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fluid volume excess

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https://www.readbyqxmd.com/read/28078858/use-of-lactated-ringer%C3%A2-s-solution-does-not-eliminate-the-risk-of-strong-ion-difference-related-metabolic-acidosis-following-on-pump-cardiac-surgery
#1
T Jovaisa, V Vicka, G Linkaitė, J Guseinovaitė, D Ringaitienė, I Norkienė
There is a growing interest in the effects of plasma sodium levels on postoperative outcomes. A trend of using balanced crystalloid solutions is based on the extensive data on chloride and the strong ion difference-related acidosis. However, effects of sodium are often overlooked in this context. The aim of the study was to establish the effects of the routine use of Lactated Ringer’s Solution (RL) on postoperative changes in sodium concentrations and whether these changes result in metabolic acidosis. We performed database analysis of 358 consecutive elective on-pump cardiac surgery cases in a tertiary referral university hospital...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28070608/xuebijing-injection-treatment-inhibits-vasopermeability-and-reduces-fluid-requirements-in-a-canine-burn-model
#2
F-B Tang, Y-L Dai, S Hu, L-Q Ma, J-Y Li, H-P Zhang, W-H Zhang, Y-G Li, H-B Wang, H-Y Lin, Q Hu, L Li
OBJECTIVE: High vasopermeability and excessive inflammation following severe burns may result in tissue edema, organ dysfunction and the loss of circulatory plasma volume, which can influence the doctor to do the prognosis to the patients. The study aims to examine whether Xuebijing injection (XBJ), an extracts of a traditional Chinese medicine used to treat sepsis in clinic, can reduces fluid requirements by inhibiting vasopermeability and tissue edema in a canine model after burn injury...
January 9, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28053070/automated-microsampling-technologies-and-enhancements-in-the-3rs
#3
L David Hopper
Data collected in vivo is essential for advising decisions on drug screening and development and basic research, and animal models are used extensively for acquiring experimental measurements. Traditionally, collection of specimens has been invasive, stressful to animal subjects, labor intensive, time-consuming and costly, and required many animals when using small models with low fluid volumes, such as rats or mice. Utilizing automated microsampling (AMS) alone or in an integrative pharmacology approach to evaluate multiple physiological, pharmacokinetic, and pharmacodynamic endpoints simultaneously in the same animal accomplishes multiple experimental goals...
December 2016: ILAR Journal
https://www.readbyqxmd.com/read/28043083/lung-ultrasound-in-the-management-of-fluid-volume-in-dialysis-patients-potential-usefulness
#4
EDITORIAL
Carmine Zoccali
Volume overload is a hidden, pervasive complication in dialysis patients with dyspnea and pulmonary edema being its main clinical manifestations. Measuring lung water has clinical potential because it allows timely treatment of lung congestion at a preclinical stage. Chest ultrasound (US) is a novel, well-validated technique that allows reliable estimates of lung water in clinical practice. The application of this technique in dialysis patients has shown that an unsuspectedly high proportion of these patients have moderate to severe lung congestion which is usually asymptomatic...
January 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/27995646/bicarbonate-rich-fluid-secretion-predicted-by-a-computational-model-of-guinea-pig-pancreatic-duct-epithelium
#5
Makoto Yamaguchi, Martin C Steward, Kieran Smallbone, Yoshiro Sohma, Akiko Yamamoto, Shigeru B H Ko, Takaharu Kondo, Hiroshi Ishiguro
A computational model of guinea-pig pancreatic duct epithelium was developed to determine the transport mechanism by which HCO3(-) ions are secreted at concentrations in excess of 140 mm. Parameters defining the contributions of the individual ion channels and transporters were estimated by least-squares fitting of the model predictions to experimental data obtained from isolated ducts and intact pancreas under a range of experimental conditions. The effects of cAMP-stimulated secretion were well replicated by increasing the activities of the basolateral Na(+) -HCO3(-) cotransporter (NBC1) and apical Cl(-) /HCO3(-) exchanger (SLC26A6), increasing the basolateral K(+) permeability and apical Cl(-) and HCO3(-) permeabilities (CFTR), and reducing the activity of the basolateral Cl(-) /HCO3(-) exchanger (AE2)...
December 20, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27992875/calf-resistivity-values-in-chronic-kidney-disease-in-a-caucasian-population
#6
Eric Seibert, Stephan G Müller, Johanna Pattmöller, Peter Kotanko, Fansan Zhu, Nathan W Levin, Roman Fiedler, Martin K Kuhlmann, Matthias Girndt
BACKGROUND: Continuous intradialytic calf bioimpedance spectroscopy (cBIS) allows assessment of changes in calf extracellular fluid volume (ECV) to determine dry weight (DW) in hemodialysis patients. During dialysis, calf ECV decreases until excessive ECV has been removed and normalized resistivity ρN,5 rises to values comparable to those of a normal population (cBIS-DW). It is not clear whether chronic kidney disease (CKD) itself influences ρN,5 and whether normal values depend on race and ethnicity...
