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restrictive fluid resuscitation

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https://www.readbyqxmd.com/read/29023316/septic-shock-resuscitation-in-the-first-hour
#1
Nicholas Simpson, Francois Lamontagne, Manu Shankar-Hari
PURPOSE OF REVIEW: We reviewed the recent advances in the initial approach to resuscitation of sepsis and septic shock patients. RECENT FINDINGS: Sepsis and septic shock are life-threatening emergencies. Two key interventions in the first hour include timely antibiotic therapy and resuscitation. Before any laboratory results, the need for resuscitation is considered if a patient with suspected infection has low blood pressure (BP) or impaired peripheral circulation found at clinical examination...
December 2017: Current Opinion in Critical Care
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
#2
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/28851407/restricted-fluid-resuscitation-in-sepsis-associated-hypotension-refresh-study-protocol-for-a-pilot-randomised-controlled-trial
#3
Stephen P J Macdonald, David McD Taylor, Gerben Keijzers, Glenn Arendts, Daniel M Fatovich, Frances B Kinnear, Simon G A Brown, Rinaldo Bellomo, Sally Burrows, John F Fraser, Edward Litton, Juan Carlos Ascencio-Lane, Matthew Anstey, David McCutcheon, Lisa Smart, Ioana Vlad, James Winearls, Bradley Wibrow
BACKGROUND: Guidelines recommend an initial intravenous (IV) fluid bolus of 30 ml/kg isotonic crystalloid for patients with sepsis and hypotension. However, there is a lack of evidence from clinical trials to support this. Accumulating observational data suggest harm associated with the injudicious use of fluids in sepsis. There is currently equipoise regarding liberal or restricted fluid-volume resuscitation as first-line treatment for sepsis-related hypotension. A randomised trial comparing these two approaches is, therefore, justified...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28782112/lower-vs-higher-fluid-volumes-in-sepsis-protocol-for-a-systematic-review-with-meta-analysis
#4
T S Meyhoff, M H Møller, P B Hjortrup, M Cronhjort, A Perner, J Wetterslev
BACKGROUND: Intravenous fluid administration with crystalloids is recommended in the initial management of sepsis. However, the quality of evidence supporting the recommendation on fluid volumes is low, and clinical equipoise exists. Potential benefits of restricting fluid volumes has been suggested, but the overall benefit or harm in patients with sepsis is unknown. Accordingly, we aim to assess patient-important benefits and harms of lower vs. higher fluid volumes in resuscitation of adult patients with sepsis...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#5
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28570315/assessment-of-outreach-by-a-regional-burn-center-could-referral-criteria-revision-help-with-utilization-of-resources
#6
Nicholas H Carter, Clint Leonard, Lisa Rae
The objective of this study was to identify trends in preburn center care, assess needs for outreach and education efforts, and evaluate resource utilization with regard to referral criteria. The authors hypothesized that many transferred patients were discharged home after brief hospitalizations and without need for operation. Retrospective chart review of all adult and pediatric transfers to our regional burn center from July 2012 to July 2014. Details of initial management including TBSA estimation, fluid resuscitation, and intubation status were recorded...
May 19, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#7
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
November 2017: Anaesthesia
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...
July 2017: Transfusion
https://www.readbyqxmd.com/read/28481669/prehospital-fluid-administration-in-trauma-patients-a-survey-of-state-protocols
#9
Sahil Dadoo, Joseph M Grover, Lukas G Keil, Kay S Hwang, Jane H Brice, Timothy F Platts-Mills
OBJECTIVE: The optimal resuscitation approach during the initial treatment of hypotensive trauma patients remains unknown, but some clinical trials have observed a survival benefit from restricting fluid administration prior to definitive hemorrhage control. We sought to characterize emergency medical services (EMS) protocols for the administration of intravenous fluids in this setting. METHODS: Publicly accessible statewide EMS protocols for the treatment of hypotensive trauma patients were included and characterized by: 1) goal of fluid administration, 2) dosing strategy, 3) maximum dose, 4) type of fluid, and 5) specific protocols for head trauma, if present...
