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https://www.readbyqxmd.com/read/29745494/understanding-fluid-homoeostasis-in-infants-and-children-part-2
#1
Doreen Crawford
Part two of this article focuses on the care and management of infants and children who are seriously ill and who have lost so much fluid that they have entered a state of shock. The pathophysiology of shock is reviewed and the types and stages of shock are considered. The challenges of identifying shock are explored and the management of fluid resuscitation with colloids rather than crystalloids is analysed. An overview of the complex management of a young person in shock is provided using a case history format...
May 10, 2018: Nursing Children and Young People
https://www.readbyqxmd.com/read/29721496/the-role-of-plasma-transfusion-in-massive-bleeding-protecting-the-endothelial-glycocalyx
#2
REVIEW
Stefano Barelli, Lorenzo Alberio
Massive hemorrhage is a leading cause of death worldwide. During the last decade several retrospective and some prospective clinical studies have suggested a beneficial effect of early plasma-based resuscitation on survival in trauma patients. The underlying mechanisms are unknown but appear to involve the ability of plasma to preserve the endothelial glycocalyx. In this mini-review, we summarize current knowledge on glycocalyx structure and function, and present data describing the impact of hemorrhagic shock and resuscitation fluids on glycocalyx...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29685796/fluids-and-organ-dysfunction-a-narrative-review-of-the-literature-and-discussion-of-5-controversial-topics
#3
Adam J Kingeter, Meredith A Kingeter, Andrew D Shaw
Evidence-based clinical decision making is at the forefront of modern cardiothoracic anesthesia practice. Therefore, as a field, cardiac anesthesiologist should strive to ensure that the available evidence is of the highest possible quality. In this narrative review, 5 important topics that the authors believe require additional investigation in cardiothoracic anesthesia and critical care related to fluid therapy and organ dysfunction are outlined briefly. In particular, the authors believe that the areas of pulmonary artery catheter use, restrictive versus liberal transfusion strategies, cardiopulmonary bypass prime composition, colloid use in resuscitation and its effects on acute kidney injury, and management of acute kidney injury after cardiac surgery hold many unanswered questions and opportunities for continued improvement in the specialty of cardiac anesthesia...
March 13, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29514510/inaction-over-retractions-of-identified-fraudulent-publications-ongoing-weakness-in-the-system-of-scientific-self-correction
#4
Christian J Wiedermann
Published articles may be retracted when their findings are no longer considered reliable due to honest error, publication misconduct, or research misconduct. This article focuses on the case of a single serial violator of research and publication ethics in anesthesiology and critical care, which is widely publicized. A chain of events led to detection of misconduct that had substantial impact on the evidence base for the safety of hydroxyethyl starch, an intravenous artificial colloid solution, which is reflected in current guidelines on fluid management and volume resuscitation...
2018: Accountability in Research
https://www.readbyqxmd.com/read/29482906/applied-physiology-of-fluid-resuscitation-in-critical-illness
#5
REVIEW
Sabrina Arshed, Michael R Pinsky
Fluids during resuscitation from shock increase mean systemic pressure and venous return. The pressure gradient for venous return must increase. Mean systemic pressure is the amount of vascular space in unstressed and stressed volume, mostly unstressed. Shock states can decrease mean systemic pressure by increasing unstressed volume, decreasing total blood volume, or decreasing the pressure gradient for venous return. Crystalloids across bodily spaces restore normal volume, whereas colloids remain in the intravascular space...
April 2018: Critical Care Clinics
https://www.readbyqxmd.com/read/29430670/the-effect-of-3-resuscitative-fluid-therapies-on-hemostasis-as-measured-by-rotational-thromboelastometry-in-dogs
#6
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...
March 2018: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/29374921/-effects-of-cardiac-support-on-delayed-resuscitation-in-extensively-burned-patients-with-shock
#7
R Xiao, Y S Huang, G A Lin, S A Yuan, D S Hu
Objective: To explore the effects of cardiac support on delayed resuscitation in extensively burned patients with shock. Methods: Clinical data of 62 extensively burned patients with shock on admission, admitted to the 159th Hospital of PLA (hereinafter referred to as our hospital) from January 2012 to January 2017, were retrospectively analyzed. They were divided into cardiac support group ( n =35) and control group ( n =27) according to the use of deslanoside and ulinastatin. All patients were treated with routine fluid resuscitation based on the formula of the Third Military Medical University till post injury hour (PIH) 48...