December 20, 2016: Nephron
https://www.readbyqxmd.com/read/27968810/a-review-of-available-techniques-for-cardiac-output-monitoring
#7
REVIEW
Kristen Marshall, Elizabeth Thomovsky, Paula Johnson, Aimee Brooks
The main objective of fluid therapy is to increase cardiac output (CO). Large, rapidly administered volumes of fluids are the cornerstone of treating patients in shock to restore circulating volume and improve tissue perfusion. However, determining exactly how much fluid a given patient requires can be challenging. If enough fluid is not given, poor tissue perfusion can lead to ischemia, anaerobic metabolism, and ultimately cell and patient death. Conversely, increased morbidity and mortality associated with excessive intravenous fluid administration has been reported in the human literature in a wide variety of conditions...
September 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/27925707/natural-mineral-bottled-waters-available-on-the-polish-market-as-a-source-of-minerals-for-the-consumers-part-2-the-intake-of-sodium-and-potassium
#8
Anna Gątarska, Joanna Ciborska, Elżbieta Tońska
Background: Natural mineral waters are purchased and consumed according to consumer preferences and possible recommendations. The choice of appropriate water should take into account not only the general level of mineralization but also the content of individual components, including electrolytes such as sodium and potassium. Sodium is necessary to ensure the proper physiological functions of the body. It is defined as a health risk factor only when its excessive intake occurs. Potassium acts antagonistically towards sodium and calcium ions, contributes to a reduction of the volume of extracellular fluids and at the same time reduces muscle tension and permeability of cell membranes...
2016: Roczniki Państwowego Zakładu Higieny
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#9
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
January 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/27871561/perioperative-fluid-therapy-defining-a-clinical-algorithm-between-insufficient-and-excessive
#10
REVIEW
Mike S Strunden, Sascha Tank, Thoralf Kerner
In the perioperative scenario, adequate fluid and volume therapy is a challenging task. Despite improved knowledge on the physiology of the vascular barrier function and its respective pathophysiologic disturbances during the perioperative process, clear-cut therapeutic principles are difficult to implement. Neglecting the physiologic basis of the vascular barrier and the cardiovascular system, numerous studies proclaiming different approaches to fluid and volume therapy do not provide a rationale, as various surgical and patient risk groups, and different fluid regimens combined with varying hemodynamic measures and variable algorithms led to conflicting results...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27846126/implementation-of-the-american-society-of-anesthesiology-s-guidelines-to-reduce-prolonged-fasting-times-in-pediatric-preoperative-patients-a-best-practice-implementation-project
#11
Carol M Costello
BACKGROUND: The American Society of Anesthesiology (ASA) guidelines for pediatric preoperative fasting have been a standard for well over a decade. However, use of protocols involving an excessive fasting duration exposes patients to the physiological impacts of fluid volume loss. OBJECTIVES: The current project aimed to improve fluid supplementation during presurgical fasting in pediatric patients at an academic medical center. Specific objectives were to increase clinical staff knowledge regarding ASA fasting standards and implement them in specific pediatric patient populations...
October 2016: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/27829730/are-we-all-guilty-of-under-estimating-intra-operative-blood-loss-during-hip-fracture-surgery
#12
Basil Budair, Usman Ahmed, James Hodson, Michael David, Mujeeb Ashraf, Tim McBride
AIM: To assess how accurately orthopaedic surgeons and anaesthesiologists estimate intraoperative blood loss during hip fracture surgery as part of the Surgical Safety Checklist (SCC). METHODS: A prospective study of 55 operations over 9 months. Pre- and post-operative estimations of blood loss were documented. Actual blood loss was determined by subtracting total amount of lavage fluid used from overall volumes in the suction bag and by weighing used swabs. RESULTS: Both, surgeons and anaesthesiologists, significantly underestimated intraoperative blood loss (p < 0...
March 2017: Journal of Orthopaedics
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
#13
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
https://www.readbyqxmd.com/read/27822741/isolated-brain-trauma-in-cats-triggers-rapid-onset-of-hypovolemia
#14
Peter Bentzer, Per-Olof Grände
BACKGROUND: Hemodynamic instability responsive to fluid resuscitation is common after a traumatic brain injury (TBI), also in the absence of systemic hemorrhage. The present study tests if an isolated severe TBI induces a decrease in plasma volume (PV). METHODS: The study was performed in three groups of anesthetized and tracheostomized male cats (n = 21). In one group (n = 8), the cats were prepared with a cranial borehole (10 mm i.d) used to expose the brain to a fluid percussion brain injury (FPI) (1...
