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balanced crystalloids

A González-Castro, M Ortiz-Lasa, J C Rodriguez-Borregan, P Escudero-Acha, E Chicote, B Suberviola, C Blanco, Y Peñasco, A Jiménez Alfonso, J Llorca, T Dierssen-Soto
INTRODUCTION AND OBJECTIVE: To evaluate, by means of a meta-analysis, the effect of normal saline on mortality in intensive care patients, when compared with the use of balanced crystalloids. MATERIAL AND METHOD: Published controlled clinical trials, randomised and sequential prospective studies in time, evaluating the mortality when physiological saline was used in patients admitted to intensive care units. Electronic search was performed in Medline, Embase, Cochrane Library, ISI Proceedings, and Web of Science, as well as a manual search of selected references...
August 9, 2018: Revista Española de Anestesiología y Reanimación
Barbara E Coons, Sophia Tam, Jeanne Rubsam, Steven Stylianos, Vincent Duron
BACKGROUND: Aggressive fluid resuscitative strategies have been the cornerstone of early trauma management for decades. However, recent prospective adult studies have challenged this practice, underlining the detrimental effect of positive fluid balance on cardiopulmonary function. Fluid overload has been associated with impaired oxygenation and morbidity in critically ill adults, but data is lacking in pediatric trauma patients. METHODS: We completed a retrospective chart review of all pediatric trauma patients 0-18 years old admitted to a level 1 trauma center from January 2013 to December 2015...
July 24, 2018: Journal of Pediatric Surgery
Adil R Dingankar, Dominic A Cave, Vijay Anand, V Ben Sivarajan, Susan Nahirniak, Cathy Sheppard, Jan Hanot, Gonzalo Garcia Guerra
OBJECTIVES: To determine the clinical benefit of using colloids versus crystalloids for volume resuscitation in children admitted after cardiac surgery. DESIGN: Retrospective pre-/postintervention cohort study. SETTING: Stollery Children's Hospital tertiary care pediatric cardiac ICU. PATIENTS: Children admitted to the pediatric cardiac ICU after cardiac surgery. INTERVENTIONS: Fluid resuscitation policy change in which crystalloids replaced albumin 5% as the primary fluid strategy for resuscitation after cardiac surgery...
July 17, 2018: Pediatric Critical Care Medicine
Wesley Hayes
Intravenous 0.9% saline has saved countless lives since it was introduced over a century ago. It remains the most widespread crystalloid in both adult and pediatric practice. However, in recent years, evidence of deleterious effects is accruing. These include increased mortality, acute kidney injury (AKI), metabolic acidosis, and coagulopathy. The predominant cause for these sequelae appears to be the excess chloride concentration of 0.9% saline relative to plasma. This has led to development of balanced isotonic solutions such as PlasmaLyte...
July 9, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ryan M Brown, Matthew W Semler
Among critically ill adults, sepsis remains both common and lethal. In addition to antibiotics and source control, fluid resuscitation is a fundamental sepsis therapy. The physiology of fluid resuscitation for sepsis, however, is complex. A landmark trial found early goal-directed sepsis resuscitation reduced mortality, but 3 recent multicenter trials did not confirm this benefit. Multiple trials in resource-limited settings have found increased mortality with early fluid bolus administration in sepsis, and the optimal approach to early sepsis resuscitation across settings remains unknown...
January 1, 2018: Journal of Intensive Care Medicine
Hannah Lindstrom, Lauren Kearney, Debbie Massey, Guy Godsall, Emma Hogan
AIM: To describe contemporary routine practice regarding rapid pre-loading of intravenous fluid management prior to epidural analgesia during labour and birth. BACKGROUND: Midwives are the key health professionals providing care for women before, during and after an epidural in labour. Part of this management involves maternal hydration; however, how midwives assess and manage maternal hydration and fluid management is not well understood. Prior to the administration of a low dose epidural for pain relief a rapid intravenous pre-loading of between 500 -1000 mls of crystalloid fluids is administered to the pregnant women...