January 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29315469/changes-in-colloid-solution-sales-in-nordic-countries
#8
U E Kongsgaard, A Holtan, A Perner
BACKGROUND: Administration of resuscitation fluid is a common intervention in the treatment of critically ill patients, but the right choice of fluid is still a matter of debate. Changes in medical practice are based on new evidence and guidelines as well as traditions and personal preferences. Official warnings against the use of hydroxyl-ethyl-starch (HES) solutions have been issued. Nordic guidelines have issued several strong recommendations favouring crystalloids over colloids in all patient groups...
April 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29282572/arterioportal-shunting-splanchnic-capillary-perfusion-and-the-effects-of-colloids-during-capnoperitoneum-in-neonatal-and-adolescent-pigs
#9
J F Kuebler, N Schukfeh, G Vieten, W A Osthaus, D Huber, N Dennhard, R Suempelmann, B M Ure, M L Metzelder
BACKGROUND: Clinical and experimental data indicate that neonates are sensitive to the CO2 pneumoperitoneum. An impaired splanchnic perfusion during laparoscopy in adults has been reported. We recently confirmed that intravenous colloids improve macrocirculatory function in neonates. We aimed to determine the impact of CO2 pneumoperitoneum on the perfusion of splanchnic organs in the young including effects of colloid application. METHODS: Male piglets (n = 25) were divided into four groups: (1) neonatal controls, (2) neonates with crystalloid restitution, (3) neonates with colloidal restitution, and (4) adolescents with crystalloid restitution...
December 27, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29261592/whole-blood-and-hextend-bookends-of-modern-tactical-combat-casualty-care-field-resuscitation-and-starting-point-for-multi-functional-resuscitation-fluid-development
#10
Forest R Sheppard, Thomas A Mitchell, Antoni R Macko, Darren M Fryer, Leasha J Schaub, Kassandra M Ozuna, Jacob J Glaser
BACKGROUND: Hemorrhage is the leading cause of preventable death in traumatically injured civilian and military populations. Pre-hospital resuscitation largely relies on crystalloid and colloid intra-vascular expansion, as whole blood and component blood therapy are logistically arduous. In this experiment, we evaluated the bookends of Tactical Combat Casualty Care Guidelines recommendations of pre-hospital resuscitation with Hextend and whole blood in a controlled hemorrhagic shock model within non-human primates, as means of a multi-functional resuscitative fluid development...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29248141/impact-of-volume-status-and-volume-therapy-on-the-kidney
#11
REVIEW
David A Roberts, Andrew D Shaw
Volume resuscitation to correct hypotension in surgical and critically ill patients is a common practice. Available evidence suggests that iatrogenic volume overload is associated with worse outcomes in established acute kidney injury. Intraoperative arterial hypotension is associated with postoperative renal dysfunction, and prompt correction with fluid management protocols that combine inotrope infusions with volume therapy targeted to indices of volume responsiveness should be considered. From the perspective of renal function, the minimum amount of intravenous fluid required to maintain perfusion and oxygen delivery is desirable...
September 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29239953/the-impact-of-prehospital-tranexamic-acid-on-blood-coagulation-in-trauma-patients
#12
Philipp Stein, Jan-Dirk Studt, Roland Albrecht, Stefan Müller, Dieter von Ow, Simon Fischer, Burkhardt Seifert, Sergio Mariotti, Donat R Spahn, Oliver M Theusinger
BACKGROUND: There is limited data on prehospital administration of tranexamic acid (TXA) in civilian trauma. The aim of this study was to evaluate changes in coagulation after severe trauma from on-scene to the hospital after TXA application in comparison to a previous study without TXA. METHODS: The study protocol was registered at ClinicalTrials.gov (NCT02354885). A prospective, multicenter, observational study investigating coagulation status in 70 trauma patients receiving TXA (1 g intravenously) on-scene versus a control group of 38 patients previously published without TXA...
February 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29229195/a-comparison-of-two-different-fluid-resuscitation-management-protocols-for-pediatric-burn-patients-a-retrospective-study
#13
Miao Huang, Jun-Feng Chen, Li-Ying Chen, Li-Qin Pan, Xiao-Jian Li, Jie-Yu Ye, Hui-Yi Tan
OBJECTIVE: Pediatric burn patients are more susceptible to burn shock than adults, and an effective fluid management protocol is critical to successful resuscitation. Our research aim was to investigate the safety and efficacy of two protocols for pediatric burn patients for use within the first 24h. METHODS: A total of 113 pediatric burn patients were enrolled from January 2007 to October 2012. Of those patients, 57 received fluid titration regimens of alternating crystalloids and colloids once within 2h in the first 24h after burn (Group A), whereas the remaining patients received regimens of alternating crystalloids and colloids once within 1h in the first 24h after burn (Group B)...
