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Fluid and electrolyte balance

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https://www.readbyqxmd.com/read/29740578/using-electrolyte-free-water-balance-to-rationalize-and-treat-dysnatremias
#1
REVIEW
Sanjeev R Shah, Gautam Bhave
Dysnatremias or abnormalities in plasma [Na+ ] are often termed disorders of water balance, an unclear physiologic concept often confused with changes in total fluid balance. However, most clinicians clearly recognize that hypertonic or hypotonic gains or losses alter plasma [Na+ ], while isotonic changes do not modify plasma [Na+ ]. This concept can be conceptualized as the electrolyte free water balance (EFWB), which defines the non-isotonic components of inputs and outputs to determine their effect on plasma [Na+ ]...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29716625/6-hydroxyethyl-starch-hes-130-0-4-diminishes-glycocalyx-degradation-and-decreases-vascular-permeability-during-systemic-and-pulmonary-inflammation-in-mice
#2
Andreas Margraf, Jan M Herter, Katharina Kühne, Anika Stadtmann, Thomas Ermert, Manuel Wenk, Melanie Meersch, Hugo Van Aken, Alexander Zarbock, Jan Rossaint
BACKGROUND: Increased vascular permeability is a pathophysiological hallmark of sepsis and results in increased transcapillary leakage of plasma fluid, hypovolemia, and interstitial edema formation. 6% hydroxyethyl starch (HES 130/0.4) is commonly used to treat hypovolemia to maintain adequate organ perfusion and oxygen delivery. The present study was designed to investigate the effects of 6% HES 130/0.4 on glycocalyx integrity and vascular permeability in lipopolysaccharide (LPS)-induced pulmonary inflammation and systemic inflammation in mice...
May 1, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29703048/tolvaptan-rescue-contrast-induced-acute-kidney-injury-a-case-report
#3
Wei-Chieh Lee, Hsiu-Yu Fang, Chih-Yuan Fang
RATIONALE: Contrast-induced acute kidney injury is one of the most serious adverse effects of contrast media and is related to three distinct but interacting mechanisms: medullary ischemia, formation of reactive oxygen species and direct tubular cell toxicity, especially in the patients with chronic kidney disease. The strategies of treatment, including stabilization of hemodynamic parameters and maintenance of normal fluid and electrolyte balance, were similar to the management of other types of acute kidney injury...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29653271/risk-factors-additional-length-of-stay-and-cost-associated-with-postoperative-ileus-following-anterior-lumbar-interbody-fusion-in-the-elderly
#4
Jason A Horowitz, Amit Jain, Varun Puvanesarajah, Rabia Qureshi, Hamid Hassanzadeh
OBJECTIVE: Identify the independent risk factors, additional length of stay, and additional cost associated with postoperative ileus following anterior lumbar interbody fusion in the elderly. METHODS: The PearlDiver Patient Records Database (Young & Ellison, LLC, Colorado Springs, CO) was queried for all Medicare patients 65 years of age and older undergoing 1 or 2 level primary elective anterior lumbar interbody fusion from 2005-2014. Independent risk factors, additional length of stay, and additional cost associated with postoperative ileus were evaluated with multivariate analysis...
April 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29597221/technical-complications-of-continuous-renal-replacement-therapy
#5
Zaccaria Ricci, Stefano Romagnoli
Continuous renal replacement therapy (CRRT) is commonly applied in critically ill patients affected by severe acute kidney injury for solute and volume control and to optimize acid-base and electrolytes balance. Although CRRT represents a life-saving procedure for these patients, it is a representation of a non-physiologic artificial kidney and the potential benefits of the treatment could be hampered by clinical and technical side effects. Different parts of the CRRT system can be a source of technical complications...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597218/membranes-and-sorbents
#6
William R Clark, Dayong Gao, Anna Lorenzin, Claudio Ronco
For continuous renal replacement therapy (CRRT), the extracorporeal filter provides solute depuration, fluid removal, and control of electrolyte and acid-base balance in critically ill patients with acute kidney injury (AKI). The membranes comprising CRRT filters are almost exclusively based on hollow fiber designs and, while adapted from the chronic hemodialysis field, have features that are specific to the requirements of CRRT nevertheless. In addition, these devices have evolved through the 40 years of CRRT in response to changes in clinical practice and the desire to extend the solute removal spectrum...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29589054/maintenance-fluid-therapy-and-fluid-creep-impose-more-significant-fluid-sodium-and-chloride-burdens-than-resuscitation-fluids-in-critically-ill-patients-a-retrospective-study-in-a-tertiary-mixed-icu-population
#7
Niels Van Regenmortel, Walter Verbrugghe, Ella Roelant, Tim Van den Wyngaert, Philippe G Jorens
PURPOSE: Research on intravenous fluid therapy and its side effects, volume, sodium, and chloride overload, has focused almost exclusively on the resuscitation setting. We aimed to quantify all fluid sources in the ICU and assess fluid creep, the hidden and unintentional volume administered as a vehicle for medication or electrolytes. METHODS: We precisely recorded the volume, sodium, and chloride burdens imposed by every fluid source administered to 14,654 patients during the cumulative 103,098 days they resided in our 45-bed tertiary ICU and simulated the impact of important strategic fluid choices on patients' chloride burdens...
