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Albumin, fluid resuscitation

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https://www.readbyqxmd.com/read/29132516/decompensated-cirrhosis-and-fluid-resuscitation
#1
REVIEW
Erin Maynard
The critically ill patient with decompensated cirrhosis has a unique physiology and alterations in albumin that need to be understood to properly resuscitate them and minimize morbidity and mortality. Little data exist on specific resuscitation of the patient with cirrhosis compared with those patients without liver disease. The effectiveness of albumin administration compared with saline administration in common settings, such as large-volume paracentesis, can be extrapolated to the care of the general surgical patient but further studies in this area are warranted...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29099424/colloids-and-the-microcirculation
#2
Huaiwu He, Dawei Liu, Can Ince
Colloid solutions have been advocated for use in treating hypovolemia due to their expected effect on improving intravascular retention compared with crystalloid solutions. Because the ultimate desired effect of fluid resuscitation is the improvement of microcirculatory perfusion and tissue oxygenation, it is of interest to study the effects of colloids and crystalloids at the level of microcirculation under conditions of shock and fluid resuscitation, and to explore the potential benefits of using colloids in terms of recruiting the microcirculation under conditions of hypovolemia...
November 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29079487/what-is-the-preferred-resuscitation-fluid-for-patients-with-severe-sepsis-and-septic-shock
#3
Michael E Winters, Robert Sherwin, Gary M Vilke, Gabriel Wardi
BACKGROUND: Current guidelines for the management of patients with severe sepsis and septic shock recommend crystalloids as the initial fluid solution of choice in the resuscitation of these patients. In recent years, there have been numerous studies published on the type of fluid used in the resuscitation of patients with sepsis. The primary goal of this article is to determine the preferred intravenous fluid for the resuscitation of patients with severe sepsis and septic shock. METHODS: A MEDLINE literature review was completed to identify studies that investigated the type of resuscitation fluid in the management of patients with severe sepsis and septic shock...
October 24, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29075932/effect-of-ringers-acetate-in-different-doses-on-plasma-volume-in-rat-models-of-hypovolemia
#4
Svajunas Statkevicius, Attila Frigyesi, Peter Bentzer
BACKGROUND: Even though crystalloids are the first choice for fluid resuscitation in hemodynamically unstable patients, their potency as plasma volume expanders in hypovolemia of different etiologies is largely unknown. The objective of the study was to investigate dose-response curves of a crystalloid in hypovolemia induced by either sepsis or hemorrhagic shock. RESULTS: Rats were randomized to resuscitation with Ringers acetate at a dose 10, 30, 50, 75, or 100 ml/kg at 4 h after induction of sepsis by cecal ligation and puncture (CLP) or 2...
October 26, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29075482/fluid-resuscitation-practices-in-cardiac-surgery-patients-in-the-usa-a-survey-of-health-care-providers
#5
Solomon Aronson, Paul Nisbet, Martin Bunke
BACKGROUND: Fluid resuscitation during cardiac surgery is common with significant variability in clinical practice. Our goal was to investigate current practice patterns of fluid volume expansion in patients undergoing cardiac surgeries in the USA. METHODS: We conducted a cross-sectional online survey of 124 cardiothoracic surgeons, cardiovascular anesthesiologists, and perfusionists. Survey questions were designed to assess clinical decision-making patterns of intravenous (IV) fluid utilization in cardiovascular surgery for five types of patients who need volume expansion: (1) patients undergoing cardiopulmonary bypass (CPB) without bleeding, (2) patients undergoing CPB with bleeding, (3) patients undergoing acute normovolemic hemodilution (ANH), (4) patients requiring extracorporeal membrane oxygenation (ECMO) or use of a ventricular assist device (VAD), and (5) patients undergoing either off-pump coronary artery bypass graft (OPCABG) surgery or transcatheter aortic valve replacement (TAVR)...
2017: Perioperative Medicine
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
#6
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/28884212/routine-sildenafil-does-not-improve-clinical-outcomes-after-fontan-operation
#7
J Leslie Gaddis Collins, Mark A Law, Santiago Borasino, W Clinton Erwin, David C Cleveland, Jeffrey A Alten
Fontan operation can be complicated by persistent chest tube output (CTO) leading to prolonged hospital length of stay (LOS). Postoperative sildenafil administration has been shown to improve clinical outcomes in selected patients after Fontan. We initiated a practice change utilizing intravenous (IV) sildenafil in early postoperative period in all patients undergoing Fontan operation with aim to decrease LOS and CTO. Nineteen patients (February 2014-May 2016) received 0.35 mg/kg sildenafil IV (three doses) followed by enteral, 1 mg/kg every eight hours until hospital discharge...