February 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#14
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte® ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg-1 . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
February 2018: Anaesthesia
https://www.readbyqxmd.com/read/29099424/colloids-and-the-microcirculation
#15
Huaiwu He, Dawei Liu, Can Ince
Colloid solutions have been advocated for use in treating hypovolemia due to their expected effect on improving intravascular retention compared with crystalloid solutions. Because the ultimate desired effect of fluid resuscitation is the improvement of microcirculatory perfusion and tissue oxygenation, it is of interest to study the effects of colloids and crystalloids at the level of microcirculation under conditions of shock and fluid resuscitation, and to explore the potential benefits of using colloids in terms of recruiting the microcirculation under conditions of hypovolemia...
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29079487/what-is-the-preferred-resuscitation-fluid-for-patients-with-severe-sepsis-and-septic-shock
#16
Michael E Winters, Robert Sherwin, Gary M Vilke, Gabriel Wardi
BACKGROUND: Current guidelines for the management of patients with severe sepsis and septic shock recommend crystalloids as the initial fluid solution of choice in the resuscitation of these patients. In recent years, there have been numerous studies published on the type of fluid used in the resuscitation of patients with sepsis. The primary goal of this article is to determine the preferred intravenous fluid for the resuscitation of patients with severe sepsis and septic shock. METHODS: A MEDLINE literature review was completed to identify studies that investigated the type of resuscitation fluid in the management of patients with severe sepsis and septic shock...
December 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29075482/fluid-resuscitation-practices-in-cardiac-surgery-patients-in-the-usa-a-survey-of-health-care-providers
#17
Solomon Aronson, Paul Nisbet, Martin Bunke
BACKGROUND: Fluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA. METHODS: We conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV) fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1) patients undergoing cardiopulmonary bypass (CPB) without bleeding, (2) patients undergoing CPB with bleeding, (3) patients undergoing acute normovolemic hemodilution (ANH), (4) patients requiring extracorporeal membrane oxygenation (ECMO) or use of a ventricular assist device (VAD), and (5) patients undergoing either off-pump coronary artery bypass graft (OPCABG) surgery or transcatheter aortic valve replacement (TAVR)...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/29059118/early-haemorrhage-control-and-management-of-trauma-induced-coagulopathy-the-importance-of-goal-directed-therapy
#18
Jakob Stensballe, Hanne H Henriksen, Pär I Johansson
PURPOSE OF REVIEW: The aim of this study was to discuss the recent developments in trauma-induced coagulopathy and the evolvement of goal-directed therapy. RECENT FINDINGS: Mortality from major trauma continues to be a worldwide problem, and massive haemorrhage remains a major cause in 40% of potentially preventable trauma deaths. Development of trauma-induced coagulopathy challenges 25-35% of the patients further increasing trauma mortality. The pathophysiology of coagulopathy in trauma reflects at least two distinct mechanisms: Acute traumatic coagulopathy, consisting of endogenous heparinization, activation of the protein C pathway, hyperfibrinolysis and platelet dysfunction, and resuscitation associated coagulopathy...
December 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29049137/effects-of-dextran-70-and-albumin-on-coagulation-in-experimental-hemorrhage-in-the-guinea-pig
#19
Ulf Schött, Thomas Kander, Peter Bentzer
BACKGROUND: Dextran-70 is a more potent plasma volume expander than albumin but use has been hampered because of it's antithrombotic properties. However, also albumin has antithrombotic properties and little is known about relative effects of these two colloids on coagulation in-vivo when controlling for differences in efficacy as plasma volume expanders. AIM: Compare effects of dextran-70 and albumin on coagulation at a dose resulting in equal plasma volume expansion...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29035463/effect-of-balanced-crystalloid-gelatin-and-hydroxyethyl-starch-on-coagulation-detected-by-rotational-thromboelastometry-in-vitro
#20
Silvie Sevcikova, Tomas Vymazal, Miroslav Durila
BACKGROUND: Fluid resuscitation with crystalloid and colloid solutions is a common treatment in perioperative medicine. However, a variety of unbalanced or balanced solutions are used in clinical practice and there is still vivid debate going on regarding selection of optimal fluid with minimal negative effect on coagulation to minimize bleeding and blood transfusion requirements. The aim of the study was to investigate adverse effects of balanced crystalloids and colloids on coagulation measured by thromboelastometry in vitro...
October 1, 2017: Clinical Laboratory
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