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intravenous fluid calculations

Oh Jeong, Young Kyu Park, Mi Ran Jung, Seong Yeob Ryu
BACKGROUND: Enhanced recovery after surgery (ERAS) aims at expediting postoperative recovery by implementing specific strategies in perioperative management. However, the tolerance to such fast-tracking protocols is under debate, especially in elderly patients. We aimed to investigate rate of compliance with the main ERAS guidelines in elderly gastrectomy patients. METHODS: Using data for 168 gastric cancer patients who underwent ERAS after gastrectomy as part of Clinical Trial NCT01653496, we calculated the rates of compliance with nine main ERAS guidelines and compared the compliance rates of elderly (≥70 years) and non-elderly (<70 years) patients...
November 23, 2016: World Journal of Surgery
Cornelia B Landersdorfer, Tri-Hung Nguyen, Linh Thuy Lieu, Gary Nguyen, Robert J Bischof, Els N Meeusen, Jian Li, Roger L Nation, Michelle P McIntosh
Colistin, administered as its inactive prodrug colistin methanesulfonate (CMS), is often used in multidrug-resistant Gram-negative pulmonary infections. The CMS and colistin pharmacokinetics in plasma and epithelial lining fluid (ELF) following intravenous and pulmonary dosing have not been evaluated in a large animal model with similar pulmonary architecture to humans.Six merino sheep (34-43kg) received an intravenous or pulmonary dose of 4-8 mg/kg CMS (sodium) or 2-3 mg/kg colistin (sulfate) in a 4-way crossover study...
November 7, 2016: Antimicrobial Agents and Chemotherapy
Chulananda Goonasekera, Kamal Ali, Ann Hickey, Lekshmi Sasidharan, Malcolm Mathew, Mark Davenport, Anne Greenough
BACKGROUND: Mortality following surgical repair of congenital diaphragmatic hernia (CDH) remains high. The volume and type of perioperative intravenous fluid administered, baro-trauma, oxygen toxicity, and the duration of anesthesia are thought to affect outcome in surgical populations. AIMS: The aim of this retrospective observational study was to determine whether the perioperative volume or type of fluids and/or the duration of anesthesia were associated with postoperative mortality and if mortality was predicted by the oxygenation index (OI) prior to or following CDH surgical repair...
December 2016: Paediatric Anaesthesia
Christopher Varga, Isaac Luria, Nikolaus Gravenstein
BACKGROUND: Air injection is carefully avoided during IV solution administration; however, ambient air is dissolved in all liquids used for intravenous (IV) therapy. A portion of this gas will come out of solution in the form of bubbles as the solution is warmed to body temperature in a fluid warming system and/or within the body. We sought to quantify the proportion of the gas theoretically dissolved in room temperature crystalloid and 4°C blood products that comes out of solution in the IV tubing on warming to 37°C...
November 2016: Anesthesia and Analgesia
Ranjana Khetarpal, Veena Chatrath, Jagjit Kaur, Anju Bala, Harjeet Singh
BACKGROUND: Intravenous (IV) fluids are an integral part of perioperative management. Intraoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing major surgeries even in nondiabetics. AIM: This study was conducted to observe the effect of different maintenance fluid regimens on intraoperative blood glucose levels in nondiabetic patients undergoing major surgeries under general anesthesia. SETTINGS AND DESIGN: Randomized double-blind study...
September 2016: Anesthesia, Essays and Researches
Brian Clemency, Colleen Clemency Cordes, Heather A Lindstrom, Jeanne M Basior, Deborah P Waldrop
OBJECTIVES: What patients intend when they make health care choices and whether they understand the meaning of orders for life-sustaining treatment forms is not well understood. The purpose of this study was to analyze the directives from a sample of emergency department (ED) patients' MOLST forms. PROCEDURES: MOLST forms that accompanied 100 patients who were transported to an ED were collected and their contents analyzed. Data categories included age, gender, if the patient completed the form for themselves, medical orders for life-sustaining treatment including intubation, ventilation, artificial nutrition, artificial fluids or other treatment, and wishes for future hospitalization or transfer...
September 27, 2016: Journal of the American Medical Directors Association
Bojan Gavrilovic, T Douglas Bradley, Daniel Vena, Owen D Lyons, Joseph M Gabriel, Milos R Popovic, Azadeh Yadollahi
OBJECTIVES: Obstructive sleep apnea (OSA) is highly prevalent in patients with fluid-retaining conditions. Using bioimpedance measurements, previous studies have shown that the greater the amount of fluid redistributed from the legs to the neck overnight, the greater the severity of OSA. Our objective was to investigate factors that predispose the development or worsening of OSA in response to experimental fluid overload. METHODS: Fifteen normotensive and non-obese adult men with and without OSA underwent polysomnography (PSG) during which normal saline was infused intravenously at a minimal rate to keep the vein open (control) or as a bolus of 22 ml/kg body weight (approximately 2 L) in a random order and crossed over after a week...
