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Colloid v crystalloid

Seung Hyun Lee, Eun-Hye Seo, Hyun Jun Park, Chung-Sik Oh, Cho Long Kim, Sewon Park, Seong-Hyop Kim
This study assessed the effects of crystalloid versus synthetic colloid in vitro on immune cells co-cultured with mouse splenocytes. Mouse splenocytes were co-cultured with three different types of fluid: Plasma solution-A® (CJ HealthCare, Seoul, Korea; the crystalloid group); Tetraspan 6%® (B. Braun Medical, Melsungen, Germany; the Colloid-T group); and Volulyte 6%® (Fresenius Kabi, Bad Homburg vor dér-Höhe, Germany; Colloid-V group). To evaluate the acquired immune response, cluster of differentiation (CD) 4+ T cells and CD8+ T cells were measured...
March 19, 2018: Scientific Reports
N MacDonald, R M Pearse
The approach to i.v. fluid therapy for hypovolaemia may significantly influence outcomes for patients who experience a systemic inflammatory response after sepsis, trauma, or major surgery. Currently, there is no single i.v. fluid agent that meets all the criteria for the ideal treatment for hypovolaemia. The physician must choose the best available agent(s) for each patient, and then decide when and how much to administer. Findings from large randomized trials suggest that some colloid-based fluids, particularly starch-based colloids, may be harmful in some situations, but it is unclear whether they should be withdrawn from use completely...
December 1, 2017: British Journal of Anaesthesia
Tara T T Tran, Anthony Pease, Anna J Wood, Jeffrey D Zajac, Johan Mårtensson, Rinaldo Bellomo, Elif I I Ekinci
BACKGROUND: Diabetic ketoacidosis (DKA) is an endocrine emergency with associated risk of morbidity and mortality. Despite this, DKA management lacks strong evidence due to the absence of large randomised controlled trials (RCTs). OBJECTIVE: To review existing studies investigating inpatient DKA management in adults, focusing on intravenous (IV) fluids; insulin administration; potassium, bicarbonate, and phosphate replacement; and DKA management protocols and impact of DKA resolution rates on outcomes...
2017: Frontiers in Endocrinology
T I Eiben, V Fuhrmann, B Saugel, S Kluge
Bleeding associated with hemorrhagic shock is often seen in emergency medical services or in the intensive care unit. Identifying the origin of the bleeding and additional disorders helps to determine the degree of the hemorrhagic shock. In order to be effective, the initial therapy until blood products are available needs to be differentiated to be effective in terms of hemodynamic stabilization and coagulation. Crystalloidal and colloidal solutions should be used carefully since those solutions bear a risk within themselves...
March 2017: Der Internist
K V Pshenisnov, Yu S Aleksandrovich, P I Mironov, Yu V Suhanov, O V Kuzmin, S A Blinov, A N Kondin
BACKGROUND: Fluid and transfusion therapy is proved to be a required component of treating children with severe major trauma significantly influencing the case outcome. OBJECTIVE: To analyze efficiency of fluid and transfusion therapy in children with severe major trauma and assess its correspondence with current recommendations. MATERIALS AND METHODS: 150 children aged from 0 to 18 years getting treatment in intensive care units of children's city hospitals of Saint Petersburg, Archangelsk, Ufa, Samara, and Leningrad region were included in the research...
January 2016: Anesteziologiia i Reanimatologiia
Christian D Taeger, Oliver Friedrich, Caroline Drechsler, Annika Weigand, Frieder Hobe, Carol I Geppert, Frank Münch, Torsten Birkholz, Rainer Buchholz, Raymund E Horch, Konstantin Präbst
In the field of free flap transfer in reconstructive surgery, the trans- or replanted tissue always undergoes cell damage during ischemia to a more or less strong extent. In previous studies we already showed that conserving muscle transplants by means of extracorporeal perfusion over a period of 6 hours by using a crystalloid solution for perfusion. However, we observed significant edema formation. In this study we aimed at reducing the edema formation by using an iso-oncotic colloid as perfusion solution...
November 4, 2016: Clinical Hemorheology and Microcirculation
J Skytte Larsson, G Bragadottir, V Krumbholz, B Redfors, J Sellgren, S E Ricksten
BACKGROUND: In the present randomized study, we evaluated the differential effects of a colloid and a crystalloid fluid on renal oxygen delivery (RD(O2)), glomerular filtration (GFR), renal oxygen consumption ((RV(O2))), and the renal oxygen supply-demand relationship (i.e., renal oxygenation) after cardiac surgery with cardiopulmonary bypass. METHODS: Thirty patients with normal preoperative renal function, undergoing uncomplicated cardiac surgery, were studied in the intensive care unit in the early postoperative period...