July 2, 2018: Journal of Advanced Nursing
Mohamed Ahmed Hamed, Abeer Shaban Goda, Reham Mohmmed Salah Eldein
Background: It is a challenge for anesthesiologists to balance between administering intravenous fluid, vasoactive agents, and inotropic drugs to maintain appropriate cardiac output. Aim: The aim of this study was to evaluate the effect of treatment algorithm guided either by pulmonary artery catheter (PAC) or by the fourth generation FloTrac/Vigileo system combined with monitoring of oxygen transport on hemodynamic management and outcome after coronary artery bypass graft surgery (CABG)...
April 2018: Anesthesia, Essays and Researches
Nándor Öveges, Ildikó László, Krisztián Tánczos, Márton Németh, Gábor Lebák, Bianca-Andreea Tudor-Drobjewski, Dániel Érces, József Kaszaki, László Rudas, Wolfgang Huber, Zsolt Molnár
INTRODUCTION: Fluid resuscitation is the cornerstone of treatment in hemorrhagic shock. Despite increasing doubts, several guidelines recommend to maintain mean arterial pressure (MAP) >65 mmHg as the most frequent indication of fluid therapy. Our aim was to investigate the effects of a MAP-guided management in a bleeding-resuscitation animal experiment. MATERIALS AND METHODS: After anesthesia and instrumentation (tbsl) animals were bled till the initial stroke volume index dropped by 50% (t0)...
2018: PloS One
Sevim Cesur, Tülay Çardaközü, Alparslan Kuş, Neşe Türkyılmaz, Ömer Yavuz
Intraoperative fluid management is quite important in terms of postoperative organ perfusion and complications. Different fluid management protocols are in use for this purpose. Our primary goal was to compare the effects of conventional fluid management (CFM) with the Pleth Variability Index (PVI) guided goal-directed fluid management (GDFM) protocols on the amount of crystalloids administered, blood lactate, and serum creatinine levels during the intraoperative period. The length of hospital stay was our secondary goal...
June 14, 2018: Journal of Clinical Monitoring and Computing
F J Candel, M Borges Sá, S Belda, G Bou, J L Del Pozo, O Estrada, R Ferrer, J González Del Castillo, A Julián-Jiménez, I Martín-Loeches, E Maseda, M Matesanz, P Ramírez, J T Ramos, J Rello, B Suberviola, A Suárez de la Rica, P Vidal
The incidence and prevalence of sepsis depend on the definitions and records that we use and we may be underestimating their impact. Up to 60% of the cases come from the community and in 30-60% we obtain microbiological information. Sometimes its presentation is ambiguous and there may be a delay in its detection, especially in the fragile population. Procalcitonin is the most validated biomarker for bacterial sepsis and the one that best discriminates the non-infectious cause. Presepsin and pro-adrenomedullin are useful for early diagnosis, risk stratification and prognosis in septic patients...
August 2018: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
H Liu, F Gong, Y H Ai, M L Ai, Q Feng, S Y Deng, Z Y Liu, L N Zhang
To explore the present status of fluid therapy and clinical outcome in critically ill patients in intensive care units (ICU). ICU patients consecutively admitted to our ICU were prospectively enrolled. Patients' demographics, laboratory data, fluid record and clinical outcome were collected. Fluid intake quantity of all patients was at peak on the fifth day which was 2 806 (1 997, 3 582) ml. From the fourth day in ICU, fluid balance started to benegative as -84 (-1 127, 612) ml and gradually increased. Crystalloid solution was the main components...
June 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Mariana F Lima, Iuri S Neville, Sergio Cavalheiro, Dafne C Bourguignon, Paolo Pelosi, Luiz M S Malbouisson
BACKGROUND: Balanced crystalloid solutions induce less hyperchloremia than normal saline, but their role as primary fluid replacement for children undergoing surgery is unestablished. We hypothesized that balanced crystalloids induce less chloride and metabolic derangements than 0.9% saline solutions in children undergoing brain tumor resection. METHODS: In total, 53 patients (age range, 6 mo to 12 y) were randomized to receive balanced crystalloid (balanced group) or 0...
June 15, 2018: Journal of Neurosurgical Anesthesiology
Andrew C McKown, Luis E Huerta, Todd W Rice, Matthew W Semler
No abstract text is available yet for this article.
