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Goal directed fluid therapy

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https://www.readbyqxmd.com/read/28632609/unwrapping-an-eras-bundle-goal-directed-fluid-therapy-ileus
#1
Jonathan P Wanderer, James P Rathmell
No abstract text is available yet for this article.
July 2017: Anesthesiology
https://www.readbyqxmd.com/read/28625234/-effect-of-global-end-diastolic-volume-index-guidance-fluid-resuscitation-in-elderly-patients-with-septic-shock
#2
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28616213/postoperative-goal-directed-therapy-and-development-of-acute-kidney-injury-following-major-elective-noncardiac-surgery-post-hoc-analysis-of-pom-o-randomized-controlled-trial
#3
Amour Patel, John R Prowle, Gareth L Ackland
Background: The role of goal-directed therapy (GDT) in preventing creatinine rise following noncardiac surgery is unclear. We performed a post-hoc analysis of a randomized controlled trial to assess the relationship between postoperative optimization of oxygen delivery and development of acute kidney injury (AKI)/creatinine rise following noncardiac surgery. Methods: Patients were randomly assigned immediately postoperatively to receive either fluid and/or dobutamine therapy to maintain/restore their preoperative oxygen delivery, or protocolized standard care (oxygen delivery only recorded)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28605442/perioperative-goal-directed-therapy-with-uncalibrated-pulse-contour-methods-impact-on-fluid-management-and-postoperative-outcome
#4
F Michard, M T Giglio, N Brienza
Previous meta-analyses suggest that perioperative goal-directed therapy (GDT) is useful to decrease postoperative morbidity. Most GDT studies analysed were done with pulmonary artery catheters, oesophageal Doppler and calibrated pulse contour methods. Uncalibrated pulse contour (uPC) techniques are an appealing alternative but their accuracy has been questioned. The effects of GDT on fluid management (volumes and volume variability) remain unclear. We performed a meta-analysis of randomized controlled trials investigating the effects of GDT with uPC methods on postoperative outcome...
June 11, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28602158/effect-of-perioperative-goal-directed-hemodynamic-therapy-on-postoperative-recovery-following-major-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#5
Yanxia Sun, Fang Chai, Chuxiong Pan, Jamie Lee Romeiser, Tong J Gan
BACKGROUND: Goal-directed hemodynamic therapy (GDHT) has been used in the clinical setting for years. However, the evidence for the beneficial effect of GDHT on postoperative recovery remains inconsistent. The aim of this systematic review and meta-analysis was to evaluate the effect of perioperative GDHT in comparison with conventional fluid therapy on postoperative recovery in adults undergoing major abdominal surgery. METHODS: Randomized controlled trials (RCTs) in which researchers evaluated the effect of perioperative use of GDHT on postoperative recovery in comparison with conventional fluid therapy following abdominal surgery in adults (i...
June 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28572520/clinical-management-of-sepsis
#6
S M Lam, A Cw Lau, R Pk Lam, W W Yan
Sepsis is a common cause of hospital admission worldwide and contributes significantly to morbidity and mortality. The definition of sepsis has evolved from the 1991 American College of Chest Physicians/Society of Critical Care Medicine definition based on the criteria of systemic inflammatory response syndrome, to the 2016 Sepsis-3 definition that incorporates the Sequential Organ Failure Assessment score. The landmark trial on protocolised early goal-directed therapy was published in 2001, but three subsequent multicentre randomised controlled trials (ProCESS, ARISE, and ProMISe) in 2014-2015 did not confirm a survival benefit with protocolised care...
June 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28558654/a-pragmatic-multi-center-trial-of-goal-directed-fluid-management-based-on-pulse-pressure-variation-monitoring-during-high-risk-surgery
#7
Luiz Marcelo Sá Malbouisson, João Manoel Silva, Maria José Carvalho Carmona, Marcel Rezende Lopes, Murilo Santucci Assunção, Jorge Luís Dos Santos Valiatti, Claudia Marques Simões, José Otavio Costa Auler
BACKGROUND: Intraoperative fluid therapy guided by mechanical ventilation-induced pulse-pressure variation (PPV) may improve outcomes after major surgery. We tested this hypothesis in a multi-center study. METHODS: The patients were included in two periods: a first control period (control group; n = 147) in which intraoperative fluids were given according to clinical judgment. After a training period, intraoperative fluid management was titrated to maintain PPV < 10% in 109 surgical patients (PPV group)...