December 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28837537/characterization-of-hypoalbuminemia-following-temporary-abdominal-closure
#8
Tyler J Loftus, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge
BACKGROUND: The purpose of this study was to characterize associations among serum proteins, negative-pressure wound therapy (NPWT) fluid loss, and primary fascial closure (PFC) following emergent laparotomy and temporary abdominal closure (TAC). We hypothesized that high levels of C-reactive protein (CRP) and NPWT output would be associated with hypoalbuminemia and failure to achieve PFC. METHODS: We performed a retrospective analysis of 233 patients managed with NPWT TAC...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28757925/passive-leg-raising-simple-and-reliable-technique-to-prevent-fluid-overload-in-critically-ill-patients
#9
Farahnak Assadi
BACKGROUND: Dynamic measures, the response to stroke volume (SV) to fluid loading, have been used successfully to guide fluid management decisions in critically ill patients. However, application of dynamic measures is often inaccurate to predict fluid responsiveness in patients with arrhythmias, ventricular dysfunction or spontaneously breathing critically ill patients. Passive leg raising (PLR) is a simple bedside maneuver that may provide an accurate alternative to guide fluid resuscitation in hypovolemic critically ill patients...
2017: International Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28739260/uses-and-misuses-of-albumin-during-resuscitation-and-in-the-neonatal-intensive-care-unit
#10
REVIEW
Wissam Shalish, Francois Olivier, Hany Aly, Guilherme Sant'Anna
Albumin is one of the most abundant proteins in plasma and serves many vital functions. Neonatal concentrations vary greatly with gestational and postnatal age. In critically ill neonates, hypoalbuminemia occurs due to decreased synthesis, increased losses or redistribution of albumin into the extravascular space, and has been associated with increased morbidities and mortality. For that reason, infusion of exogenous albumin as a volume expander has been proposed for various clinical settings including hypotension, delivery room resuscitation, sepsis and postoperative fluid management...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28599038/albumin-for-prehospital-fluid-resuscitation-of-hemorrhagic-shock-in-tactical-combat-casualty-care
#11
Nicholas M Studer, Michael D April, F Bowling, Paul D Danielson, Andrew P Cap
Optimal fluid resuscitation on the battlefield in the absence of blood products remains unclear. Contemporary Combat medics are generally limited to hydroxyethyl starch or crystalloid solutions, both of which present significant drawbacks. Obtaining US Food and Drug Administration (FDA)-approved freeze-dried plasma (FDP) is a top casualty care research priority for the US Military. Interest in this agent reflects a desire to simultaneously expand intravascular volume and address coagulopathy. The history of FDP dates to the Second World War, when American expeditionary forces used this agent frequently...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28498856/patterns-of-intravenous-fluid-resuscitation-use-in-adult-intensive-care-patients-between-2007-and-2014-an-international-cross-sectional-study
#12
Naomi E Hammond, Colman Taylor, Simon Finfer, Flavia R Machado, YouZhong An, Laurent Billot, Frank Bloos, Fernando Bozza, Alexandre Biasi Cavalcanti, Maryam Correa, Bin Du, Peter B Hjortrup, Yang Li, Lauralyn McIntryre, Manoj Saxena, Frédérique Schortgen, Nicola R Watts, John Myburgh
BACKGROUND: In 2007, the Saline versus Albumin Fluid Evaluation-Translation of Research Into Practice Study (SAFE-TRIPS) reported that 0.9% sodium chloride (saline) and hydroxyethyl starch (HES) were the most commonly used resuscitation fluids in intensive care unit (ICU) patients. Evidence has emerged since 2007 that these fluids are associated with adverse patient-centred outcomes. Based on the published evidence since 2007, we sought to determine the current type of fluid resuscitation used in clinical practice and the predictors of fluid choice and determine whether these have changed between 2007 and 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28414664/gonococcal-endocarditis-the-gift-that-stops-giving-an-uncommon-presentation-of-a-common-disease
#13
G Olayemi, M Oferczak, A Elagizi, I El-Abbassi, M Eschete, J Crowe
INTRODUCTION: Gonorrhea is the 2nd most common sexually transmitted disease in the US with 800,000 cases of gonorrhea each year. Disseminated gonorrhea infection occurs in 0.5 percent - 3 percent of these patients and is more frequent in woman younger than 40 years of age. CASE: A 36 year old woman with a history of polysubstance abuse presented with 10 day history of feeling generally unwell. At presentation, vitals were remarkable for tachycardia and hypotension...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28411114/circulating-biologically-active-adrenomedullin-bio-adm-predicts-hemodynamic-support-requirement-and-mortality-during-sepsis
#14
MULTICENTER STUDY
Pietro Caironi, Roberto Latini, Joachim Struck, Oliver Hartmann, Andreas Bergmann, Giuseppe Maggio, Marco Cavana, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Serge Masson
BACKGROUND: The biological role of adrenomedullin (ADM), a hormone involved in hemodynamic homeostasis, is controversial in sepsis because administration of either the peptide or an antibody against it may be beneficial. METHODS: Plasma biologically active ADM (bio-ADM) was assessed on days 1, 2, and 7 after randomization of 956 patients with sepsis or septic shock to albumin or crystalloids for fluid resuscitation in the multicenter Albumin Italian Outcome Sepsis trial...