June 13, 2018: American Journal of Respiratory and Critical Care Medicine
Johann Morelle, Amadou Sow, Charles-André Fustin, Catherine Fillée, Elvia Garcia-Lopez, Bengt Lindholm, Eric Goffin, Fréderic Vandemaele, Bengt Rippe, Carl M Öberg, Olivier Devuyst
Background Osmosis drives transcapillary ultrafiltration and water removal in patients treated with peritoneal dialysis. Crystalloid osmosis, typically induced by glucose, relies on dialysate tonicity and occurs through endothelial aquaporin-1 water channels and interendothelial clefts. In contrast, the mechanisms mediating water flow driven by colloidal agents, such as icodextrin, and combinations of osmotic agents have not been evaluated. Methods We used experimental models of peritoneal dialysis in mouse and biophysical studies combined with mathematical modeling to evaluate the mechanisms of colloid versus crystalloid osmosis across the peritoneal membrane and to investigate the pathways mediating water flow generated by the glucose polymer icodextrin...
July 2018: Journal of the American Society of Nephrology: JASN
N J Ekbal, P Hennis, A Dyson, M Mythen, M F M James, M Singer
BACKGROUND: Commercially available crystalloid solutions used for volume replacement do not exactly match the balance of electrolytes found in plasma. Large volume administration may lead to electrolyte imbalance and potential harm. We hypothesised that haemodilution using solutions containing different anions would result in diverse biochemical effects, particularly on acid-base status, and different outcomes. METHODS: Anaesthetised, fluid-resuscitated, male Wistar rats underwent isovolaemic haemodilution by removal of 10% blood volume every 15 min, followed by replacement with one of three crystalloid solutions based on acetate, lactate, or chloride...
June 2018: British Journal of Anaesthesia
Alexandre Joosten, Sean Coeckelenbergh, Amelie Delaporte, Brigitte Ickx, Jean Closset, Thierry Roumeguere, Luc Barvais, Luc Van Obbergh, Maxime Cannesson, Joseph Rinehart, Philippe Van der Linden
BACKGROUND: Goal-directed fluid therapy (GDFT) has been associated with improved patient outcomes. However, implementation of GDFT protocols remains low despite growing published evidence and the recommendations of multiple regulatory bodies in Europe. We developed a closed-loop-assisted GDFT management system linked to a pulse contour monitor to assist anaesthesiologists in applying GDFT. OBJECTIVE: To assess the impact of our closed-loop system in patients undergoing major abdominal surgery in an academic hospital without a GDFT programme...
May 9, 2018: European Journal of Anaesthesiology
Julia Werner, Oliver Hunsicker, Anja Schneider, Henryk Stein, Christian von Heymann, Adrian Freitag, Aarne Feldheiser, Klaus-Dieter Wernecke, Claudia Spies
BACKGROUND: While hydroxyethyl starch (HES) solutions are not recommended any longer in critically ill patients, data on efficacy and safety during surgery are still limited. METHODS: In a randomized controlled trial 63 patients were assigned to receive 10% HES (130/0.42), 6% HES (130/0.42), or crystalloid within a goal-directed hemodynamic algorithm during pancreatic surgery. The primary endpoints were intraoperative volume of HES and time until fully on oral diet...
April 2018: Medicine (Baltimore)
Joana Silva, Luís Gonçalves, Patrícia Pontífice Sousa
BACKGROUND: shock refers to a physiological situation that puts life at risk. Its early identification and the timely institution of therapeutic measures can avoid death. Despite the frequent administration of fluid therapy as a treatment for shock, the type and dose of fluids to be delivered remain undetermined. AIM: to determine the type of fluids to be administered and the type of approach to be performed in the different types of shock. METHOD: integrative literature review...
April 26, 2018: British Journal of Nursing: BJN
Shigenari Matsuyama, Ryusuke Miki, Hirotada Kittaka, Haruki Nakayama, Shota Kikuta, Satoshi Ishihara, Shinichi Nakayama
Aim: In recent years, with the concept of damage control resuscitation, hemostasis and preoperative fluid restriction have been carried out, but there is controversy regarding the effectiveness of fluid restriction. Methods: From April 2007 to March 2013, 101 trauma patients presented with hemorrhagic shock (systolic blood pressure ≤90 mmHg) at the prehospital or emergency department and were admitted to Hyogo Emergency Medical Center (Hyogo, Japan). They underwent emergency hemostasis by surgery and transcatheter arterial embolization...
April 2018: Acute Medicine & Surgery
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
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