
BACKGROUND: Spinal anesthesia is a preferred technique over general anesthesia for cesarean delivery. It avoids maternal airway related complications, aspiration and neonatal depression. However hypotension following spinal anesthesia can lead to decrease in uterine blood flow and neonatal hypoxia. AIMS: We aimed to evaluate the efficacy of 15 1of crystalloid preloading versus prophylactic intravenous bolus of 10 mg ephedrine as an antihypotensive measure for cesarean section...
September 2016: Anesthesia, Essays and Researches
V A Reva, Y Matsumura, T Hörer, D A Sveklov, A V Denisov, S Y Telickiy, A B Seleznev, E R Bozhedomova, J Matsumoto, I M Samokhvalov, J J Morrison
PURPOSE: The aim of this study is to evaluate the early survival and organ damage following 30 and 60 min of thoracic resuscitative endovascular balloon occlusion of the aorta (REBOA) in an ovine model of severe hemorrhagic shock. METHODS: Eighteen sheep were induced into shock by undergoing a 35 % controlled exsanguination over 30 min. Animals were randomized into three groups: 60-min REBOA 30 min after the bleeding (60-REBOA), 30-min REBOA 60 min after the bleeding (30-REBOA) and no-REBOA control (n-REBOA)...
October 13, 2016: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Kambiz Masoumi, Arash Forouzan, Ali Asgari Darian, Alireza Rafaty Navaii
BACKGROUND: Appropriate fluid therapy affects morbidity and mortality rates. A conclusion is yet to be reached on the role of crystalloids and colloids in immediate fluid therapy. This study was done to determine the suitable solution in immediate resuscitation of patients with hemorrhagic shock caused by tissue trauma. METHODS: One hundred trauma patients with hemorrhagic shock, who underwent fluid therapy in the emergency unit, were assigned randomly to two groups of hydroxyethyl starch (Voluven) and normal saline...
November 2016: Journal of Clinical Medicine Research
Tomoo Shimada, Ikuko Hara-Nishimura
Protein-storage vacuoles (PSVs) are specialized vacuoles that sequester large amounts of storage proteins. During seed development, PSVs are formed de novo and/or from preexisting lytic vacuoles. Seed PSVs can be subdivided into four distinct compartments: membrane, globoid, matrix, and crystalloid. In this chapter, we introduce easy methods for isolation of PSVs and their membranes from pumpkin seeds. These methods facilitate the identification and characterization of PSV components.
2017: Methods in Molecular Biology
Matthew Schuldes, Jeffrey B Riley, Stephen G Francis, Sean Clingan
Gaseous microemboli (GME) are an abnormal physiological occurrence during cardiopulmonary bypass and extracorporeal membrane oxygenation (ECMO). Several studies have correlated negative sequelae with exposure to increased amounts of GME. Hypobaric oxygenation is effective at eliminating GME in hollow-fiber microporous membrane oxygenators. However, hollow-fiber diffusion membrane oxygenators, which are commonly used for ECMO, have yet to be validated. The purpose of this study was to determine if hypobaric oxygenation, compared against normobaric oxygenation, can reduce introduced GME when used on diffusion membrane oxygenators...
September 2016: Journal of Extra-corporeal Technology
Alfredo Guilherme Haack Couto, Bruno Araújo, Roberto André Torres de Vasconcelos, Marcos José Renni, Clóvis Orlando Da Fonseca, Ismar Lima Cavalcanti
BACKGROUND: Hemipelvectomy is a major orthopedic surgical procedure indicated in specific situations. Although many studies discuss surgical techniques for hemipelvectomy, few studies have presented survival data, especially in underdeveloped countries. Additionally, there is limited information on anesthesia for orthopedic oncologic surgeries. The primary aim of this study was to determine the survival rate after hemipelvectomy, and the secondary aims were to evaluate anesthesia and perioperative care associated with hemipelvectomy and determine the influence of the surgical technique (external hemipelvectomy [amputation] or internal hemipelvectomy [limb sparing surgery]) on anesthesia and perioperative care in Brazil...
