keyword
MENU ▼
Read by QxMD icon Read
search

Goal directed fluid therapy

keyword
https://www.readbyqxmd.com/read/28330460/sepsis-recognition-in-the-emergency-department-impact-on-quality-of-care-and-outcome
#1
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
#2
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
#3
(no author information available yet)
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...
March 21, 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
#4
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
https://www.readbyqxmd.com/read/28211020/goal-directed-fluid-restriction-during-brain-surgery-a-prospective-randomized-controlled-trial
#5
Jinfeng Luo, Jing Xue, Jin Liu, Bin Liu, Li Liu, Guo Chen
BACKGROUND: The value of goal-directed fluid therapy in neurosurgical patients, where brain swelling is a major concern, is unknown. The aim of our study was to evaluate the effect of an intraoperative goal-directed fluid restriction (GDFR) strategy on the postoperative outcome of high-risk patients undergoing brain surgery. METHODS: High-risk patients undergoing brain surgery were randomly assigned to a usual care group (control group) or a GDFR group. In the GDFR group, (1) fluid maintenance was restricted to 3 ml/kg/h of a crystalloid solution and (2) colloid boluses were allowed only in case of hypotension associated with a low cardiac index and a high stroke volume variation...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28187752/targeting-urine-output-and-30-day-mortality-in-goal-directed-therapy-a-systematic-review-with-meta-analysis-and-meta-regression
#6
Esther N van der Zee, Mohamud Egal, Diederik Gommers, A B Johan Groeneveld
BACKGROUND: Oliguria is associated with a decreased kidney- and organ perfusion, leading to organ damage and increased mortality. While the effects of correcting oliguria on renal outcome have been investigated frequently, whether urine output is a modifiable risk factor for mortality or simply an epiphenomenon remains unclear. We investigated whether targeting urine output, defined as achieving and maintaining urine output above a predefined threshold, in hemodynamic management protocols affects 30-day mortality in perioperative and critical care...
February 10, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28126672/goal-directed-fluid-therapy-for-reducing-risk-of-surgical-site-infections-following-abdominal-surgery-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#7
REVIEW
Jianhu Yuan, Yanxia Sun, Chuxiong Pan, Tianzuo Li
BACKGROUND AND OBJECTIVE: Surgical site infections (SSIs) become a key indicator of quality of care. This meta-analysis aimed to determine the effect of goal-directed fluid therapy (GDFT) on the risk of SSIs after abdominal surgery. METHODS: MEDLINE, Embase, CINAHL, Scopus, the Cochrane Controlled Trials Register, and Cochrane Database of Systematic Reviews were searched for randomized controlled trials (RCTs), from inception to May 2016 that compared the incidence of SSIs in abdominal surgical patients with or without GDFT treatment...
January 23, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28094478/fluid-management-in-cardiac-surgery-patients-pitfalls-challenges-and-solutions
#8
Elena Bignami, Marcello Guarnieri, Marco Gemma
Fluid administration is a powerful tool for hemodynamic stabilization as it increases preload and improves cardiac function in fluid-responsive patients. However, there are various types of fluid to choose from. The use of colloids and crystalloids in non-cardiac Intensive Care Units (ICU) has been reported, showing controversial results. Many trials on sepsis in a non-cardiac ICU setting show that colloids, in particular hydroxyethyl starches and gelatins, might have a detrimental effect on kidney function, and on major outcomes such as mortality...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28067711/early-goal-directed-therapy-for-sepsis-a-novel-solution-for-discordant-survival-outcomes-in-clinical-trials
#9
Andre C Kalil, Daniel W Johnson, Steven J Lisco, Junfeng Sun
OBJECTIVES: Early goal-directed therapy has shown discordant survival outcomes in sepsis studies. We aim to find the reasons for this discordance. DESIGN: Random-effects and Bayesian hierarchical analyses. SETTING: Studies that evaluated early goal-directed therapy. SUBJECTS: Patients with severe sepsis and/or septic shock. INTERVENTIONS: Early goal-directed therapy. MEASUREMENTS AND MAIN RESULTS: A total of 19,998 patients were included in the main analysis: 31 observational (n = 15,656) and six randomized (n = 4,342) studies...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27999663/implementation-of-goal-directed-fluid-therapy-during-hip-revision-arthroplasty-a-matched-cohort-study
#10
Marit Habicher, Felix Balzer, Viktor Mezger, Jennifer Niclas, Michael Müller, Carsten Perka, Michael Krämer, Michael Sander
BACKGROUND: Several randomized controlled trials (RCTs) have demonstrated that intraoperative goal-directed fluid therapy (GDFT) can decrease postsurgical complications in patients undergoing major abdominal surgery. However, very few studies have demonstrated the value of goal-directed therapy (GDT) in patients undergoing orthopaedic surgery and confirmed it is as useful in real-life conditions. Therefore, we initiated a GDFT implementation programme in patients undergoing hip revision arthroplasty in order to assess its effects on postoperative complications (e...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27968811/a-review-of-central-venous-pressure-and-its-reliability-as-a-hemodynamic-monitoring-tool-in-veterinary-medicine
#11
REVIEW
Kristen M Hutchinson, Scott P Shaw
OBJECTIVE: To review the current literature regarding central venous pressure (CVP) in veterinary patients pertaining to placement (of central line), measurement, interpretation, use in veterinary medicine, limitations, and controversies in human medicine. ETIOLOGY: CVP use in human medicine is a widely debated topic, as numerous sources have shown poor correlation of CVP measurements to the volume status of a patient. Owing to the ease of placement and monitoring in veterinary medicine, CVP remains a widely used modality for evaluating the hemodynamic status of a patient...
