keyword
https://read.qxmd.com/read/38532434/optimization-of-cardiopulmonary-bypass-prime-fluid-to-preserve-microcirculatory-perfusion-during-on-pump-coronary-artery-bypass-graft-surgery-prime-study-protocol-for-a-double-blind-randomized-trial
#1
JOURNAL ARTICLE
Anne M Beukers, Carolien S E Bulte, Ruben J Bosch, Susanne Eberl, Charissa E van den Brom, Stephan A Loer, Alexander B A Vonk
BACKGROUND: Acute microcirculatory perfusion disturbances and organ edema are important factors leading to organ dysfunction during cardiac surgery with cardiopulmonary bypass (CPB). Priming of the CPB system with crystalloid or colloid fluids, which inevitably leads to hemodilution, could contribute to this effect. However, there is yet no optimal evidence-based strategy for this type of priming. Hence, we will investigate different priming strategies to reduce hemodilution and preserve microcirculatory perfusion...
March 26, 2024: Trials
https://read.qxmd.com/read/38530649/iatrogenic-hyperchloremia-an-overview-in-hospitalized-patients-for-pharmacists
#2
JOURNAL ARTICLE
Amoreena Most, Sarah Nordbeck, Nicholas Farina
DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: The purpose of this therapeutic update is to provide pharmacists with a general overview of the pathophysiology of hyperchloremia and describe strategies to help prevent development of this electrolyte abnormality in hospitalized patients...
March 26, 2024: American Journal of Health-system Pharmacy: AJHP
https://read.qxmd.com/read/38499323/assessment-of-adherence-to-the-2020-surviving-sepsis-campaign-guidelines-for-fluid-resuscitation-in-children-with-suspected-septic-shock-in-paediatric-emergency-departments-a-prospective-multicentre-study
#3
JOURNAL ARTICLE
Julian San Geroteo, Michael Levy, Marion Bailhache, Claire De Jorna, Elodie Privat, Oussama Gasmi, Maria Fuentes-Lopez, Yacine Laoudi, Mustapha Mazeghrane, Aline Malterre, Pauline Bories, Khaled Abdel Aal, Iozefina Arjoca, Jean Gaschignard, Davy Tanchaleune, Philippe Minodier, Fabien Audren, Tifanny Mazetier, Pauline Quagliaro, Florence Raimond, Soria Sieng, Blandine Robert, Delphine Wohrer, Nathalie De Suremain, Stéphane Dauger
BACKGROUND: Paediatric sepsis is the leading cause of death in children under 5 years. No studies have evaluated the application of the Surviving Sepsis Campaign 2020 (SSC-2020) guidelines in paediatric emergency departments (PEDs). OBJECTIVE: To assess physician adherence to the SSC-2020 fluid resuscitation guidelines in children with suspected septic shock in PEDs. METHODS: This was a prospective multicentre observational study conducted in 21 French hospitals over 5 sequential weeks, between November 2021 and March 2022...
March 18, 2024: Archives of Disease in Childhood
https://read.qxmd.com/read/38454546/evaluation-of-a-protocol-change-promoting-lactated-ringers-over-normal-saline-in-the-treatment-of-diabetic-ketoacidosis
#4
JOURNAL ARTICLE
Jake Johnson, Andjela Drincic, Emma Buddenhagen, Kaitlyn Nein, Kaeli Samson, Trek Langenhan
BACKGROUND: Current guidelines recommend normal saline (NS) for fluid resuscitation in the management of patients presenting with diabetic ketoacidosis (DKA). However, previous prospective studies have demonstrated improvement in patient-specific outcomes, including time to DKA resolution, when balanced crystalloid fluids are used. METHODS: We conducted a single institution, retrospective cohort study of adult patients admitted with DKA before and after a protocol change within our institution, which shifted the default resuscitative and maintenance fluid in our DKA management protocol from NS to lactated Ringer's solution (LR)...
March 7, 2024: Journal of Diabetes Science and Technology
https://read.qxmd.com/read/38453302/resuscitation-and-care-in-the-trauma-bay
#5
REVIEW
Jan-Michael Van Gent, Thomas W Clements, Bryan A Cotton
Start balanced resuscitation early (pre-hospital if possible), either in the form of whole blood or 1:1:1 ratio. Minimize resuscitation with crystalloid to minimize patient morbidity and mortality. Trauma-induced coagulopathy can be largely avoided with the use of balanced resuscitation, permissive hypotension, and minimized time to hemostasis. Using protocolized "triggers" for massive and ultramassive transfusion will assist in minimizing delays in transfusion of products, achieving balanced ratios, and avoiding trauma induced coagulopathy...