May 30, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28500653/blood-transfusion-in-the-surgical-treatment-of-adolescent-idiopathic-scoliosis-a-single-center-experience-of-patient-blood-management-in-210-cases
#8
Søren Ohrt-Nissen, Naeem Bukhari, Casper Dragsted, Martin Gehrchen, Pär I Johansson, Jesper Dirks, Jakob Stensballe, Benny Dahl
BACKGROUND: The surgical treatment of adolescent idiopathic scoliosis can be associated with substantial blood loss, requiring allogeneic red blood cell (RBC) transfusion. This study describes the use of RBC and the effect of a standardized perioperative patient blood management program. STUDY DESIGN AND METHODS: Patients treated with posterior instrumented fusion were consecutively enrolled over a 6-year period. Patient blood management strategies were implemented in 2011, including prophylactic tranexamic acid, intraoperative permissive hypotension, restrictive fluid therapy (including avoidance of synthetic colloids), restrictive RBC trigger according to institutional standardized protocol, the use of cell savage, and goal-directed therapy according to thrombelastography...
May 12, 2017: Transfusion
https://www.readbyqxmd.com/read/28484814/contemporary-approaches-to-perioperative-iv-fluid-therapy
#9
REVIEW
Paul S Myles, Sam Andrews, Jonathan Nicholson, Dileep N Lobo, Monty Mythen
BACKGROUND: Intravenous fluid therapy is required for most surgical patients, but inappropriate regimens are commonly prescribed. The aim of this narrative review was to provide evidence-based guidance on appropriate perioperative fluid management. METHOD: We did a systematic literature search of the literature to identify relevant studies and meta-analyses to develop recommendations. RESULTS: Of 275 retrieved articles, we identified 25 articles to inform this review...
May 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28459732/goal-directed-fluid-therapy-does-not-reduce-primary-postoperative-ileus-after-elective-laparoscopic-colorectal-surgery-a-randomized-controlled-trial
#10
Juan C Gómez-Izquierdo, Alessandro Trainito, David Mirzakandov, Barry L Stein, Sender Liberman, Patrick Charlebois, Nicolò Pecorelli, Liane S Feldman, Franco Carli, Gabriele Baldini
BACKGROUND: Inadequate perioperative fluid therapy impairs gastrointestinal function. Studies primarily evaluating the impact of goal-directed fluid therapy on primary postoperative ileus are missing. The objective of this study was to determine whether goal-directed fluid therapy reduces the incidence of primary postoperative ileus after laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program. METHODS: Randomized patient and assessor-blind controlled trial conducted in adult patients undergoing laparoscopic colorectal surgery within an Enhanced Recovery After Surgery program...
July 2017: Anesthesiology
https://www.readbyqxmd.com/read/28439133/importance-of-pharmacy-involvement-in-the-treatment-of-sepsis
#11
Joseph B Cavanaugh, Jesse B Sullivan, Nicole East, Jessica N Nodzon
Purpose: A review of the impact of pharmacists on appropriate medication selection, timing of administration, and as members of a multidisciplinary sepsis response team. Summary: Early goal-directed therapy (EGDT), currently recommended by the 2013 Surviving Sepsis Campaign guidelines for the management of patients with sepsis, includes the administration of appropriate antibiotics in patients with septic shock within the first hour. Multidisciplinary teams containing pharmacists have been shown to decrease time to antibiotic delivery, time to antibiotic administration, and patient mortality...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28378467/compared-effects-on-cerebral-oxygenation-of-ephedrine-vs-phenylephrine-to-treat-hypotension-during-carotid-endarterectomy
#12
Jugurtha Aliane, Christian Dualé, Nader Guesmi, Charlotte Baud, Eugenio Rosset, Bruno Pereira, Damien Bouvier, Pierre Schoeffler
While both ephedrine and phenylephrine are currently used to treat hypotension occurring during carotid endarterectomy (CEA) under general anaesthesia, phenylephrine may have deleterious effects on the cerebral watershed, due to its exclusively vasoconstrictive action. In this controlled, double-blind randomised trial, we compared the effects of ephedrine and phenylephrine administered in a standardised algorithm to treat the first hypotensive event occurring since induction of anaesthesia until carotid cross-clamping...
April 4, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28377842/goal-directed-fluid-therapy-what-the-mind-does-not-know-the-eye-cannot-see
#13
COMMENT
Joshua A Bloomstone, Randal O Dull, Lais H C Navarro
No abstract text is available yet for this article.
February 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28343684/fluid-therapy-recommendations-for-major-abdominal-surgery-via-rica-recommendations-revisited-part-ii-goal-directed-hemodynamic-therapy-rationale-for-optimising-intravascular-volume
#14
J Ripollés-Melchor, D Chappell, H D Aya, Á Espinosa, M G Mhyten, A Abad-Gurumeta, S D Bergese, R Casans-Francés, J M Calvo-Vecino
No abstract text is available yet for this article.
