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Colloid resuscitation

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https://www.readbyqxmd.com/read/29315469/changes-in-colloid-solution-sales-in-nordic-countries
#1
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...
January 7, 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
#2
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
#3
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
#4
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
#5
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...
December 11, 2017: 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
#6
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)...
December 8, 2017: 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
#7
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...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29099424/colloids-and-the-microcirculation
#8
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...
November 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29079487/what-is-the-preferred-resuscitation-fluid-for-patients-with-severe-sepsis-and-septic-shock
#9
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...
October 24, 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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28988172/haemodynamic-response-to-crystalloids-or-colloids-in-shock-an-exploratory-subgroup-analysis-of-a-randomised-controlled-trial
#14
Nicholas Heming, Souheil Elatrous, Samir Jaber, Anne Sylvie Dumenil, Joël Cousson, Xavier Forceville, Antoine Kimmoun, Jean Louis Trouillet, Jérôme Fichet, Nadia Anguel, Michael Darmon, Claude Martin, Sylvie Chevret, Djillali Annane
OBJECTIVE: To compare the haemodynamic effect of crystalloids and colloids during acute severe hypovolaemic shock. DESIGN: Exploratory subgroup analysis of a multicentre randomised controlled trial (Colloids Versus Crystalloids for the Resuscitation of the Critically Ill, CRISTAL, ClinicalTrials.gov NCT00318942). SETTING: CRISTAL was conducted in intensive care units in Europe, North Africa and Canada. PARTICIPANTS: Current analysis included all patients who had a pulmonary artery catheter in place at randomisation...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28929101/current-trends-in-volume-replacement-therapy-and-the-use-of-synthetic-colloids-in-small-animals-an-internet-based-survey-2016
#15
Ivayla D Yozova, Judith Howard, Nadja E Sigrist, Katja-Nicole Adamik
The use of synthetic colloids (SCs), particularly hydroxyethyl starch (HES), in people has changed in recent years following new evidence raising concerns about their efficacy and safety. Although fluid therapy guidelines for small animals are often extrapolated from human medicine, little information exists on current practice in veterinary medicine. The objective of the present study was to investigate current fluid selection, use of plasma volume expanders including SCs, and recent changes in their use in small animal practice...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28884212/routine-sildenafil-does-not-improve-clinical-outcomes-after-fontan-operation
#16
J Leslie Gaddis Collins, Mark A Law, Santiago Borasino, W Clinton Erwin, David C Cleveland, Jeffrey A Alten
Fontan operation can be complicated by persistent chest tube output (CTO) leading to prolonged hospital length of stay (LOS). Postoperative sildenafil administration has been shown to improve clinical outcomes in selected patients after Fontan. We initiated a practice change utilizing intravenous (IV) sildenafil in early postoperative period in all patients undergoing Fontan operation with aim to decrease LOS and CTO. Nineteen patients (February 2014-May 2016) received 0.35 mg/kg sildenafil IV (three doses) followed by enteral, 1 mg/kg every eight hours until hospital discharge...
December 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28834855/choice-of-fluids-for-resuscitation-of-the-critically-ill-what-nurses-need-to-know
#17
Whitney Gross, Michael Samarin, Lauren A Kimmons
Fluid administration is one of the most universal interventions in the intensive care unit; however, there remains a lack of optimal fluid choice in clinical practice. With increasing evidence suggesting that the choice and dose of fluid may influence patient outcomes, it is important to have an understanding of the differences between the various fluid products and these potential effects in order for nurses to navigate the critically ill patient. This article reviews properties, adverse effects, and monitoring of commonly used colloid and crystalloid fluids, providing information that may aid in fluid selection in the intensive care unit...
October 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28814247/fluid-and-medication-considerations-in-the-traumatized-patient
#18
Amita Misir
This article reviews fluid therapy and medications in pediatric trauma. For resuscitation in the setting of hemorrhagic shock, isotonic crystalloid solution is the first-line agent of choice. Colloid solutions offer no additional benefit, introduce possible increased risks and cost more than crystalloids. Blood products, starting with pRBCs, should be introduced after 20-40 ml/kg of crystalloid has been administered if there is ongoing need for volume replacement. The use of a massive transfusion protocol of 1:1:1 (if >30 kg) or 30:20:20 (if <30 kg) of pRBCs:FFP:platelets is suggested after an initial 30 ml/kg of pRBcs have been administered...
August 14, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28790176/impaired-liver-regeneration-after-hepatectomy-and-bleeding-is-associated-with-a-shift-from-hepatocyte-proliferation-to-hypertrophy
#19
Idit Matot, Nathalie Nachmansson, Omri Duev, Susanne Schulz, Katrin Schroeder-Stein, Stilla Frede, Rinat Abramovitch
Extensive liver resections are common, and bleeding is frequent in these operations. Impaired regeneration after partial hepatectomy (PHx) may contribute to liver failure. We thus assessed the impact of acute bleeding on the liver regeneration progress after PHx and explored possible contributing molecular mechanisms. In rats, the regeneration progress was delayed and attenuated with PHx and bleeding and was not restored with colloid resuscitation. Livers restored their initial volume by postoperative day (POD) 2 after PHx through hepatocyte proliferation vs...
August 8, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/28742231/different-resuscitation-strategies-and-novel-pharmacologic-treatment-with-valproic-acid-in-traumatic-brain-injury
#20
REVIEW
Simone E Dekker, Vahagn C Nikolian, Martin Sillesen, Ted Bambakidis, Patrick Schober, Hasan B Alam
Traumatic brain injury (TBI) is a leading cause of death in young adults, and effective treatment strategies have the potential to save many lives. TBI results in coagulopathy, endothelial dysfunction, inflammation, cell death, and impaired epigenetic homeostasis, ultimately leading to morbidity and/or mortality. Commonly used resuscitation fluids such as crystalloids or colloids have several disadvantages and might even be harmful when administered in large quantities. There is a need for next-generation treatment strategies (especially in the prehospital setting) that minimize cellular damage, improve survival, and enhance neurological recovery...
July 25, 2017: Journal of Neuroscience Research
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