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https://www.readbyqxmd.com/read/29474273/damage-control-resuscitation-in-pediatric-trauma
#1
Meghan Gilley, Suzanne Beno
PURPOSE OF REVIEW: Damage control resuscitation is an overall management strategy used in trauma patients to rapidly restore physiologic stability, while mitigating hypothermia, coagulopathy and acidosis. We review the evidence and current practice of damage control resuscitation in pediatric trauma patients with a specific focus on fluid management. RECENT FINDINGS: There have been a number of studies over the last several years examining crystalloid fluid resuscitation, balanced blood product transfusion practice and hemostatic agents in pediatric trauma...
February 22, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29463168/associated-mortality-of-liberal-fluid-administration-in-sepsis
#2
Mathew R Johnson, T Patrick Reed, Denise K Lowe, William D Cahoon
Fluid resuscitation, to restore intravascular volume and improve oxygen delivery, is a crucial step in early resuscitation efforts of patients with sepsis or septic shock. The 2016 Surviving Sepsis Campaign guidelines suggest the use of dynamic versus static measures of fluid responsiveness and fluid resuscitation with at least 30 mL/kg of intravenous crystalloid within the first 3 hours followed by fluid administration if hemodynamic factors continue to improve. Despite these recommendations, risks to this practice may exist as multiple studies have demonstrated an association between a positive fluid balance and/or administration of large fluid volume and increase in mortality...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29461392/combined-colloid-preload-and-crystalloid-coload-versus-crystalloid-coload-during-spinal-anesthesia-for-cesarean-delivery-a-randomized-controlled-trial
#3
Mohamed Mohamed Tawfik, Amany Ismail Tarbay, Ahmed Mohamed Elaidy, Karim Ali Awad, Hanaa Mohamed Ezz, Mohamed Ahmed Tolba
BACKGROUND: The optimal strategy of fluid administration during spinal anesthesia for cesarean delivery is still unclear. Ultrasonography of the inferior vena cava (IVC) has been recently used to assess the volume status and predict fluid responsiveness. In this double-blind, randomized controlled study, we compared maternal hemodynamics using a combination of 500-mL colloid preload and 500-mL crystalloid coload versus 1000-mL crystalloid coload. We assessed the IVC at baseline and at subsequent time points after spinal anesthesia...
February 14, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29461162/an-online-survey-of-small-animal-veterinarians-regarding-current-fluid-therapy-practices-in-dogs-and-cats
#4
Kate Hopper, Alejandro Garcia Rojas, Linda Barter
OBJECTIVE To determine common fluid therapy practices of small animal practitioners and identify fluid therapy-related knowledge gaps that may benefit from improved educational efforts, targeted research, or both. DESIGN Online survey. SAMPLE 1,496 small animal veterinarians PROCEDURES An online survey was provided to members of the Veterinary Information Network between December 23, 2013, and January 30, 2014. The survey consisted of 24 questions investigating the administration of crystalloid and synthetic colloid solutions, but not blood products, and focused primarily on the choice of fluid type, frequency of administration, type of patient treated with fluids, treatment with fluids subcutaneously versus IV, and potassium supplementation of fluids...
March 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29460374/del-nido-cardioplegia-for-minimally-invasive-aortic-valve-replacement
#5
Michael S Koeckert, Deane E Smith, Patrick F Vining, Neel K Ranganath, Thomas Beaulieu, Didier F Loulmet, Elias Zias, Aubrey C Galloway, Eugene A Grossi
BACKGROUND: We analyzed the impact and safety of del Nido Cardioplegia (DNC) in patients undergoing minimally invasive aortic valve replacement (MIAVR). METHODS: We analyzed all isolated MIAVR replacements from 5/2013-6/2015 excluding re-operative patients. The approach was a hemi-median sternotomy in all patients. Patients were divided into two cohorts, those who received 4:1 crystalloid:blood DNC solution and those in whom standard 1:4 Buckberg-based cardioplegia (WBC) was used...
February 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29456349/effects-of-crystalloid-preloading-20-ml-kg-on-hemodynamics-in-relation-to-postural-changes-in-patients-undergoing-neurosurgical-procedures-in-sitting-position
#6
M Ranjith, Prasanna Udupi Bidkar, K Narmadalakshmi, Praveen R Talawar
Background: Hemodynamic disturbances are common during positioning the patients from supine to sitting for neurosurgical procedures. The reported incidence of hypotension varies from 5% to 32%. The aim of the study was to study the effect of crystalloid preloading on hemodynamic parameters during positioning the patient from supine to sitting position. Materials and Methods: In this prospective observational trial, 20 patients were enrolled. Two patients had a patent foramen ovale on transesophageal echocardiography and were excluded from the study...