September 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28398962/population-based-assessment-of-intraoperative-fluid-administration-practices-across-three-surgical-specialties
#10
COMPARATIVE STUDY
Scott E Regenbogen, Nirav J Shah, Stacey D Collins, Samantha Hendren, Michael J Englesbe, Darrell A Campbell
OBJECTIVE: To assess the variation in hospitals' approaches to intraoperative fluid management and their association with postoperative recovery. BACKGROUND: Despite increasing interest in goal-directed, restricted-volume fluid administration for major surgery, there remains little consensus on optimal strategies, due to the lack of institution-level studies of resuscitation practices. METHODS: Among 64 hospitals in a state-wide surgical collaborative, we profiled fluid administration practices during 8404 intestinal resections, 22,854 hysterectomies, and 1471 abdominopelvic endovascular procedures...
May 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28329897/maternal-labor-delivery-and-perinatal-outcomes-associated-with-placental-abruption-a-systematic-review
#11
Katheryne L Downes, Katherine L Grantz, Edmond D Shenassa
Objective Risk factors for placental abruption have changed, but there has not been an updated systematic review investigating outcomes. Methods We searched PubMed, EMBASE, Web of Science, SCOPUS, and CINAHL for publications from January 1, 2005 through December 31, 2016. We reviewed English-language publications reporting estimated incidence and/or risk factors for maternal, labor, delivery, and perinatal outcomes associated with abruption. We excluded case studies, conference abstracts, and studies that lacked a referent/comparison group or did not clearly characterize placental abruption...
August 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28321321/associations-between-fluid-balance-and-outcomes-in-critically-ill-children-a-protocol-for-a-systematic-review-and-meta-analysis
#12
Rashid Alobaidi, Catherine Morgan, Rajit K Basu, Erin Stenson, Robin Featherstone, Sumit R Majumdar, Sean M Bagshaw
BACKGROUND: Fluid therapy is a mainstay during the resuscitation of critically ill children. After initial stabilization, excessive fluid accumulation may lead to complications of fluid overload, which has been independently associated with increased risk for mortality and major morbidity in critically ill children. OBJECTIVES: Perform an evidence synthesis to describe the methods used to measure fluid balance, define fluid overload, and evaluate the association between fluid balance and outcomes in critically ill children...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28246141/vasopressor-use-following-traumatic-injury-protocol-for-a-systematic-review
#13
Mathieu Hylands, Augustin Toma, Nicolas Beaudoin, Anne-Julie Frenette, Frederick D'Aragon, Emilie Belley-Côté, Morten Hylander, François Lauzier, Reed Alexander Siemieniuk, Emmanuel Charbonney, Joey Kwong, Jon Henrik Laake, Gordon Guyatt, Per Olav Vandvik, Bram Rochwerg, Robert Green, Ian Ball, Damon Scales, Srinivas Murthy, Sandro Rizoli, Pierre Asfar, François Lamontagne
INTRODUCTION: Worldwide, traumatic casualties are projected to exceed 8 million by year 2020. Haemorrhagic shock and brain injury are the leading causes of death following trauma. While intravenous fluids have traditionally been used to support organ perfusion in the setting of haemorrhage, recent investigations have suggested that restricting fluid therapy by tolerating more severe hypotension may improve survival. However, the safety of permissive hypotension remains uncertain, particularly among patients who have suffered a traumatic brain injury...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28150304/effects-of-fluid-restriction-on-measures-of-circulatory-efficacy-in-adults-with-septic-shock
#14
RANDOMIZED CONTROLLED TRIAL
P B Hjortrup, N Haase, J Wetterslev, T Lange, H Bundgaard, B S Rasmussen, N Dey, E Wilkman, L Christensen, D Lodahl, M Bestle, A Perner
BACKGROUND: The haemodynamic consequences of fluid resuscitation in septic shock have not been fully elucidated. Therefore, we assessed circulatory effects in the first 24 h of restriction of resuscitation fluid as compared to standard care in intensive care unit (ICU) patients with septic shock. METHODS: This was a post-hoc analysis of the multicentre CLASSIC randomised trial in which patients with septic shock, who had received the initial fluid resuscitation, were randomised to a protocol restricting resuscitation fluid or a standard care protocol in nine ICUs...