November 7, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27791015/overdrinking-swallowing-inhibition-and-regional-brain-responses-prior-to-swallowing
#15
Pascal Saker, Michael J Farrell, Gary F Egan, Michael J McKinley, Derek A Denton
In humans, drinking replenishes fluid loss and satiates the sensation of thirst that accompanies dehydration. Typically, the volume of water drunk in response to thirst matches the deficit. Exactly how this accurate metering is achieved is unknown; recent evidence implicates swallowing inhibition as a potential factor. Using fMRI, this study investigated whether swallowing inhibition is present after more water has been drunk than is necessary to restore fluid balance within the body. This proposal was tested using ratings of swallowing effort and measuring regional brain responses as participants prepared to swallow small volumes of liquid while they were thirsty and after they had overdrunk...
October 25, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27779417/incorporation-of-hard-and-soft-protein-protein-interactions-into-models-for-crowding-effects-in-binary-and-ternary-protein-mixtures-comparison-of-approximate-analytical-solutions-with-numerical-simulation
#16
Travis Hoppe, Allen P Minton
In order to better understand how nonspecific interactions between solutes can modulate specific biochemical reactions taking place in complex media, we introduce a simplified model aimed at elucidating general principles. In this model, solutions containing two or three species of interacting globular proteins are modeled as a fluid of spherical particles interacting through square well potentials that qualitatively capture both steric hard core repulsion and longer-ranged attraction or repulsion. The excess chemical potential, or free energy of solvation, of each particle species is calculated as a function of species concentrations, particle radii, and square well interaction range and depth...
November 23, 2016: Journal of Physical Chemistry. B
https://www.readbyqxmd.com/read/27754173/sy-14-3-primary-aldosteronism-in-resistant-hypertension
#17
David Calhoun
: Resistant hypertension refers to patients with difficult-to-treat hypertension, generally defined as needing three or more medications of different classes, including, if tolerated, a diuretic. Observational studies indicate that the prevalence of resistant hypertension based on the preceding definition of needing 3 or medications for blood pressure (BP) control is approximately 15-20% of patients being treated for hypertension. However, causes of pseudoresistance are common, including poor BP technique, poor adherence, white coat effects, and under-treatment, all of which must be identified in order to distinguish apparent resistance from true treatment resistance...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27744075/prone-versus-sitting-position-in-neurosurgery-differences-in-patients-hemodynamic-management
#18
Teemu Luostarinen, Ann-Christine Lindroos, T Niiya, M Silvasti-Lundell, Alexey Schramko, Juha Hernesniemi, Tarja Randell, Tomi Niemi
OBJECTIVE: Neurosurgery in general anesthesia exposes patient to hemodynamic alternations both in prone and sitting position. As the comparison of the sitting and prone position in neurosurgery is scarce, we aimed to evaluate hemodynamic profile during stroke volume-directed fluid administration in patients undergoing neurosurgery either in sitting or prone position. METHODS: Thirty patients in prone and 28 in sitting position in two separate prospective trials were randomized to receive either Ringer's Acetate (RAC) or hydroxyethyl starch (HES 130 kDa/0...
October 12, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27738483/comparison-of-the-effectiveness-of-hydroxyethyl-starch-voluven-solution-with-normal-saline-in-hemorrhagic-shock-treatment-in-trauma
#19
Kambiz Masoumi, Arash Forouzan, Ali Asgari Darian, Alireza Rafaty Navaii
BACKGROUND: Appropriate fluid therapy affects morbidity and mortality rates. A conclusion is yet to be reached on the role of crystalloids and colloids in immediate fluid therapy. This study was done to determine the suitable solution in immediate resuscitation of patients with hemorrhagic shock caused by tissue trauma. METHODS: One hundred trauma patients with hemorrhagic shock, who underwent fluid therapy in the emergency unit, were assigned randomly to two groups of hydroxyethyl starch (Voluven) and normal saline...
November 2016: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27736042/lung-and-cardiac-ultrasound-for-hemodynamic-monitoring-of-patients-with-severe-pre-eclampsia
#20
J Ambrozic, G Brzan Simenc, K Prokselj, N Tul, M Cvijic, M Lucovnik
OBJECTIVE: To evaluate lung and cardiac ultrasound for the assessment of fluid tolerance and fluid responsiveness before and after delivery in pregnant women with severe pre-eclampsia (PE). METHODS: This was a prospective observational study of singleton pregnant women with severe PE and healthy term controls. Lung ultrasound echo comet score (ECS), which denotes the amount of extravascular lung water, was obtained using the 28-rib interspaces technique. The echocardiographic E/e' ratio, measured by pulsed-wave and tissue Doppler, was used as a marker of diastolic left ventricular function...
January 2017: Ultrasound in Obstetrics & Gynecology
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