July 2016: Sleep Medicine
Melvin E Klegerman, Melanie R Moody, Jermaine R Hurling, Tao Peng, Shao-Ling Huang, David D McPherson
RATIONALE: We have produced a liposomal formulation of xenon (Xe-ELIP) as a neuroprotectant for inhibition of brain damage in stroke patients. This mandates development of a reliable assay to measure the amount of dissolved xenon released from Xe-ELIP in water and blood samples. METHODS: Gas chromatography-Mass Spectrometry (GC-MS) was used to quantify xenon gas released into the headspace of vials containing Xe-ELIP samples in water or blood. In order to determine blood concentration of xenon in vivo after Xe-ELIP administration, 6 mg Xe-ELIP lipid was infused intravenously into rats...
September 30, 2016: Rapid Communications in Mass Spectrometry: RCM
Stella Andrea Glasmacher, William Stones
BACKGROUND: Lactate concentration is a robust predictor of mortality but in many low resource settings facilities for its analysis are not available. Anion gap (AG), calculated from clinical chemistry results, is a marker of metabolic acidosis and may be more easily obtained in such settings. In this systematic review and meta-analysis we investigated whether the AG predicts mortality in adult patients admitted to critical care settings. METHODS: We searched Medline, Embase, Web of Science, Scopus, The Cochrane Library and regional electronic databases from inception until May 2016...
2016: BMC Anesthesiology
Steven L Moulton, Jane Mulligan, Anon Srikiatkhachorn, Siripen Kalayanarooj, Greg Z Grudic, Sharone Green, Robert V Gibbons, Gary W Muniz, Carmen Hinojosa-Laborde, Alan L Rothman, Stephen J Thomas, Victor A Convertino
BACKGROUND: Early recognition and treatment of circulatory volume loss is essential in the clinical management of dengue viral infection. We hypothesized that a novel computational algorithm, originally developed for noninvasive monitoring of blood loss in combat casualties, could: (1) indicate the central volume status of children with dengue during the early stages of "shock"; and (2) track fluid resuscitation status. METHODS: Continuous noninvasive photoplethysmographic waveforms were collected over a 5-month period from three children of Thai ethnicity with clinical suspicion of dengue...
August 24, 2016: Journal of Medical Case Reports
Adam Sutherland, Elizabeth Jemmett, Stephen Playfor
INTRODUCTION: Fluid overload of 10% at 48 hrs (100 ml/kg additional fluid) is strongly associated with morbidity in critically ill children.1 Contributors include fluid resuscitation, acute kidney injury, and administration of intravenous drugs. Acute Kidney Injury has been observed to be more prevalent in infants.2 Drug infusions are historically prepared according to bodyweight to run at large volumes to facilitate end-of-bed calculation and administration. We report the impact of using standardised concentrations on fluid overload in critically ill children in a tertiary general PICU...
September 2016: Archives of Disease in Childhood
Diarmaid Semple, Moninne Howlett
AIM: Since the discontinuation of a commercially available liquid calcium medicine, there have been various local strategies to obtain adequate calcium levels, particularly in suspected 22Q11.2 deletion syndrome children post cardiothoracic surgery. Pharmacy obtained on special order a Calcium Liquid food supplement (0.5 mmol calcium/ml) for use in those children whom effervescent tablets did not appear to improve corrected calcium. Anecdotally it was thought that calcium liquid was better tolerated and absorbed, resulting in quicker recovery time of corrected calcium than use of the effervescent tablets...
September 2016: Archives of Disease in Childhood
Roger A Langford, Malcolm Hogg, Andrew R Bjorksten, Daryl L Williams, Kate Leslie, Kris Jamsen, Carl Kirkpatrick
BACKGROUND: We compared plasma and cerebrospinal fluid (CSF) pharmacokinetics of paracetamol after intravenous (IV) and oral administration to determine dosing regimens that optimize CSF concentrations. METHODS: Twenty-one adult patients were assigned randomly to 1 g IV, 1 g oral or 1.5 g oral paracetamol. An IV cannula and lumbar intrathecal catheter were used to sample venous blood and CSF, respectively, over 6 hours. The plasma and CSF maximum concentrations (Cmax), times to maximum concentrations (Tmax), and area under the plasma and CSF concentration-time curves (AUCs) were calculated using noncompartmental techniques...
