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Colloid resuscitation

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https://www.readbyqxmd.com/read/28275202/low-volume-resuscitation-for-hemorrhagic-shock-understanding-the-mechanism-of-peg-20k
#1
Valerie Plant, Dan Parrish, Ashley Limkemann, Paula Ferrada, Michel Aboutanos, Martin J Mangino
Hemorrhagic shock leads to cell and tissue swelling and no reflow from compressed capillaries. Cell impermeants, including polyethylene glycol-20,000 (PEG-20k), reverse ischemia-induced cell swelling, extend low volume resuscitation (LVR) time after shock, and increase tolerance to the low volume state. The purpose of this study was to explore the mechanisms of action of PEG-20k containing LVR solutions. We hypothesized that PEG-20k acts as both an oncotic agent and an impermeant in the microcirculation, which moves water out of the extracellular space and into the capillaries to affect peripheral capillary filling and enhanced perfusion during the low volume state...
March 8, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28257392/prehospital-hypertonic-fluid-resuscitation-for-trauma-patients-a-systematic-review-and-meta-analysis
#2
Claire de Crescenzo, Farzam Gorouhi, Edgardo S Salcedo, Joseph M Galante
BACKGROUND: Prehospital assessment of a patient's circulation status and appropriate resuscitation with intravenous fluids plays a critical role in patients with obvious hemorrhage or systolic blood pressure below 90 mmHg. OBJECTIVES: We assessed the efficacy and safety of prehospital administration of crystalloids, or colloids to improve the survival rate of trauma patients with acceptable safety profile. DATA SOURCES: We searched SCOPUS, Embase, TRIP database, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and PubMed as per search protocol from 1 January 1900 to 12 February 2015...
March 2, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28243006/audit-of-preoperative-fluid-resuscitation-in-perforation-peritonitis-patients-using-physiological-and-operative-severity-score-for-enumeration-of-mortality-and-morbidity
#3
Sunil Kumar
CONTEXT: Debate continues regarding fluid (crystalloid vs. colloid) of choice for resuscitation. Physiological and Operative Severity Score for enUmeration of Mortality and Morbidity (POSSUM) may be used to compare the benefits of preoperative fluid resuscitation with crystalloids and colloids in peritonitis patients. AIMS: The aim of this study is to compare crystalloid and colloid for preoperative resuscitation using morbidity, mortality, length of hospital stay (LOS), and time taken to resuscitate as the outcome parameters...
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28239944/pancreatoduodenectomy-and-the-risk-of-complications-from-perioperative-fluid-administration
#4
Preetjote Gill, Terence C Chua, Yeqian Huang, Shreya Mehta, Anubhav Mittal, Anthony J Gill, Jaswinder S Samra
BACKGROUND: The dogma of administering sufficient intravenous fluids aggressively to avoid under-resuscitation has recently been challenged. Evidence suggests that excessive perioperative fluid administration may be associated with negative clinical outcomes in gastrointestinal surgery. This study examines the impact of fluid administration on perioperative outcomes in patients undergoing pancreatoduodenectomy (PD). METHODS: A retrospective analysis of 202 patients undergoing PD between January 2004 and August 2015 was performed...
February 27, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28149246/acute-kidney-injury-in-critically-burned-patients-resuscitated-with-a-protocol-that-includes-low-doses-of-hydroxyethyl-starch
#5
M Sánchez-Sánchez, A Garcia-de-Lorenzo, L Cachafeiro, E Herrero, M J Asensio, A Agrifoglio, E Flores, B Estebanez, P Extremera, C Iglesias, J R Martinez
Acute kidney injury (AKI) is an important complication in burn patients. Recently, it has been recommended that hydroxyethyl starch (HES) be avoided in burn patients because it increases the incidence of AKI. Our purpose was to study incidence of AKI in critically ill burn patients resuscitated with Ringer's solution and supplements of HES. We conducted an observational study of 165 patients admitted to the critical care burn unit (with 30 ± 15% TBSA burned). The main outcome measures were incidence of AKI, contributions of colloids and crystalloids, various severity scores, comorbidities, complications and mortality...