April 2024: Surgical Clinics of North America
https://read.qxmd.com/read/38417255/the-sodium-correction-factor-for-dogs-undergoing-treatment-for-a-hyperglycemic-crisis-is-a-1-6-meq-l-decrease-in-sodium-per-100-mg-dl-increase-in-glucose
#6
JOURNAL ARTICLE
Sanna M Gough, Britt Thevelein, Benjamin M Brainard, Amie Koenig
OBJECTIVE: To determine the sodium correction factor for clinical use in hyperglycemic diabetic dogs. SAMPLE: Retrospective analysis of 76 hospitalization episodes from 67 different dogs presenting to the University of Georgia Veterinary Teaching Hospital between January 1, 2015, and January 1, 2023. METHODS: For each hospitalization episode, paired blood sodium and glucose concentration measurements were recorded from the time of presentation until glucose concentration was ≤ 201 mg/dL...
February 27, 2024: Journal of the American Veterinary Medical Association
https://read.qxmd.com/read/38413306/intraoperative-normal-saline-administration-and-acute-kidney-injury-in-patients-undergoing-liver-transplantation
#7
JOURNAL ARTICLE
Ji-Yoon Jung, Jae-Woo Ju, Hyun-Kyu Yoon, Ho-Jin Lee, Won Ho Kim
BACKGROUND: Normal saline is still used in patients undergoing living donor liver transplantation (LDLT) with normonatremia. We investigated whether the normal saline administered during LDLT is associated with the increased risk of acute kidney injury (AKI) compared with the balanced crystalloids. METHODS: We reviewed 1011 cases undergoing LDLT. The primary exposure variable was normal saline administered intraoperatively compared with the balanced crystalloid...
February 26, 2024: Transplantation Proceedings
https://read.qxmd.com/read/38349600/perioperative-balanced-crystalloids-versus-normal-saline-during-kidney-transplantation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
REVIEW
Muhammad Imran, Yehya Khlidj, Ahmed Naeem, Aiman Tanveer, Nour Fakih, Ateeba Kamran, Mohamed Abuelazm
BACKGROUND: In kidney transplant (KT) surgery, the perioperative administration of intravenous (IV) fluids plays a crucial role, with potential effects on graft function. Our meta-analysis aims to assess the post-KT outcomes of perioperative balanced crystalloids (BC) versus normal saline (NS). METHODS: We conducted a comprehensive search across five databases to identify relevant randomized controlled trials (RCTs). The search results were imported into Covidence for article eligibility screening, and all relevant outcome data were synthesized using risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CIs) in meta-analysis models within RevMan 5...
February 13, 2024: International Urology and Nephrology
https://read.qxmd.com/read/38348514/enhanced-recovery-after-surgery-eras-%C3%A2-society-abdominal-and-thoracic-surgery-recommendations-a-systematic-review-and-comparison-of-guidelines-for-perioperative-and-pharmacotherapy-core-items
#9
JOURNAL ARTICLE
Bowen K Powers, Harley L Ponder, Rachelle Findley, Rachel Wolfe, Gourang P Patel, Richard H Parrish
INTRODUCTION: Worldwide, ERAS® Society guidelines have ushered in a new era of perioperative care. The purpose of this systematic review is to compare published core elements and pharmacotherapy recommendations embedded within ERAS® Society abdominal and thoracic surgery (ATS) guidelines. Determining whether a consensus exists for pharmacological core items would make future guideline preparation for similar surgeries more standardized and could improve patient care by reducing unnecessary protocol variations...
February 13, 2024: World Journal of Surgery
https://read.qxmd.com/read/38343480/balanced-crystalloids-versus-isotonic-saline-in-pediatric-sepsis-a-comprehensive-systematic-review-and-meta-analysis
#10
JOURNAL ARTICLE
Asmaa Mhanna, Azizullah Beran, Omar Srour, Mohammed Mhanna, Ahmad Assaly, Abdelrahman Elsayed, Nicholas G Horen, Ragheb Assaly
PURPOSE: We conducted a comprehensive meta-analysis to compare the effects of balanced crystalloids (BC) and isotonic saline (IS) in pediatric sepsis. METHODS: A systematic search was performed for studies comparing BC and IS in pediatric sepsis. Outcomes included mortality, acute kidney injury (AKI), need for renal replacement therapy (RRT), hospital length of stay (LOS), and pediatric intensive care unit (PICU) LOS. A random-effect models was used to calculated pooled odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CIs)...