January 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29455308/fluid-therapy-and-outcome-a-prospective-observational-study-in-65-german-intensive-care-units-between-2010-and-2011
#7
Christian Ertmer, Bernhard Zwißler, Hugo Van Aken, Michael Christ, Fabian Spöhr, Axel Schneider, Robert Deisz, Matthias Jacob
BACKGROUND: Outcome data on fluid therapy in critically ill patients from randomised controlled trials may be different from data obtained by observational studies under "real-life" conditions. We conducted this prospective, observational study to investigate current practice of fluid therapy (crystalloids and colloids) and associated outcomes in 65 German intensive care units (ICUs). In total, 4545 adult patients who underwent intravenous fluid therapy were included. The main outcome measures were 90-day mortality, ICU mortality and acute kidney injury (AKI)...
February 17, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29447255/hydroxyethyl-starch-for-volume-expansion-after-subarachnoid-haemorrhage-and-renal-function-results-of-a-retrospective-analysis
#8
Sven Bercker, Tanja Winkelmann, Thilo Busch, Sven Laudi, Dirk Lindner, Jürgen Meixensberger
BACKGROUND: Hydroxyethyl starch (HES) was part of "triple-H" therapy for prophylaxis and therapy of vasospasm in patients with subarachnoid haemorrhage (SAH). The European Medicines Agency restricted the use of HES in 2013 due to an increase of renal failure in critically ill patients receiving HES compared to crystalloid fluids. The occurrence of renal insufficiency in patients with SAH due to HES is still uncertain. The purpose of our study was to evaluate whether there was an association with renal impairment in patients receiving HES after subarachnoid haemorrhage...
2018: PloS One
https://www.readbyqxmd.com/read/29446989/comparison-of-the-efficacy-of-two-human-fibrinogen-concentrates-to-treat-dilutional-coagulopathy-in-vitro
#9
Thorsten Haas, Melissa M Cushing, Lars M Asmis
Both congenital and acquired fibrinogen deficiency can be safely treated with administration of fibrinogen concentrate. The aim of this study was to test the efficacy of a new fibrinogen product (Fibryga) compared to a licensed product (Haemocomplettan) in an in vitro model of dilutional coagulopathy. Ten blood specimens from healthy volunteers were diluted 1:1 with balanced crystalloid solution and subsequently supplemented with each fibrinogen concentrate at a dose replicating in vivo supplementation (50 mg kg -1 )...
February 15, 2018: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29441339/early-postoperative-small-bowel-obstruction-after-laparotomy-for-trauma-incidence-and-risk-factors
#10
Wu Seong Kang, Yun Chul Park, Young Goun Jo, Jung Chul Kim
Purpose: This study aimed to investigate the incidence and risk factors of early postoperative small bowel obstruction (EPSBO) after laparotomy for trauma patients. Methods: From 2009 to 2016, consecutive patients who had undergone laparotomy for trauma were retrospectively evaluated. EPSBO was defined as the presence of signs and symptoms of obstruction between postoperative days 7 and 30, or obstruction occurring anytime within 30 days and lasting more 7 days...
February 2018: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/29438568/haemodynamic-assessment-and-support-in-sepsis-and-septic-shock-in-resource-limited-settings
#11
David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W Dünser, Arjen M Dondorp, Marcus J Schultz
Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking. Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind...
February 9, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29430670/the-effect-of-3-resuscitative-fluid-therapies-on-hemostasis-as-measured-by-rotational-thromboelastometry-in-dogs
#12
Sunita Seshia, M Casey Gaunt, Beverly A Kidney, Marion L Jackson
BACKGROUND: Evidence suggests that administration of intravenous fluids impairs hemostasis. Thromboelastometry (TEM) may provide a more sensitive measure of the fluid effects on hemostasis than traditional coagulation tests. OBJECTIVE: The study aim was to determine if resuscitative fluid therapy affects hemostasis, as measured by TEM. MATERIALS AND METHODS: Using a randomized crossover design, 6 healthy dogs were administered intravenous colloid, crystalloid, and hypertonic saline at therapeutic doses...
February 11, 2018: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/29429774/normal-saline-for-intravenous-fluid-therapy-in-critically-ill-patients
#13
REVIEW
Fei-Hu Zhou, Chao Liu, Zhi Mao, Peng-Lin Ma
The efficacy and safety of normal saline (NS) for fluid therapy in critically ill patients remain controversy. In this review, we summarized the evidence of randomized controlled trials (RCTs) which compared NS with other solutions in critically ill patients. The results showed that when compared with 6% hydroxyethyl starch (HES), NS may reduce the onset of acute kidney injury (AKI). However, there is no significant different in mortality and incidence of AKI when compared with 10% HES, albumin and buffered crystalloid solution...