September 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28149031/thoughts-on-the-current-management-of-acute-aluminum-phosphide-toxicity-and-proposals-for-therapy-an-evidence-based-review
#6
REVIEW
Maryam Vasheghani Farahani, Davood Soroosh, Sayed Mahdi Marashi
The majority of aluminum phosphide (ALP) toxicity cases are suicidal attempts. Despite advances in critical care medicine, the mortality rate of ALP remains very high. Unfortunately, knowledge on the toxicokinetics of ALP is very low. An obsolete idea was proposed that inhibition of complex IV of cytochrome C oxidase is responsible for multiorgan dysfunction. However, based on human studies, this effect might be insignificant. Thus, a novel idea proposes that the main mechanism might be vascular wall integrity disruption...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27894390/-effects-of-different-fluid-resuscitation-program-on-renal-function-in-swine-during-shock-stage-of-severe-burn
#7
G L Su, W X Huang, J Chen, D J Xue, J J Zhou
Objective: To explore the effects of different fluid resuscitation program on renal function in swine during shock stage of severe burn. Methods: Twenty-four Guangxi Bama miniature swine were inflicted with 40% total body surface area on the back, and then they were divided into four groups according to the random number table, with 6 swine in each group. At post injury hour (PIH) 2, swine in succinylated gelatin group (S), hydroxyethyl starch group (H), and allogeneic plasma group (A) were respectively resuscitated with succinylated gelatin, hydroxyethyl starch 130/0...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27848268/use-of-intravenous-fluids-solutions-a-narrative-review
#8
N El Gkotmi, C Kosmeri, T D Filippatos, M S Elisaf
OBJECTIVE: Intravenous fluids are broadly categorized into colloids and crystalloids. The aim of this review is to present under a clinical point of view the characteristics of intravenous fluids that make them more or less appropriate either for maintaining hydration when enteral intake is contraindicated or for treating hypovolemia. METHODS: We considered randomized trials and meta-analyses as well as narrative reviews evaluating the effects of colloids or crystalloids in patients with hypovolemia or as maintenance fluids published in the PubMed and Cochrane databases...
March 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27779578/does-small-volume-resuscitation-with-crystalloids-or-colloids-influence-hemostasis-and-survival-of-rabbits-subjected-to-lethal-uncontrolled-hemorrhage
#9
Bijan Shams Kheirabadi, Nahir Miranda, Irasema B Terrazas, Mary D Gonzales, Rose C Grimm, Michael A Dubick
BACKGROUND: Prehospital, small-volume resuscitation of combat casualties with a synthetic colloid (6% hydroxyethyl starch [HES] 670/0.75) has been recommended when blood or blood components are unavailable. We studied hemostatic effects of a newer synthetic colloid (6% HES, 130/0.4) compared with either a natural colloid (albumin) or to crystalloids in an uncontrolled hemorrhage model. METHODS: Spontaneously breathing New Zealand white rabbits (3.4 ± 0.1 kg) were anesthetized, instrumented, and subjected to a splenic injury with uncontrolled bleeding...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27779350/adrenal-insufficiency-in-neonates-after-cardiac-surgery-with-cardiopulmonary-bypass
#10
Jack H Crawford, Matthew S Hull, Santiago Borasino, Brad L Steenwyk, Kristal M Hock, Kevin Wall, Jeffrey A Alten
BACKGROUND: Cardiopulmonary bypass (CPB) may lead to adrenal insufficiency (AI). Emerging evidence supports association of AI with morbidity after cardiac surgery. AIMS: The aim of this study was to define AI incidence in neonates undergoing complex cardiac surgery with CPB and its association with intraoperative post-CPB outcomes. METHODS: Forty subjects enrolled in a prior randomized control trial who received preoperative methylprednisolone as part of our institutional neonatal bypass protocol were included...
January 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27767972/erythrocyte-interactions-comparison-of%C3%A2-the%C3%A2-aggregation-power-of-polymer-molecules-used-in-medicine-not-only-size%C3%A2-does-matter
#11
S Jovtchev, S Alexandrov, N Hristova-Avakumova, S Miteva, L Traikov, D Gerasimova, S Stoeff
BACKGROUND: Different colloids are used as a part of solutions for fluid resuscitation and organ preservation: hydroxyethyl starches (HES), dextran (Dx), polyethylene glycols (PEG), polyvinyl pyrrolidone (PVP). Some of the problems associated with their application are addressed to alteration in erythrocyte (ERY) rheology. OBJECTIVE: We intended to estimate in vitro and compare the aggregation power (AP) of these molecules related to ERY interactions. METHODS: Washed human ERY are used during the study...
2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27738483/comparison-of-the-effectiveness-of-hydroxyethyl-starch-voluven-solution-with-normal-saline-in-hemorrhagic-shock-treatment-in-trauma
#12
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
https://www.readbyqxmd.com/read/27737718/resuscitation-with-polymeric-plasma-substitutes-is-permissive-for-systemic-inflammatory-response-syndrome-and-sepsis-in-multiply-injured-patients-a-retrospective-cohort-study
#13
Kai Sprengel, Hanspeter Simmen, Clément M L Werner, Simon Sulser, Michael Plecko, Catharina Keller, Ladislav Mica
OBJECTIVE: Multiple trauma is often accompanied by systemic inflammatory response syndrome (SIRS). The aim of this study was to investigate the impact of polymeric plasma substitutes on the development of SIRS or sepsis. METHODS: We included 2969 patients aged ≥16 years with an Injury Severity Score (ISS) >16 in this study. The sample was subdivided into three groups: patients who did not receive colloids and those who received <5L colloids and >5L colloids within the first 48 h...