October 7, 2016: World Journal of Surgical Oncology
Alexandra Mani, Chryssoula Staikou, Iosifina Karmaniolou, Nikolaos Orfanos, Anastassios Mylonas, Tzortzis Nomikos, Agathi Pafiti, Apostolos Papalois, Nikolaos Arkadopoulos, Vassilios Smyrniotis, Kassiani Theodoraki
AIM OF THE STUDY: To investigate the pulmonary oxidative stress and possible protective effect of N-Acetylcysteine (NAC) and Desferoxamine (DFX)in a porcine model subjected to hemorrhagic shock. MATERIALS AND METHODS: Twenty-one pigs were randomly allocated to Group-A (sham, n = 5), Group-B (fluid resuscitation, n = 8) and Group-C (fluid, NAC and DFX resuscitation, n = 8). Groups B and C were subjected to a 40-min shock period induced by liver trauma, followed by a 60-min resuscitation period...
August 15, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Fernando G Zampieri, Alexandre B Libório, Alexandre B Cavalcanti
PURPOSE OF REVIEW: To describe recent advances in the understanding of the role of fluid composition in renal outcomes in critically ill patients. RECENT FINDINGS: The debate on fluid composition is now focused in a pragmatic discussion on fluid electrolyte composition. The resurgence of this debate was propelled by several observational studies that suggested that balanced (i.e., low chloride) solutions were associated with less acute kidney injury in critically ill patients...
September 28, 2016: Current Opinion in Critical Care
T K Kim, K Nam, Y J Cho, J J Min, Y J Hong, K U Park, D M Hong, Y Jeon
The infusion of fluids to patients may affect tissue microcirculation and the endothelial glycocalyx. However, the effects of hydroxyethyl starch and crystalloid on endothelial glycocalyx degradation and microvascular reactivity have not been evaluated in detail. We hypothesised that hydroxyethyl starch may cause less endothelial glycocalyx degradation and better microvascular reactivity than that caused by crystalloid. We randomly allocated 120 patients undergoing off-pump coronary artery bypass graft surgery to receive up to 20 ml...
September 26, 2016: Anaesthesia
Christian S Scheer, Christian Fuchs, Sven-Olaf Kuhn, Marcus Vollmer, Sebastian Rehberg, Sigrun Friesecke, Peter Abel, Veronika Balau, Christoph Bandt, Konrad Meissner, Klaus Hahnenkamp, Matthias Gründling
OBJECTIVE: To investigate the impact of a quality improvement initiative for severe sepsis and septic shock focused on the resuscitation bundle on 90-day mortality. Furthermore, effects on compliance rates for antiinfective therapy within the recommended 1-hour interval are evaluated. DESIGN: Prospective observational before-after cohort study. SETTING: Tertiary university hospital in Germany. PATIENTS: All adult medical and surgical ICU patients with severe sepsis and septic shock...
September 22, 2016: Critical Care Medicine
Ramin Bighamian, Andrew T Reisner, Jin-Oh Hahn
This paper presents a lumped-parameter model that can reproduce blood volume response to fluid infusion. The model represents the fluid shift between the intravascular and interstitial compartments as the output of a hypothetical feedback controller that regulates the ratio between the volume changes in the intravascular and interstitial fluid at a target value (called "target volume ratio"). The model is characterized by only three parameters: the target volume ratio, feedback gain (specifying the speed of fluid shift), and initial blood volume...
2016: Frontiers in Physiology
Joseph B Miller, Christopher Lewandowski, Charles R Wira, Andrew Taylor, Charlotte Burmeister, Robert Welch
BACKGROUND: Plasma expansion in acute ischemic stroke has potential to improve cerebral perfusion, but the long-term effects on functional outcome are mixed in prior trials. The goal of this study was to evaluate how the magnitude of plasma expansion affects neurological recovery in acute stroke. METHODS: This was a secondary analysis of data from the Albumin in Acute Stroke Part 2 trial investigating the relationship between the magnitude of overall intravenous volume infusion (crystalloid and colloid) to clinical outcome...
September 14, 2016: Neurocritical Care
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