September 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/27958191/wet-or-dry-a-review-of-intravenous-fluid-administration-in-anesthesia-practice
#12
Matthew D'Angelo, R Kyle Hodgen
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of anesthesia races to meet the evolving demands of surgery, anesthetists must align knowledge generation with the individualized needs of the patient...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27940452/perioperative-goal-directed-haemodynamic-therapy-based-on-flow-parameters-a-concept-in-evolution
#13
L Meng, P M Heerdt
Haemodynamic management incorporating direct or surrogate stroke volume monitoring has experienced a rapid evolution, because of emergence of the "goal-directed therapy" concept and technological developments aimed at providing a parameter leading to the goal. Nonetheless, consensus on both definitions of the ideal "goal" and strategies for achieving it remain elusive. For this review, we first consider basic physiological and patient monitoring factors relevant to the concept of "fluid responsiveness", and then focus upon randomized controlled trials and meta-analyses involving goal-directed haemodynamic therapy based on various flow parameters...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27935782/wet-or-dry-a-review-of-intravenous-fluid-administration-in-anesthesia-practice
#14
Matthew D'Angelo, R Kyle Hodgen
Fluid therapy has dramatically changed since its early inception nearly 200 years ago. Administration of intravenous fluid (IVF) has evolved from a "drip" technique to the algorithmic approach of the anesthetic fluid plan, and is now moving toward Goal-Directed Fluid Therapy. As the science and culture of fluid management evolves, anesthetists must remain focused on "why" anesthetic fluid matters. The purpose of IVF administration is to support tissue perfusion and maintain euvolemia. As the evidence underlying perioperative practice matures and the science of anesthesia races to meet the evolving demands of surgery, anesthetists must align knowledge generation with the individualized needs of the patient...
January 2017: Annual Review of Nursing Research
https://www.readbyqxmd.com/read/27922870/quality-and-safety-in-health-care-part-xx-goal-directed-fluid-therapy-and-the-universal-protocol
#15
Jay A Harolds
There have been numerous initiatives to improve quality and safety in surgery. Goal-directed fluid therapy and a quality bundle for emergency laparotomy surgery are two of them. The establishment of a Universal Protocol to prevent the wrong procedure, the wrong patient having a procedure, or the wrong site for a procedure is an important safeguard for patients.
March 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27916041/-progress-of-perioperative-goal-directed-fluid-therapy-on-prognosis-of-patients
#16
J Zhao, Y H Yu
Fluid therapy is an important part of perioperative period, also one of the most controversial issues. Having reviewed the relevant research in recent years as well as the large-scale meta-analysis, the perioperative goal-directed fluid therapy has been discussed from the aspects of evaluating indicators, new methods and latest progress, and the impact on the prognosis. It manifests that the development of goal-directed fluid therapy makes a better prognosis than traditional fluid therapy, therefore it has also became an important perioperative treatment strategy...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27908328/the-new-usual-care
#17
REVIEW
Jared Radbel, Daniel Boutsikaris
Recent literature continues to refine which components of the early goal-directed therapy (EGDT) algorithm are necessary. Given it utilizes central venous pressure, continuous central venous oxygen saturation, routine blood transfusions, and inotropic medications, this algorithm can be timely, invasive, costly, and potentially harmful. New trials highlight early recognition, early fluid resuscitation, appropriate antibiotic treatment, source control, and the application of a multidisciplinary evidence-based approach as essential components of current sepsis management...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27894494/optimal-fluid-therapy-for-traumatic-hemorrhagic-shock
#18
REVIEW
Ronald Chang, John B Holcomb
The resuscitation of traumatic hemorrhagic shock has undergone a paradigm shift in the last 20 years with the advent of damage control resuscitation (DCR). Major principles of DCR include minimization of crystalloid, permissive hypotension, transfusion of a balanced ratio of blood products, and goal-directed correction of coagulopathy. In particular, plasma has replaced crystalloid as the primary means for volume expansion for traumatic hemorrhagic shock. Predicting which patient will require DCR by prompt and accurate activation of a massive transfusion protocol, however, remains a challenge...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27876325/does-early-goal-directed-therapy-decrease-mortality-compared-with-standard-care-in-patients-with-septic-shock
#19
Michael E Winters, Robert Sherwin, Gary M Vilke, Gabriel Wardi
BACKGROUND: Current international guidelines for the treatment of patients with severe sepsis and septic shock recommend that patients receive targeted care to various physiologic endpoints, thereby optimizing tissue perfusion and oxygenation. These recommendations are primarily derived from a protocol published >15 years ago, which was viewed by many as complex and was therefore not widely adopted. Instead, many emergency physicians focused on the administration of early antibiotics, source control, aggressive fluid resuscitation, vasoactive medications as needed to maintain mean arterial blood pressure, and careful monitoring of these patients...
March 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27823892/practical-considerations-in-sepsis-resuscitation
#20
Brit Long, Alex Koyfman, Katharine L Modisett, Christian J Woods
BACKGROUND: Sepsis is a common condition managed in the emergency department, and the majority of patients respond to resuscitation measures, including antibiotics and i.v. fluids. However, a proportion of patients will fail to respond to standard treatment. OBJECTIVE: This review elucidates practical considerations for management of sepsis in patients who fail to respond to standard treatment. DISCUSSION: Early goal-directed therapy revolutionized sepsis management...
November 4, 2016: Journal of Emergency Medicine
keyword
keyword
45596
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"