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Fluid and electrolyte balance

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https://www.readbyqxmd.com/read/28693594/the-impact-of-phosphate-balanced-crystalloid-infusion-on-acid-base-homeostasis-palance-study-study-protocol-for-a-randomized-controlled-trial
#1
Judith-Irina Pagel, Nikolai Hulde, Tobias Kammerer, Michaela Schwarz, Daniel Chappell, Alexander Burges, Klaus Hofmann-Kiefer, Markus Rehm
BACKGROUND: This study aims to investigate the effects of a modified, balanced crystalloid including phosphate in a perioperative setting in order to maintain a stable electrolyte and acid-base homeostasis in the patient. METHODS/DESIGN: This is a single-centre, open-label, randomized controlled trial involving two parallel groups of female patients comparing a perioperative infusion regime with sodium glycerophosphate and Jonosteril® (treatment group) or Jonosteril® (comparator) alone...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28686506/the-impact-of-aging-on-epithelial-barriers
#2
Alan R Parrish
The epithelium has many critical roles in homeostasis, including an essential responsibility in establishing tissue barriers. In addition to the fundamental role in separating internal from external environment, epithelial barriers maintain nutrient, fluid, electrolyte and metabolic waste balance in multiple organs. While, by definition, barrier function is conserved, the structure of the epithelium varies across organs. For example, the skin barrier is a squamous layer of cells with distinct structural features, while the lung barrier is composed of a very thin single cell to minimize diffusion space...
June 26, 2017: Tissue Barriers
https://www.readbyqxmd.com/read/28675827/hyperglycemia-induced-hyponatremia-reevaluation-of-the-na-correction-factor
#3
Matthew B Wolf
This study addresses the clinically important relationship between the decreases in plasma Na(+) and the increases in plasma glucose concentrations seen in diabetes and other hyperglycemic syndromes. This plasma 'Na(+) correction factor', is generally accepted as 1.6mM Na(+) per 100mg% glucose (0.29mM/mM in SI units) assuming osmotic equilibrium, although much larger numbers have been measured in experiments on normal humans. To resolve this controversy, a mathematical model of whole-body fluid-electrolyte balance was used to perform the experiment wherein plasma glucose concentration was increased to diabetic levels and the plasma Na(+) concentration changes assessed, without the complications seen in human experiments...
June 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28660810/intravenous-fluid-and-electrolyte-administration-in-elective-gastrointestinal-surgery-mechanisms-of-excessive-therapy
#4
R G Simpson, J Quayle, N Stylianides, G Carlson, M Soop
INTRODUCTION While clinical guidelines stress the importance of the judicious perioperative intravenous fluid administration, data show that adherence to these protocols is poor. The reasons have not been identified. We therefore audited the magnitude and indications of fluid and electrolyte administration in a teaching hospital. We hypothesised that epidural analgesia is associated with excessive fluid therapy. MATERIALS AND METHODS Intravenous fluid and electrolyte administration during the day of surgery and the subsequent 2 days in consecutive patients undergoing elective gastrointestinal surgery between November 2013 and May 2014 were retrospectively audited...
July 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28652798/combined-aquaretic-and-diuretic-therapy-in-acute-heart-failure
#5
Michael Goyfman, Paul Zamudio, Kristine Jang, Jennifer Chee, Catherine Miranda, Javed Butler, Nand K Wadhwa
INTRODUCTION: Acute heart failure (AHF) is a leading cause of hospitalization and readmission in the US. The present study evaluated maximum diuresis while minimizing electrolyte imbalances, hemodynamic instability, and kidney dysfunction, to achieve a euvolemic state safely in a shorter period of time. METHODS AND RESULTS: A protocol of combined therapy with furosemide, metolazone, and spironolactone, with or without tolvaptan and acetazolamide, was used in 17 hospitalized patients with AHF...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28651510/pharmacodynamics-of-intravenous-frusemide-bolus-in-critically-ill-patients
#6
Agnes Huang, Nora Luethi, Johan Mårtensson, Rinaldo Bellomo, Luca Cioccari
OBJECTIVE: To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients. DESIGN, SETTING AND PATIENTS: A prospective observational study of 21 critically ill patients in a tertiary intensive care unit in Australia. INTERVENTIONS: We collected information on urine output (UO), fluid balance, serum and urinary electrolyte levels, serum biochemical levels and haemodynamics...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#7
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28553873/does-fluid-resuscitation-with-balanced-solutions-induce-electrolyte-and-metabolic-abnormalities-an-in-vitro-assessment
#8
Łukasz J Krzych, Piotr F Czempik
BACKGROUND: Popular intravenous fluids in clinical use may have impact on electrolyte concentration and metabolic balance and should be considered as powerful pharmacologic agents. There is growing body of evidence that fluid therapy should be more individualized and preferably based on balanced solutions. AIM: We sought to investigate impact of three commonly used balanced fluids on electrolytes and metabolic equilibrium in an in vitro setting. METHODS: Study group comprised 32 healthy male volunteers (no history of any acute/chronic disorder or known metabolic abnormalities), aged 21-35 (29 ± 4) years, weighting 59-103 (81...