2024: Proceedings of the Baylor University Medical Center
https://read.qxmd.com/read/38294265/-the-highlights-of-kidney-transplantation-in%C3%A2-2023
#11
JOURNAL ARTICLE
Sacha A De Serres, Lionel Couzi
In 2023, significant advances were made in various areas of kidney transplantation. Firstly, the use of a balanced crystalloid solution in the recipient appears to prevent the delay in graft function, unlike hypothermia in the donor and normothermic pulsatile perfusion. Understanding the pathophysiology of humoral rejection has progressed, highlighting the major role of HLA class II molecules and innate immune cells (NK and monocytes expressing FCGR3A). An automatic Banff classification algorithm has been developed to better categorize biopsies in currently known diagnoses...
January 31, 2024: Néphrologie & Thérapeutique
https://read.qxmd.com/read/38229147/the-effect-of-passive-leg-raising-test-on-intracranial-pressure-and-cerebral-autoregulation-in-brain-injured-patients-a-physiological-observational-study
#12
JOURNAL ARTICLE
Antonio Messina, Agnieszka Uryga, Alberto Giardina, Pietro Ciliberti, Denise Battaglini, Nicolo' Patroniti, Marek Czosnyka, Xavier Monnet, Maurizio Cecconi, Chiara Robba
BACKGROUND: The use of the passive leg raising (PLR) is limited in acute brain injury (ABI) patients with increased intracranial pressure (ICP) since the postural change of the head may impact on ICP and cerebral autoregulation. However, the PLR use may prevent a positive daily fluid balance, which had been recently associated to worse neurological outcomes. We therefore studied early and delayed effects of PLR on the cerebral autoregulation of patients recovering from ABI. MATERIALS AND METHODS: This is a Prospective, observational, single-center study conducted in critically ill patients admitted with stable ABI and receiving invasive ICP monitoring, multimodal neuromonitoring and continuous hemodynamic monitoring...
January 16, 2024: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/38229019/effects-of-albumin-and-crystalloid-priming-strategies-on-red-blood-cell-transfusions-in-on-pump-cardiac-surgery-a-network-meta-analysis
#13
Tianlong Wang, Jing Wang, Mingru Zhang, Han Zhang, Qiaoni Zhang, Gang Liu, Wenhao Dong, Yuefu Wang, Bingyang Ji
BACKGROUND: In on-pump cardiac surgery, the albumin priming strategy could maintain colloid osmotic pressure better than crystalloid solutions and reduce excessive perioperative fluid balance. However, a high-quality meta-analysis is required to compare the safety of these approaches in perioperative red blood cell (RBC) transfusions. Owing to limited direct evidence, we conducted a network meta-analysis (NMA) to increase the pool of studies and provide indirect evidence. METHODS: The pre-defined primary outcomes were intraoperative and the first 24 h postoperative RBC transfusion volume in units...
January 16, 2024: BMC Anesthesiology
https://read.qxmd.com/read/38185648/transfusion-practice-in-central-norway-a-regional-cohort-study-in-patients-suffering-from-major-haemorrhage
#14
JOURNAL ARTICLE
Marte Irene Skille Carlsen, Jostein Rødseth Brede, Christian Medby, Oddvar Uleberg
BACKGROUND: In patients with major hemorrhage, balanced transfusions and limited crystalloid use is recommended in both civilian and military guidelines. This transfusion strategy is often applied in the non-trauma patient despite lack of supporting data. The aim of this study was to describe the current transfusion practice in patients with major hemorrhage of both traumatic and non-traumatic etiology in Central Norway, and discuss if transfusions are in accordance with appropriate massive transfusion protocols...
January 7, 2024: BMC Emergency Medicine
https://read.qxmd.com/read/38164322/a-comparison-between-saline-and-balanced-solutions-in-kidney-transplants-a-randomized-clinical-trial
#15
JOURNAL ARTICLE
Heitor Medeiros, Paulo H Lima, Vital S Junior, Diego A Souza, Aline M Pinheiro, Rand R Martins, Kellen M A H Costa, Jose Hipolito D Junior, Paulo J Medeiros, Wallace A Da Silva
Objective This study aimed to investigate the impact of different types of intravenous fluids - normal saline (NS), lactated Ringer's solution (LR), and PlasmaLyte (PL) - on the acid-base balance and electrolyte concentration following kidney transplant, a common procedure for patients with end-stage renal disease (ESRD). Methodology A randomized controlled trial design was employed, wherein the primary parameters analyzed were postoperative pH and serum potassium levels. Postoperative concentrations of serum bicarbonate, sodium, chloride, and creatinine, as well as graft functionality, were assessed as secondary outcomes...