November 2015: British Journal of Anaesthesia
M Basora, M J Colomina, V Moral, M S Asuero de Lis, E Boix, J L Jover, J V Llau, M P Rodrigo, J Ripollés, J M Calvo Vecino
The present Clinical practice guide responds to the clinical questions about security in the choice of fluid (crystalloid, colloid or hydroxyethyl starch 130) in patients who require volume replacement during perioperative period of non-cardiac surgeries. From the evidence summary, recommendations were made following the GRADE methodology. In this population fluid therapy based on crystalloids is suggested (weak recommendation, low quality evidence). In the events where volume replacement is not reached with crystalloids, the use of synthetic colloids (hydroxyethyl starch 130 or modified fluid gelatin) is suggested instead of 5% albumin (weak recommendation, low quality evidence)...
January 2016: Revista Española de Anestesiología y Reanimación
Byung Moon Choi, Myung Hwan Karm, Kyeo Woon Jung, Young Goo Yeo, Kyu Taek Choi
BACKGROUND: In a previous study, fluid kinetic models were applied to describe the volume expansion of the fluid space by administration of crystalloid and colloid solutions. However, validation of the models were not performed, it is necessary to evaluate the predictive performance of these models in another population. METHODS: Ninety five consenting patients undergoing elective spinal surgery under general anesthesia were enrolled in this study. These patients were randomly assigned to three fluid groups i...
April 2015: Korean Journal of Anesthesiology
O Vassal, J-M Bonnet, A Barthelemy, B Allaouchiche, I Goy-Thollot, V Louzier, C Paquet, J-Y Ayoub, O Dauwalder, M Jacquet-Lagrèze, S Junot
BACKGROUND: Acute kidney injury (AKI) is common in sepsis. Treatments allowing maintenance of renal blood flow (RBF) could help to prevent AKI associated with renal hypoperfusion. Amino acids (AA) have been associated with an increase of RBF and glomerular filtration rate (GFR) in several species. The aim of this study was to evaluate the effects of an AA infusion on RBF and GFR in a porcine model of septic shock. METHODS: A total of 17 piglets were randomly assigned into three groups: Sham (Sham, n = 5), sepsis without AA (S-NAA, n = 6), sepsis treated with AA (S-AA, n = 6)...
May 2015: Acta Anaesthesiologica Scandinavica
V Gauthier, M K Holowaychuk, C L Kerr, A M E Bersenas, R Darren Wood
BACKGROUND: Synthetic colloids are often used during fluid resuscitation and affect coagulation. OBJECTIVE: To compare the effects of an isotonic crystalloid and synthetic colloid on coagulation in healthy dogs and dogs with systemic inflammation. ANIMALS: Sixteen adult purpose-bred Beagles. METHODS: Randomized, placebo-controlled, blinded study. Dogs were randomized into one of two groups receiving fluid resuscitation with either 40 mL/kg IV 0...
January 2015: Journal of Veterinary Internal Medicine
V Trichur Ramakrishnan, Srihari Cattamanchi
Resuscitation of a severely traumatised patient with the administration of crystalloids, or colloids along with blood products is a common transfusion practice in trauma patients. The determination of this review article is to update on current transfusion practices in trauma. A search of PubMed, Google Scholar, and bibliographies of published studies were conducted using a combination of key-words. Recent articles addressing the transfusion practises in trauma from 2000 to 2014 were identified and reviewed...
September 2014: Indian Journal of Anaesthesia
K Raghunathan, P T Murray, W S Beattie, D N Lobo, J Myburgh, R Sladen, J A Kellum, M G Mythen, A D Shaw
Fluid management during critical illness is a dynamic process that may be conceptualized as occurring in four phases: rescue, optimization, stabilization, and de-escalation (mobilization). The selection and administration of resuscitation fluids is one component of this complex physiological sequence directed at restoring depleted intravascular volume. Presently, the selection of i.v. fluid is usually dictated more by local practice patterns than by evidence. The debate on fluid choice has primarily focused on evaluating outcome differences between 'crystalloids vs colloids'...