May 29, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28544917/effective-and-safe-mannitol-administration-in-patients-undergoing-supratentorial-tumor-surgery-a-prospective-randomized-and-double-blind-study
#9
Eren Fatma Akcil, Ozlem Korkmaz Dilmen, Esra Sultan Karabulut, Serdar Selcuk Koksal, Fatis Altindas, Yusuf Tunali
OBJECTIVES: Although osmotic diuresis with mannitol is commonly used to provide brain relaxation, there is no consensus regarding its optimal dose and combination with loop diuretics. The aim of the present study is to evaluate the effects of mannitol and combination of furosemide with different doses of mannitol on brain relaxation and on blood electrolytes, lactate level, urine output, fluid balance and blood osmolarity in patients undergoing supratentorial tumor surgery. PATIENTS AND METHODS: This prospective, randomized, double blind, placebo-controlled study included 51 patients (ASA I-III) scheduled for elective supratentorial craniotomy...
August 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28520883/effect-of-isotonic-versus-hypotonic-maintenance-fluid-therapy-on-urine-output-fluid-balance-and-electrolyte-homeostasis-a-crossover-study-in-fasting-adult-volunteers
#10
N Van Regenmortel, T De Weerdt, A H Van Craenenbroeck, E Roelant, W Verbrugghe, K Dams, M L N G Malbrain, T Van den Wyngaert, P G Jorens
Background.: Daily and globally, millions of adult hospitalized patients are exposed to maintenance i.v. fluid solutions supported by limited scientific evidence. In particular, it remains unclear whether fluid tonicity contributes to the recently established detrimental effects of fluid, sodium, and chloride overload. Methods.: This crossover study consisted of two 48 h study periods, during which 12 fasting healthy adults were treated with a frequently prescribed solution (NaCl 0...
June 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28514645/oleanolic-acid-modulates-the-renin-angiotensin-system-and-cardiac-natriuretic-hormone-concomitantly-with-volume-and-pressure-balance-in-rats
#11
You Mee Ahn, Yoon Hee Choi, Jung Joo Yoon, Yun Jung Lee, Kyung Woo Cho, Dae Gill Kang, Ho Sub Lee
Oleanolic acid is known to possess beneficial effects on the regulation of the cardiovascular homeostasis. However, the exact nature of the role of oleanolic acid on the regulation of body fluid balance and blood pressure homeostasis and its mechanisms involved are not well defined. Experiments were performed to identify the effects of oleanolic acid on the renin-angiotensin system and cardiac natriuretic hormone (ANP) system, and also renal function and blood pressure in normotensive and renovascular hypertensive rats...
May 14, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28469455/perioperative-care-of-patients-with-liver-cirrhosis-a-review
#12
REVIEW
Naeem Abbas, Jasbir Makker, Hafsa Abbas, Bhavna Balar
The incidence of cirrhosis is rising, and identification of these patients prior to undergoing any surgical procedure is crucial. The preoperative risk stratification using validated scores, such as Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease, perioperative optimization of hemodynamics and metabolic derangements, and postoperative monitoring to minimize the risk of hepatic decompensation and complications are essential components of medical management. The advanced stage of cirrhosis, emergency surgery, open surgeries, old age, and coexistence of medical comorbidities are main factors influencing the clinical outcome of these patients...
2017: Health Services Insights
https://www.readbyqxmd.com/read/28431202/pharmacological-interventions-for-acute-pancreatitis
#13
REVIEW
Elisabetta Moggia, Rahul Koti, Ajay P Belgaumkar, Federico Fazio, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: In people with acute pancreatitis, it is unclear what the role should be for medical treatment as an addition to supportive care such as fluid and electrolyte balance and organ support in people with organ failure. OBJECTIVES: To assess the effects of different pharmacological interventions in people with acute pancreatitis. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 9), MEDLINE, Embase, Science Citation Index Expanded, and trial registers to October 2016 to identify randomised controlled trials (RCTs)...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28422408/prevention-of-the-osmotic-demyelination-syndrome-after-liver-transplantation-a-multidisciplinary-perspective
#14
J F Crismale, K A Meliambro, S DeMaria, D B Bronster, S Florman, T D Schiano
The osmotic demyelination syndrome (ODS) is a serious neurologic condition that occurs in the setting of rapid correction of hyponatremia. It presents with protean manifestations, from encephalopathy to the "locked-in" syndrome. ODS can complicate liver transplantation (LT), and its incidence may increase with the inclusion of serum sodium as a factor in the Model for End-Stage Liver Disease score. A comprehensive understanding of risk factors for the development of ODS in the setting of LT, along with recommendations to mitigate the risk of ODS, are necessary...