March 27, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29566072/behaviour-during-transportation-predicts-stress-response-and-lower-airway-contamination-in-horses
#8
Barbara Padalino, Sharanne L Raidal, Peter Knight, Pietro Celi, Leo Jeffcott, Gary Muscatello
This study aimed to document the effects of an eight hour journey on behavioural, clinical, haematological, environmental and respiratory parameters, and to identify possible associations between factors. Twelve horses underwent clinical examination, respiratory endoscopy with tracheal wash (TW) aspiration, and collection of venous and arterial blood before (BJ) and after the journey (AJ). TW were submitted for conventional quantitative bacteriological evaluation and genetic microbiome analyses. Behaviour was assessed in stables prior to transportation and throughout the journey...
2018: PloS One
https://www.readbyqxmd.com/read/29523609/iatrogenic-water-intoxication-in-a-female-adolescent-with-hypopituitarism
#9
Ana Margarida Monteiro, Olinda Marques, Sofia Martins, Ana Antunes
The authors report a case of a 15-year-old girl with hypopituitarism due to pituitary stalk interruption syndrome diagnosed in the neonatal period. The patient was admitted to the emergency room with impaired consciousness and hypoglycaemia. The day before, she increased her water intake to about 1.5 L to perform a pelvic ultrasound. In the following hours, she developed vomiting and food refusal. Blood analysis revealed hypoglycaemia, hyponatraemia, decreased serum osmolality and normal urinary density. Hyponatraemia and adrenal crisis were managed with a gradual but slow resolution of consciousness and electrolytic balance...
March 9, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29506859/comparison-of-acid-base-and-electrolyte-changes-following-administration-of-6-hydroxyethyl-starch-130-0-42-in-a-saline-and-a-polyionic-solution-in-anaesthetized-dogs
#10
Katja N Adamik, Rafael Obrador, Judith Howard
OBJECTIVE: To evaluate the effects of a 6% hydroxyethyl starch (130/0.42) in either a buffered, electrolyte-balanced (HES-BAL) or saline (HES-SAL) carrier solution on electrolyte concentrations and acid-base parameters in healthy anaesthetized dogs. STUDY DESIGN: Prospective randomised clinical study. ANIMALS: A group of 40 client-owned dogs undergoing general anaesthesia for elective surgical procedures or diagnostic imaging. METHODS: During anaesthesia, dogs were intravenously administered 15 mL kg-1 of either HES-SAL (n = 20) or HES-BAL (n = 20) over 30-40 minutes...
May 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29483882/fluid-metabolism-in-athletes-running-seven-marathons-in-seven-consecutive-days
#11
Daniela Chlíbková, Pantelis T Nikolaidis, Thomas Rosemann, Beat Knechtle, Josef Bednář
Purpose: Hypohydration and hyperhydration are significant disorders of fluid metabolism in endurance performance; however, little relevant data exist regarding multi-stage endurance activities. The aim of the present study was to examine the effect of running seven marathons in 7 consecutive days on selected anthropometric, hematological and biochemical characteristics with an emphasis on hydration status. Methods: Participants included 6 women and 20 men (age 42.6 ± 6.2 years). Data was collected before day 1 (B1 ) and after day 1 (A1 ), 4 (A4 ), and 7 (A7 )...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29426350/effect-of-gelatin-polysuccinat-on-cerebral-oxygenation-and-microcirculation-in-a-porcine-haemorrhagic-shock-model
#12
Alexander Ziebart, Christian Möllmann, Andreas Garcia-Bardon, Jens Kamuf, Moritz Schäfer, Rainer Thomas, Erik K Hartmann
BACKGROUND: During early treatment of haemorrhagic shock maintenance of cerebral and end-organ oxygen supply by fluid resuscitation is mandatory. Gelatin-polysuccinat (GP) recently regained attention despite a still unclear risk profile and widely unknown effects on cerebral and peripheral microcirculation. This study investigates the effects of GP versus balanced electrolyte solution (BEL) with focus on cerebral regional oxygen saturation and peripheral microcirculation in a porcine haemorrhagic shock model...