November 2014: British Journal of Anaesthesia
Martin D Zielinski, Donald Jenkins, Bryan A Cotton, Kenji Inaba, Gary Vercruysse, Raul Coimbra, Carlos V R Brown, Darrell E R Alley, Joseph DuBose, Thomas M Scalea
BACKGROUND: Severely injured patients undergoing damage-control laparotomy (DCL) have multiple risk factors for adult respiratory distress syndrome (ARDS), making it challenging to differentiate the contributions of individual causative factors. We aimed to determine the relative contributions of ARDS risk factors. METHODS: Analysis of the prospectively collected American Association for the Surgery of Trauma Multi-institutional Open Abdomen Database was performed...
December 2014: Journal of Trauma and Acute Care Surgery
Stefanie Voigtsberger, Martin Urner, Melanie Hasler, Birgit Roth Z'Graggen, Christa Booy, Donat R Spahn, Beatrice Beck-Schimmer
The use of hydroxyethyl starch (HES) in sepsis has been shown to increase mortality and acute kidney injury. However, the knowledge of the exact mechanism by which several fluids, especially starch preparations may impair end-organ function particularly in the kidney, is still missing. The aim of this study was to measure the influence of different crystalloid and colloid fluid compositions on the inflammatory response in the kidney, the liver and the lung using a rodent model of acute endotoxemia. Rats were anesthetized and mechanically ventilated...
2014: PloS One
Holger Krebbel, Aarne Feldheiser, Olga Müller, Willehad Boemke, Michael Sander, Carsten Perka, Klaus-Dieter Wernecke, Claudia Spies
OBJECTIVE: To investigate changes in standard base excess (SBE) when administering two different infusion regimens for elective hip replacement within a goal-directed haemodynamic algorithm. METHODS: This prospective, double-blind, randomized, controlled study enrolled patients scheduled for primary hip replacement surgery, who were randomized to receive either an unbalanced crystalloid (chloride: 155.5 mmol/l) or a 1 : 1 mixture of a balanced crystalloid and a balanced colloid (6% w/v hydroxyethyl starch 130/0...
April 2014: Journal of International Medical Research
O I Datsiuk, V O Shapryns'kyĭ, I P Shlapak
The possibility of intraarterial access for infusion in patients with severe acute pancreatitis (AP) (initial severity score using the APACHE II assessment scale 16 points) is discussed. The results of the intraarterial crystalloid and colloid solutions infusion and its influence into the state of systemic hemodynamic in patients with organ dysfunction are demonstrated. Positive influence of the proposed method for recovering of central hemodynamic parameters in patients with cardiac and/or respiratory dysfunction and the outcome of early phases of AP were ascertained...
September 2013: Klinichna Khirurhiia
C Rosenthal, J Rau, T Volk, M Sander, S Ziemer, C Von Heymann
BACKGROUND: Volume substitution using colloids and crystalloids dose-dependently induces dilutional coagulopathy. For treatment, fibrinogen concentrate and fresh frozen plasma are options, though the effective dosage of either agent is unclear. The objective of this study was to evaluate, whether high-dose fibrinogen or recommended doses of fresh frozen plasma are equally effective in reversing profound dilutional coagulopathy in vitro. METHODS: Blood samples of ten healthy volunteers were diluted by 60% with normal saline, balanced 4% gelatin, or balanced 6% hydroxyethyl starch 130/0...
August 2014: Minerva Anestesiologica
D R A Yates, S J Davies, H E Milner, R J T Wilson
BACKGROUND: Goal-directed fluid therapy has been shown to improve outcomes after colorectal surgery, but the optimal type of i.v. fluid to use is yet to be established. Theoretical advantages of using hydroxyethyl starch (HES) for goal-directed therapy include a reduction in the total volume of fluid required, resulting in less tissue oedema. Recent work has demonstrated that new generations of HES have a good safety profile, but their routine use in the perioperative setting has not been demonstrated to confer outcome benefit...
February 2014: British Journal of Anaesthesia
Karthik Raghunathan, Andrew D Shaw, Sean M Bagshaw
PURPOSE OF REVIEW: We discuss the formulation of a prescription for intravenous (i.v.) fluid therapy (a 'volume prescription') for critically ill patients: pros/cons of different fluid types; accurate dosing; and qualitative and quantitative toxicities. Updated physiologic concepts are invoked and results of recent major clinical trials on i.v. fluid therapy in the acutely ill are interpreted. RECENT FINDINGS: Context is vital and any fluid can be harmful if dosed incorrectly...
August 2013: Current Opinion in Critical Care
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