April 19, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28357122/therapeutically-targeting-guanylate-cyclase-c-computational-modeling-of-plecanatide-a-uroguanylin-analog
#15
Andrea Brancale, Kunwar Shailubhai, Salvatore Ferla, Antonio Ricci, Marcella Bassetto, Gary S Jacob
Plecanatide is a recently developed guanylate cyclase-C (GC-C) agonist and the first uroguanylin analog designed to treat chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). GC-C receptors are found across the length of the intestines and are thought to play a key role in fluid regulation and electrolyte balance. Ligands of the GC-C receptor include endogenous agonists, uroguanylin and guanylin, as well as diarrheagenic, Escherichia coli heat-stable enterotoxins (ST)...
April 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28341694/30-years-of-the-mineralocorticoid-receptor-mineralocorticoid-receptor-and-nacl-transport-mechanisms-in-the-renal-distal-nephron
#16
REVIEW
Shigeru Shibata
A key role of aldosterone and mineralocorticoid receptor is to regulate fluid volume and K(+) homeostasis in the body by acting on the renal distal nephron. Global responses of the kidney to elevated aldosterone levels are determined by the coordinate action of different constituent tubule cells, including principal cells, intercalated cells and distal convoluted tubule cells. Recent studies on genetic mutations causing aldosterone overproduction have identified the molecules involved in aldosterone biosynthesis in the adrenal gland, and there is also increasing evidence for mechanisms and signaling pathways regulating the balance between renal NaCl reabsorption and K(+) secretion, the two major effects of aldosterone...
July 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28338158/-diagnosis-and-treatment-of-duodenal-injury-and-fistula
#17
Kunmei Gong, Shikui Guo, Kunhua Wang
Duodenal injury is a serious abdominal organ injury. Duodenal fistula is one of the most serious complications in gastrointestinal surgery, which is concerned for its critical status, difficulty in treatment and high mortality. Thoracic and abdominal compound closed injury and a small part of open injury are common causes of duodenal injury. Iatrogenic or traumatic injury, malnutrition, cancer, tuberculosis, Crohn's disease etc. are common causes of duodenal fistula, however, there has been still lacking of ideal diagnosis and treatment by now...
March 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28336818/increased-exposure-to-sodium-during-pregnancy-and-lactation-changes-basal-and-induced-behavioral-and-neuroendocrine-responses-in-adult-male-offspring
#18
Marcia S Silva, Fabiana Lúcio-Oliveira, Andre Souza Mecawi, Lucas F Almeida, Silvia G Ruginsk, Michael P Greenwood, Mingkwan Greenwood, Laura Vivas, Lucila L K Elias, David Murphy, José Antunes-Rodrigues
Excessive sodium (Na(+)) intake in modern society has been associated with several chronic disorders such as hypertension. Several studies suggest that early life events can program physiological systems and lead to functional changes in adulthood. Therefore, we investigated behavioral and neuroendocrine responses under basal conditions and after 48 h of water deprivation in adult (60-day-old Wistar rats) male, Wistar rats originating from dams were offered only water or 0.15 mol/L NaCl during pregnancy and lactation...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28267585/disturbances-of-thirst-and-fluid-balance-associated-with-aging
#19
REVIEW
Denovan P Begg
During heat waves, significant mortality and morbidity occurs in elderly populations due to heat-stress and dehydration. The dehydration is primarily attributable to inadequate water intake caused by dysfunction of the central nervous system mechanisms controlling thirst. The phenomenon of a reduced thirst in response to dehydration in aging was first observed decades ago and has been examined extensively since. The reduced thirst and ingestive behavior have been reported consistently in response to hyperosmotic stimuli, hypovolemic stimuli and dehydration in both elderly humans and animal models of aging...
March 4, 2017: Physiology & Behavior
https://www.readbyqxmd.com/read/28241247/peritoneal-dialysis-vs-furosemide-for-prevention-of-fluid-overload-in-infants-after-cardiac-surgery-a-randomized-clinical-trial
#20
RANDOMIZED CONTROLLED TRIAL
David M Kwiatkowski, Stuart L Goldstein, David S Cooper, David P Nelson, David L S Morales, Catherine D Krawczeski
Importance: Fluid overload after congenital heart surgery is frequent and a major cause of morbidity and mortality among infants. Many programs have adopted the use of peritoneal dialysis (PD) for fluid management; however, its benefits compared with those of traditional diuretic administration are unknown. Objective: To determine whether infants randomized to PD vs furosemide for the treatment of oliguria have a higher incidence of negative fluid balance on postoperative day 1, as well as avoidance of 10% fluid overload; shorter duration of mechanical ventilation, intensive care unit stay, and inotrope use; and fewer electrolyte abnormalities...
April 1, 2017: JAMA Pediatrics
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