June 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28343682/fluid-therapy-recommendations-for-major-abdominal-surgery-via-rica-recommendations-revisited-part-iii-goal-directed-hemodynamic-therapy-rationale-for-maintaining-vascular-tone-and-contractility
#15
J Ripollés-Melchor, D Chappell, H D Aya, Á Espinosa, M G Mhyten, A Abad-Gurumeta, S D Bergese, R Casans-Francés, J M Calvo-Vecino
No abstract text is available yet for this article.
June 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28341372/evaluation-of-remote-dielectric-sensing-reds-technology-guided-therapy-for-decreasing-heart-failure-re-hospitalizations
#16
Offer Amir, Tuvia Ben-Gal, Jean Marc Weinstein, Jorge Schliamser, Daniel Burkhoff, Aharon Abbo, William T Abraham
OBJECTIVE: We tested whether remote dielectric sensing (ReDS)-directed fluid management reduces readmissions in patients recently hospitalized for heart failure (HF). BACKGROUND: Pulmonary congestion is the most common cause of worsening HF leading to hospitalization. Accurate remote monitoring of lung fluid volume may guide optimal treatment and prevent re-hospitalization. ReDS technology is a quantitative non-invasive method for measuring absolute lung fluid volume...
March 3, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#17
Marius Morr, Alexander Lukasz, Eva Rübig, Hermann Pavenstädt, Philipp Kümpers
BACKGROUND: Appropriate and timely recognition of sepsis is a prerequisite for starting goal-directed therapy bundles. We analyzed the appropriateness of sepsis recognition and documentation with regard to adequacy of therapy and outcome in an internal medicine emergency department (ED). METHODS: This study included 487 consecutive patients ≥18 years of age who presented to a university hospital ED during a 4-week period. Clinical, laboratory, and follow-up data were acquired independently from documentation by ED physicians...
March 23, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28321811/interleukin-2-old-and-new-approaches-to-enhance-immune-therapeutic-efficacy
#18
Pooja Dhupkar, Nancy Gordon
Interleukin-2 (IL-2) is a very well-known cytokine that has been studied for the past 35 years. It plays a major role in the growth and proliferation of many immune cells such NK and T cells. It is an important immunotherapy cytokine for the treatment of various diseases including cancer. Systemic delivery of IL-2 has shown clinical benefit in renal cell carcinoma and melanoma patients. However, its use has been limited by the numerous toxicities encountered with the systemic delivery. Intravenous IL-2 causes the well-known "capillary leak syndrome," or the leakage of fluid from the circulatory system to the interstitial space resulting in hypotension (low blood pressure), edema, and dyspnea that can lead to circulatory shock and eventually cardiopulmonary collapse and multiple organ failure...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28320242/early-goal-directed-therapy-for-septic-shock-a-patient-level-meta-analysis
#19
Kathryn M Rowan, Derek C Angus, Michael Bailey, Amber E Barnato, Rinaldo Bellomo, Ruth R Canter, Timothy J Coats, Anthony Delaney, Elizabeth Gimbel, Richard D Grieve, David A Harrison, Alisa M Higgins, Belinda Howe, David T Huang, John A Kellum, Paul R Mouncey, Edvin Music, Sandra L Peake, Francis Pike, Michael C Reade, M Zia Sadique, Mervyn Singer, Donald M Yealy
BACKGROUND: After a single-center trial and observational studies suggesting that early, goal-directed therapy (EGDT) reduced mortality from septic shock, three multicenter trials (ProCESS, ARISE, and ProMISe) showed no benefit. This meta-analysis of individual patient data from the three recent trials was designed prospectively to improve statistical power and explore heterogeneity of treatment effect of EGDT. METHODS: We harmonized entry criteria, intervention protocols, outcomes, resource-use measures, and data collection across the trials and specified all analyses before unblinding...
June 8, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28253353/effect-of-goal-directed-therapy-on-outcome-after-esophageal-surgery-a-quality-improvement-study
#20
Denise P Veelo, Mark I van Berge Henegouwen, Kirsten S Ouwehand, Bart F Geerts, Maarten C J Anderegg, Susan van Dieren, Benedikt Preckel, Jan M Binnekade, Suzanne S Gisbertz, Markus W Hollmann
BACKGROUND: Goal-directed therapy (GDT) can reduce postoperative complications in high-risk surgery patients. It is uncertain whether GDT has the same benefits in patients undergoing esophageal surgery. Goal of this Quality Improvement study was to evaluate the effects of a stroke volume guided GDT on post-operative outcome. METHODS AND FINDINGS: We compared the postoperative outcome of patients undergoing esophagectomy before (99 patients) and after (100 patients) implementation of GDT...
2017: PloS One
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