January 31, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29416246/effect-of-lactate-versus-acetate-based-intravenous-fluids-on-acid-base-balance-in-patients-undergoing-free-flap-reconstructive-surgeries
#14
Sunil Rajan, Soumya Srikumar, Pulak Tosh, Lakshmi Kumar
Background and Aims: Use of lactated intravenous fluids during long surgeries could cause lactate accumulation and lactic acidosis. Acetate-based solutions could be advantageous as they are devoid of lactate. The primary aim of the study was to assess the effect of use of an acetated solution or Ringer's lactate (RL) as intraoperative fluid on lactate levels in patients without hepatic dysfunction undergoing prolonged surgeries. Material and Methods: This was a prospective, randomized, controlled trial involving sixty patients belonging to American Society of Anesthesiologists Physical Status I to II undergoing major head and neck surgeries with free flap reconstruction...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29406176/normal-saline-versus-a-balanced-crystalloid-for-goal-directed-perioperative-fluid-therapy-in-major-abdominal-surgery-a-double-blind-randomised-controlled-study
#15
C A Pfortmueller, G-C Funk, C Reiterer, A Schrott, O Zotti, B Kabon, E Fleischmann, G Lindner
BACKGROUND: This double-blind randomised controlled trial investigated whether normal saline or a balanced crystalloid has distinct effects on vasopressor use in patients undergoing major abdominal surgery. METHODS: Patients received either normal saline 0.9% or an acetate-buffered crystalloid for intraoperative volume replacement in a goal-directed fashion. The primary outcome was need for vasopressors; the secondary outcomes were the total dose of catecholamines, total perioperative fluid, and unplanned intensive care admissions...
February 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29398426/the-influence-of-fluid-management-on-outcomes-in-preeclampsia-a-systematic-review-and-meta-analysis
#16
T Pretorius, G van Rensburg, R A Dyer, B M Biccard
BACKGROUND: The optimal fluid management strategy to ensure best outcomes in preeclamptic patients remains a controversial issue, with little evidence to support any one approach. OBJECTIVE: The aim of this systematic review was to investigate the effect of various fluid management strategies on clinical outcomes, haemodynamic indices and biochemical markers in preeclamptic women and their babies. Primary outcome measures were the occurrence of pulmonary oedema and/or the development of renal impairment...
December 20, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29394952/renal-protective-effect-of-a-hydration-supplemented-with-magnesium-in-patients-receiving-cisplatin-for-head-and-neck-cancer
#17
Takahiro Kimura, Taijiro Ozawa, Nobuhiro Hanai, Hitoshi Hirakawa, Hidenori Suzuki, Hiroshi Hosoi, Yasuhisa Hasegawa
BACKGROUND: Our study analyzes the effect of magnesium supplementation on nephrotoxicity in patients receiving cisplatin for head and neck cancer. METHODS: We retrospectively reviewed the medical records of patients with head and neck cancer who received two doses of cisplatin (80 mg/m2) and 5-fluorouracil (800 mg/m2) 3 weeks apart from August 2008 to October 2012. The regimen prior to 2011 (crystalloid-only) involved the administration of 1000 mL of lactated Ringer's solution on the day prior to cisplatin infusion and 2000 mL of continuous infusion of saline on the day of cisplatin infusion...
February 2, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29391354/metformin-associated-lactic-acidosis-mimicking-ischaemic-bowel
#18
Sajjad Ali, Heloise Labuschagne, Nickolay Azarov, Zakaria Hindi, Lavi Oud
Metformin-associated lactic acidosis (MALA) is a rare complication among patients who are diabetic, commonly presenting with non-specific findings, and developing mostly among those with other risk factors for lactic acidosis. We report the development of MALA in a 67-year-old man with diabetes who presented with progressive abdominal pain and bloody diarrhoea. On presentation the patient was in shock, with signs suggestive of peritonitis, and with severe lactic acidosis, renal failure and non-specific findings on abdominal CT...
February 1, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29389698/goal-directed-fluid-resuscitation-protocol-based-on-arterial-waveform-analysis-of-major-burn-patients-in-a-mass-burn-casualty
#19
Hao-Yu Chiao, Chang-Yi Chou, Yuan-Sheng Tzeng, Chih-Hsin Wang, Shyi-Gen Chen, Niann-Tzyy Dai
BACKGROUND: Adequate fluid titration during the initial resuscitation period of major burn patients is crucial. This study aimed to evaluate the feasibility and efficacy of a goal-directed fluid resuscitation protocol that used hourly urine output plus the arterial waveform analysis FloTrac (Edwards LifeSciences, Irvine, Calif) system for major burns to avoid fluid overload. METHODS: We conducted a retrospective cohort study of 43 major burn patients at the Tri-Service General Hospital after the Formosa Fun Coast Dust Explosion on June 27, 2015...
January 31, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29386022/thromboelastometric-assessment-of-hemostasis-following-hydroxyethyl-starch-130-0-4-administration-as-a-constant-rate-infusion-in-hypoalbuminemic-dogs
#20
Angelica Botto, Barbara Bruno, Cristiana Maurella, Fulvio Riondato, Alberto Tarducci, Giulio Mengozzi, Antonio Borrelli
BACKGROUND: The primary aim was to evaluate by means of thromboelastometry (ROTEM) the effects of hydroxyethyl starch (HES) 130/0.4 administered as a constant rate infusion (CRI) on hemostasis in hypoalbuminemic dogs. The second aim was to use ROTEM analysis to detect whether all hypoalbuminemic dogs of our population were hypercoagulable. RESULTS: The study sample was 20 hypoalbuminemic dogs (albumin < 2 g/dl) with normal perfusion parameters and requiring intravenous fluid therapy...
January 31, 2018: BMC Veterinary Research
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