April 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28033136/permissive-hypotension-and-trauma-can-fluid-restriction-reduce-the-incidence-of-ards
#15
REVIEW
Melissa Kolarik, Eric Roberts
Emergency care, including the resuscitation of patients involved in traumatic events, has evolved over the years. A prior practice of utilizing large volumes of crystalloids has been found to contribute to complications such as coagulopathy, fluid overload, and adult respiratory distress syndrome (ARDS). In contrast, permissive hypotension is a method of fluid restriction that allows for low blood pressure and mean arterial pressure during the resuscitation period. When permissive hypotension occurs and fluids are restricted in trauma patients, the incidence of ARDS can be reduced significantly with improvement in patient outcomes...
January 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28027250/important-developments-in-burn-care
#16
REVIEW
Kevin J Zuo, Abelardo Medina, Edward E Tredget
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Explain the epidemiology of severe burn injury in the context of socioeconomic status, gender, age, and burn cause. 2. Describe challenges with burn depth evaluation and novel methods of adjunctive assessment. 3. Summarize the survival and functional outcomes of severe burn injury. 4. State strategies of fluid resuscitation, endpoints to guide fluid titration, and sequelae of overresuscitation. 5. Recognize preventative measures of sepsis...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27914759/fluid-management-in-patients-with-trauma-restrictive-versus-liberal-approach
#17
REVIEW
Lee Palmer
Massive hemorrhage remains a major cause of traumatic deaths. The ideal fluid resuscitative strategy is much debated. Research has provided inconsistent results regarding which fluid strategy is ideal; the optimum fluid type, timing, and volume remains elusive. Aggressive large-volume resuscitation has been the mainstay based on controlled hemorrhage animal models. For uncontrolled hemorrhagic shock, liberal fluid resuscitative strategies exacerbate the lethal triad, invoke resuscitative injury, and increase mortality while more restrictive fluid strategies tend to ameliorate trauma-induced coagulopathy and favor a greater chance of survival...
March 2017: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27906869/early-and-sustained-vasopressin-infusion-augments-the-hemodynamic-efficacy-of-restrictive-fluid-resuscitation-and-improves-survival-in-a-liver-laceration-model-of-hemorrhagic-shock
#18
Raúl J Gazmuri, Kasen Whitehouse, Karla Whittinghill, Alvin Baetiong, Kruti Shah, Jeejabai Radhakrishnan
BACKGROUND: Current management of hemorrhagic shock favors restrictive fluid resuscitation before control of the bleeding source. We investigated the additional effects of early and sustained vasopressin infusion in a swine model of hemorrhagic shock produced by liver laceration. METHODS: Forty male domestic pigs (32-40 kg) had a liver laceration inflicted with an X-shaped blade clamp, 32 received a second laceration at minute 7.5, and 24 received two additional lacerations at minute 15...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27871539/liberal-or-restrictive-fluid-management-during-elective-surgery-a-systematic-review-and-meta-analysis
#19
REVIEW
Pim B B Schol, Ivon M Terink, Marcus D Lancé, Hubertina C J Scheepers
This article reviews if a restrictive fluid management policy reduces the complication rate if compared to liberal fluid management policy during elective surgery. The PubMed database was explored by 2 independent researchers. We used the following search terms: "Blood transfusion (MESH); transfusion need; fluid therapy (MESH); permissive hypotension; fluid management; resuscitation; restrictive fluid management; liberal fluid management; elective surgery; damage control resuscitation; surgical procedures, operative (MESH); wounds (MESH); injuries (MESH); surgery; trauma patients...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27828823/hold-the-pendulum-rates-of-acute-kidney-injury-are-increased-in-patients-who-receive-resuscitation-volumes-less-than-predicted-by-the-parkland-equation
#20
MULTICENTER STUDY
Stephanie A Mason, Avery B Nathens, Celeste C Finnerty, Richard L Gamelli, Nicole S Gibran, Brett D Arnoldo, Ronald G Tompkins, David N Herndon, Marc G Jeschke
OBJECTIVE: To determine whether restrictive fluid resuscitation results in increased rates of acute kidney injury (AKI) or infectious complications. BACKGROUND: Studies demonstrate that patients often receive volumes in excess of those predicted by the Parkland equation, with potentially detrimental sequelae. However, the consequences of under-resuscitation are not well-studied. METHODS: Data were collected from a multicenter prospective cohort study...
December 2016: Annals of Surgery
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