February 9, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29420145/body-map-of-regional-versus-whole-body-sweating-rate-and-sweat-electrolyte-concentrations-in-men-and-women-during-moderate-exercise-heat-stress
#13
Lindsay B Baker, Corey T Ungaro, Bridget C Sopeña, Ryan P Nuccio, Adam J Reimel, James M Carter, John R Stofan, Kelly A Barnes
This study determined the relations between regional (REG) and whole body (WB) sweating rate (RSR and WBSR, respectively) and REG and WB sweat [Na+ ] during exercise. Twenty-six recreational athletes (17 men, 9 women) cycled for 90 min while WB sweat [Na+ ] was measured using the washdown technique. RSR and REG sweat [Na+ ] were measured from 9 regions using absorbent patches. RSR and REG sweat [Na+ ] from all regions were significantly (p<0.05) correlated with WBSR (r=0.58-0.83) and WB sweat [Na+ ] [r=0...
February 8, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29412539/understanding-fluid-homeostasis-in-infants-and-children-part-1
#14
Doreen Crawford
Fluid requirements differ between infants and children. It is important for children's nurses to understand the principles of fluid mechanics and apply this understanding to ensure each child's state of hydration, and thereby preserve their safety and well-being. This two-part article aims to introduce the concept of fluid balance and electrolytes to children's nursing students, help them identify what is normal and what is not, and provide guidance on what actions should be taken when problems occur. It may also be useful for registered nurses to use for revalidation...
February 7, 2018: Nursing Children and Young People
https://www.readbyqxmd.com/read/29386975/balanced-fluid-versus-saline-based-fluid-in-post-operative-severe-traumatic-brain-injury-patients-acid-base-and-electrolytes-assessment
#15
Mohamad Hasyizan Hassan, Wan Mohd Nazaruddin Wan Hassan, Rhendra Hardy Mohd Zaini, Wan Fadzlina Wan Muhd Shukeri, Huda Zainal Abidin, Chong Soon Eu
Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU...
October 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29340799/fully-automated-life-support-an-implementation-and-feasibility-pilot-study-in-healthy-pigs
#16
Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer, Martin Schenk
BACKGROUND: Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lacking in the medical sector. With respect to workload and safety, especially, the intensive care unit appears to be an important and challenging application field. Whereas many closed-loop subsystems for single applications already exist, no comprehensive system covering multiple therapeutic aspects and interactions is available yet...
January 16, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29339230/balanced-crystalloids-vs-0-9-saline-for-adult-patients-undergoing-non-renal-surgery-a-meta-analysis
#17
REVIEW
Lili Huang, Xiaoshuang Zhou, Hai Yu
BACKGROUND: Fluid maintenance and resuscitation is an important strategy during major surgeries. There has been a debate on the choice of crystalloids over the past decades. 0.9% saline (normal saline) is more likely to cause hyperchloremic acidosis when compared to balanced crystalloids with low chloride content. Meta-analyses comparing these two kinds of crystalloids have been performed in renal transplantations. We aim to compare the safety of balanced crystalloids to normal saline among adult patients undergoing non-renal surgery...
March 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29283518/digestive-and-nondigestive-functions-of-rodents-salivary-glands
#18
REVIEW
V V Ivanova, I V Milto, I V Sukhodolo, O N Serebryakova, A V Buzenkova
Major salivary glands play a role not only in digestion, but also in regulation of other functions in rodents. In this review, we analyzed and summarized the data about the rodents' parotid, submandibular and sublingual salivary glands functions, which is not limited to the production of saliva and action of its hydrolytic enzymes on food in the oral cavity. In recent decades significantly expanded understanding of major salivary glands nondigestive functions. They are involved in excretion of metabolic products, maintaining fluid and electrolyte balance...
January 2017: Uspekhi Fiziologicheskikh Nauk
https://www.readbyqxmd.com/read/29281773/fluid-and-electrolyte-management-across-the-age-continuum
#19
Tamara M Kear
Optional function of body systems depends upon fluid and electrolyte balance; however, across the lifespan, disorders of fluid and electrolytes offset this, and the causative factors are varied. Nurses play a major role in the management of fluid and electrolyte balance. This article focuses on the role total body water content, plasma proteins, kidney function, and drug metabolism have on the age-related physiology impacting fluid and electrolyte balance, and on nursing implications.
November 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29233909/oral-contraceptives-and-renal-water-handling-a-diurnal-study-in-young-women
#20
Charlotte Graugaard-Jensen, Gitte M Hvistendahl, Jørgen Frøkiær, Peter Bie, Jens Christian Djurhuus
To test the hypothesis that use of oral contraceptives (OC) changes diurnal variation in fluid balance mechanisms including blood pressure, secretion of vasopressin and oxytocin, and renal water and electrolyte excretion. Fifteen naturally cycling (NC) women in mid-follicular phase and 11 long-term OC users were included in a 24-h standardized inpatient study for measurements of vasopressin, oxytocin, sodium, and osmolality in plasma as well as urinary excretion of electrolytes, aquaporin-2, and prostaglandin E2...
December 2017: Physiological Reports
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