September 2016: Anesthesia and Analgesia
Akiko Nishimura, Yoko Tabuchi, Mutsumi Kikuchi, Rikuo Masuda, Kinuko Goto, Takehiko Iijima
BACKGROUND: The revised Starling law suggests that intravenously infused fluid may leak into the interstitium and not remain in the intravascular space. This hypothesis is supported by clinical findings that postoperative weight gain is proportional to the amount of infused fluid. The distribution of intravenously administered fluid between the interstitium and intravascular space deserves evaluation, as postoperative weight gain because of intraoperative infusion is an important risk factor for postoperative adverse events...
October 2016: Anesthesia and Analgesia
Xiaobao Zhang, Jiying Feng, Pin Zhu, Hengfei Luan, Yong Wu, Zhibin Zhao
BACKGROUND: Both hypovolemia and hypervolemia are connected with increased morbidity and mortality in the treatment and prognosis of patients. An accurate assessment of volume state allows the optimization of organ perfusion and oxygen supply. Recently, ultrasonography has been used to detect hypovolemia in critically ill patients and perioperative patients. The objective of our study was to assess the correlation between inferior vena cava (IVC) variation obtained with ultrasound and stroke volume variation (SVV) measured by the Vigileo/FloTrac monitor, as fluid responsiveness indicators, in patients undergoing anesthesia for surgery...
July 2016: Journal of Surgical Research
Shinji Naganawa, Toshiki Nakane, Hisashi Kawai, Toshiaki Taoka
PURPOSE: In textbooks, the perivascular space (PVS) is described as non-enhancing after the intravenous administration of gadolinium-based contrast agent (IV-GBCA). We noticed that the PVS sometimes has high signal intensity (SI) on heavily T2-weighted 3D-FLAIR (hT2-FL) images obtained 4 h after IV-GBCA. The purpose of this study was to retrospectively evaluate the contrast enhancement of the PVS. MATERIALS AND METHODS: In 8 healthy subjects and 19 patients with suspected endolymphatic hydrops, magnetic resonance cisternography (MRC) and hT2-FL images were obtained before and 4 h after a single dose of IV-GBCA...
July 12, 2016: Magnetic Resonance in Medical Sciences: MRMS
Nancy Perrottet, Françoise Brunner-Ferber, Eric Grouzmann, François Spertini, Jérôme Biollaz, Thierry Buclin, Nicolas Widmer
BACKGROUND: During clinical trials, researchers rarely question nominal doses specified on labels of investigational products, overlooking the potential for inaccuracies that may result when calculating pharmacokinetic and pharmacodynamic parameters. This study evaluated the disparity between nominal doses and the doses actually administered in two Phase I trials of a biosimilar drug. METHODS: In Trial A, 12 healthy volunteers received various doses of an interferon β-1a biosimilar via either subcutaneous or intravenous injection, prepared by partially emptying 0...
July 16, 2016: Trials
Tobias Hilbert, Sven Klaschik, Richard K Ellerkmann, Christian Putensen, Marcus Thudium
BACKGROUND: In case of intravascular fluid depletion, large veins react to volume expansion with dilation. Little is known about the reaction of arterial vessels. We herein report on the effect of a standardized fluid bolus on the diameter of the common carotid artery (CCA) and its association with hemodynamic parameters, assessed in 20 mechanically ventilated patients after cardiac surgery. CCA was visualized using ultrasound, and the percentage increase in diastolic diameter was calculated by measuring before and after administration of crystalloid infusion solution...
2016: SpringerPlus
Humberto Morales, Lisa Lemen, Ranasinghage Samaratunga, Peter Nguyen, Thomas Tomsick
AIM: To characterize the effects of iodinated contrast material (ICM) on magnetic resonance imaging (MRI) comparing different sequences and magnetic fields, with emphasis to similarities/differences with well-known signal characteristics of hemorrhage in the brain. METHODS: Aliquots of iopamidol and iodixanol mixed with normal saline were scanned at 1.5T and 3T. Signal intensity (SI) was measured using similar spin-echo (SE)-T1, SE-T2, gradient-echo (GRE) and fluid-attenuation-inversion-recovery (FLAIR) sequences at both magnets...
June 28, 2016: World Journal of Radiology
Ying-ying Tan, Ya-yun Wang, Qi Zhang
OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Quchi" (LI 11) on arterial blood pressure (BP), sympathetic nerve activity, barorefiex sensitivity (BRS) and expression of brain derived neurotrophic factor (BDNF) and nicotinamide adenine dinucleotide phosphate (NADPH) enzyme subunit p 47 phox in the rostral ventrolateral medulla (RVML) in hypertension rats. METHODS: A total of 45 male SD rats were randomly divided into sham operation, artificial cerebro-spinal fluid (aCSF) , model, "Quchi"(LI 11), and Jianyu (LI 15) groups (n = 9 in each group)...
April 2016: Zhen Ci Yan Jiu, Acupuncture Research
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