October 13, 2016: European Journal of Medical Research
https://www.readbyqxmd.com/read/27715338/n-acetylcysteine-and-desferoxamine-reduce-pulmonary-oxidative-stress-caused-by-hemorrhagic-shock-in-a-porcine-model
#14
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
https://www.readbyqxmd.com/read/27665246/in-view-of-standardization-part-2-management-of-challenges-in-the-initial-treatment-of-burn-patients-in-burn-centers-in-germany-austria-and-switzerland
#15
Benjamin Ziegler, Christoph Hirche, Johannes Horter, Jurij Kiefer, Paul Alfred Grützner, Thomas Kremer, Ulrich Kneser, Matthias Münzberg
INTRODUCTION: Initial therapy of severe burns in specialized burn trauma centers is a challenging task faced by the treating multi-professional and interdisciplinary team. A lack of consistent operating procedures and varying structural conditions was recently demonstrated in preliminary data of our group. These results raised the question on how specific treatment measures in acute burn care are met in the absence of standardized guidelines. MATERIAL AND METHODS: A specific questionnaire containing 57 multiple-choice questions was sent to all 22 major burn centers in Germany, Austria and Switzerland...
March 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27636739/an-investigation-into-the-effects-of-in-vitro-dilution-with-different-colloid-resuscitation-fluids-on-clot-microstructure-formation
#16
Matthew James Lawrence, Nick Marsden, Jakub Kaczynski, Gareth Davies, Nia Davies, Karl Hawkins, Sounder Perumal, Martin Rowan Brown, Keith Morris, Simon J Davidson, Phylip Rhodri Williams, Phillip Adrian Evans
BACKGROUND: Balancing the beneficial effects of resuscitation fluids against their detrimental effect on hemostasis is an important clinical issue. We aim to compare the in vitro effects of 3 different colloid resuscitation fluids (4.5% albumin, hydroxyethyl starch [Voluven 6%], and gelatin [Geloplasma]) on clot microstructure formation using a novel viscoelastic technique, the gel point. This novel hemorheologic technique measures the biophysical properties of the clot and provides an assessment of clot microstructure from its viscoelastic properties...
September 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27626366/resuscitation-with-pooled-and-pathogen-reduced-plasma-attenuates-the-increase-in-brain-water-content-following-traumatic-brain-injury-and-hemorrhagic-shock-in-rats
#17
Gustav Folmer Genét, Peter Bentzer, Sisse Rye Ostrowski, Pär Ingemar Johansson
Traumatic brain injury and hemorrhagic shock is associated with blood-brain barrier (BBB) breakdown and edema formation. Recent animal studies have shown that fresh frozen plasma (FFP) resuscitation reduces brain swelling and improves endothelial function compared to isotonic NaCl (NS). The aim of this study was to investigate whether pooled and pathogen-reduced plasma (OctaplasLG(®) [OCTA]; Octapharma, Stockholm, Sweden) was comparable to FFP with regard to effects on brain water content, BBB permeability, and plasma biomarkers of endothelial glycocalyx shedding and cell damage...
March 1, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27600130/fluid-creep-and-over-resuscitation
#18
REVIEW
Jeffrey R Saffle
Fluid creep is the term applied to a burn resuscitation, which requires more fluid than predicted by standard formulas. Fluid creep is common today and is linked to several serious edema-related complications. Increased fluid requirements may accompany the appropriate resuscitation of massive injuries but dangerous fluid creep is also caused by overly permissive fluid infusion and the lack of colloid supplementation. Several strategies for recognizing and treating fluid creep are presented.
October 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27600123/colloids-in-acute-burn-resuscitation
#19
REVIEW
Robert Cartotto, David Greenhalgh
Colloids have been used in varying capacities throughout the history of formula-based burn resuscitation. There is sound experimental evidence that demonstrates colloids' ability to improve intravascular colloid osmotic pressure, expand intravascular volume, reduce resuscitation requirements, and limit edema in unburned tissue following a major burn. Fresh frozen plasma appears to be a useful and effective immediate burn resuscitation fluid but its benefits must be weighed against its costs, and risks of viral transmission and acute lung injury...
October 2016: Critical Care Clinics
https://www.readbyqxmd.com/read/27578311/successful-management-of-intraoperative-acute-bilateral-pulmonary-embolism-in-a-high-grade-astrocytoma-patient
#20
Wail N Khraise, Mohammed Z Allouh, Mohammad Y Hiasat, Raed S Said
BACKGROUND Intraoperative pulmonary embolism (PE) is a rare life-threatening complication in patients undergoing surgical intervention. Generally, cancer patients have a higher risk for developing this complication. Unfortunately, there is no standard procedure for its management. CASE REPORT We report the case of a 39-year-old woman with high-grade glioma in the right frontal lobe who was admitted to the surgical theater for craniotomy and excision of the tumor. During the general anesthesia procedure and just before inserting the central venous line, her end-tidal CO2 and O2 saturation dropped sharply...
August 31, 2016: American Journal of Case Reports
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