December 2023: Curēus
https://read.qxmd.com/read/38126191/fluid-therapy-in-diabetic-ketoacidosis
#16
JOURNAL ARTICLE
Mahesh Ramanan, Anthony Delaney, Balasubramanian Venkatesh
PURPOSE OF REVIEW: To evaluate recent evidence (2021-2023) on fluid therapy in diabetic ketoacidosis. Key evidence gaps which require generation of new evidence are discussed. RECENT FINDINGS: Balanced crystalloid solutions, compared to the commonly recommended and used 0.9% sodium chloride solution (saline), may result in better outcomes for patients with diabetic ketoacidosis, including faster resolution of acidosis, less hyperchloremia and shorter hospital length of stay...
December 1, 2023: Current Opinion in Clinical Nutrition and Metabolic Care
https://read.qxmd.com/read/38114893/bicarbonate-ringer-s-solution-could-improve-the-intraoperative-acid-base-equilibrium-and-reduce-hepatocellular-enzyme-levels-after-deceased-donor-liver-transplantation-a-randomized-controlled-study
#17
RANDOMIZED CONTROLLED TRIAL
Qingkai Li, Ying Liu, Yanan Wang, Xin Shan, Chunxiao Liu, Zhihua Li, Jinglin Cao, Jian Dou, Guanjie Xu, Qiujun Wang, Xiaojuan Qie
BACKGROUND: Bicarbonate Ringer's (BR) solution is a direct liver and kidney metabolism-independent HCO3 - buffering system. We hypothesized that BR solution would be more effective in improving acid-base equilibrium and more conducive to better liver function than Acetate Ringer's (AR) solution in conventional orthotopic liver transplantation (OLT) patients. METHODS: Sixty-nine adult patients underwent OLT. Patients in the bicarbonate and acetate groups received BR solution or AR solution as infused crystalloids and graft washing solution, respectively...
December 19, 2023: BMC Anesthesiology
https://read.qxmd.com/read/38111852/comparisons-of-electrolyte-balance-efficacy-of-two-gelatin-balanced-crystalloid-for-surgery-patients-under-general-anesthesia-a-multi-center-prospective-randomized-single-blind-controlled-study
#18
JOURNAL ARTICLE
Guangyou Duan, Haibo Deng, Hong Fu, Lingzhi Wang, Hanyu Yang
PURPOSE: This study aimed to compare the electrolyte balance efficacies of two Gelatin-Balanced Crystalloid in clinical applications. METHODS: A multi-center, prospective, randomized, single-blind, parallel controlled study was conducted among non-cardiac surgery patients, with clinical registration number ChiCTR2200062999. They were randomized into Succinylated Gelatin, Multiple Electrolytes and Sodium Acetate Injection (SG-MESAI) group (experimental group) and Succinylated Gelatin Injection (SGI) infusion group (control group)...
2023: International Journal of General Medicine
https://read.qxmd.com/read/38101966/intravenous-albumin-in-cardiac-and-vascular-surgery-a-systematic-review-and-meta-analysis
#19
REVIEW
Nikolaos J Skubas, Jeannie Callum, Aarti Bathla, Homa Keshavarz, Dean Fergusson, Bovey Wu, Simon Stanworth, Nadine Shehata
BACKGROUND: Intravenous albumin is commonly utilised in cardiovascular surgery for priming of the cardiopulmonary bypass circuit, volume replacement, or both, although the evidence to support this practice is uncertain. The aim was to compare i.v. albumin with synthetic colloids and crystalloids for paediatric and adult patients undergoing cardiovascular surgery for all-cause mortality and other perioperative outcomes. METHODS: A systematic review and meta-analysis of randomised controlled trials (RCTs) of i...
February 2024: British Journal of Anaesthesia
https://read.qxmd.com/read/38093626/beyond-the-surviving-sepsis-campaign-guidelines-a-systematic-review-of-interventions-affecting-mortality-in-sepsis
#20
JOURNAL ARTICLE
Chiara Sartini, Giovanni Landoni, Alessandro Belletti, Yuki Kotani, Nicolò Maimeri, Michele Umbrello, Andrey Yavorovskiy, Matthieu Jabaudon
INTRODUCTION: Sepsis-related mortality is decreasing over time after the introduction of "Surviving Sepsis Campaign" Guidelines in 2004. The last Guidelines version collects 93 recommendations, but several interventions supported by randomized evidence of mortality reduction are not included. EVIDENCE ACQUISITION: We performed a systematic review of all randomized controlled trials reporting a statistically significant mortality reduction in septic patients and compared the identified studies to the Surviving Sepsis Campaign Guidelines 2021 to highlight discrepancies...
December 13, 2023: Panminerva Medica
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