August 2017: Chest
https://www.readbyqxmd.com/read/28380062/different-effects-of-fluid-loading-with-saline-gelatine-hydroxyethyl-starch-or-albumin-solutions-on-acid-base-status-in-the-critically-ill
#15
RANDOMIZED CONTROLLED TRIAL
Angélique M E Spoelstra-de Man, Annemieke Smorenberg, A B Johan Groeneveld
INTRODUCTION: Fluid administration in critically ill patients may affect acid-base balance. However, the effect of the fluid type used for resuscitation on acid-base balance remains controversial. METHODS: We studied the effect of fluid resuscitation of normal saline and the colloids gelatine 4%, hydroxyethyl starch (HES) 6%, and albumin 5% on acid-base balance in 115 clinically hypovolemic critically ill patients during a 90 minute filling pressure-guided fluid challenge by a post-hoc analysis of a prospective randomized clinical trial...
2017: PloS One
https://www.readbyqxmd.com/read/28361122/risk-factors-for-intractable-ascites-after-adult-to-adult-living-donor-liver-transplantation-using-left-lobe
#16
Shinichi Matsudaira, Yoichi Ishizaki, Jiro Yoshimoto, Noriko Fujiwara, Seiji Kawasaki
BACKGROUND: Intractable ascites is one of the causes of graft loss after adult-to-adult living donor liver transplantation (LDLT) using a small graft. Identification of factors associated with increasing posttransplant ascites has important implications for prevention and treatment. METHODS: All 59 consecutive adult patients who underwent left lobe LDLT without portal inflow modulation between October 2002 and February 2016 were prospectively enrolled. Factors associated with the average daily amount of ascites for 2 weeks after LDLT were assessed...
March 2017: Transplantation Direct
https://www.readbyqxmd.com/read/28328710/fatty-acid-saturation-of-albumin-used-in-resuscitation-fluids-modulates-cell-damage-in-shock-in-vitro-results-using-a-novel-technique-to-measure-fatty-acid-binding-capacity
#17
Alexander H Penn, Michael A Dubick, Ivo P Torres Filho
The use of albumin for resuscitation has not proven as beneficial in human trials as expected from numerous animal studies. One explanation could be the practice of adding fatty acid (FA) during manufacture of pharmaceutical albumin. During ischemia, unbound free FAs (FFA) in the circulation could potentially induce cellular damage. We hypothesized that albumins with higher available binding capacities (ABC) for FFAs may prevent that damage. Therefore, we developed a technique to measure ABC, determined if pharmaceutical human serum albumin (HSA) has decreased ABC compared to FA-free bovine serum albumin (BSA), and if binding capacity would affect hemolysis when blood is mixed with exogenous FFA at levels similar to those observed in shock...
March 21, 2017: Shock
https://www.readbyqxmd.com/read/28105603/resuscitation-fluid-composition-affects-hepatic-inflammation-in-a-murine-model-of-early-sepsis
#18
Amanda L Patrick, Peter M Grin, Nicole Kraus, Michelle Gold, Matthew Berardocco, Patricia C Liaw, Alison E Fox-Robichaud
BACKGROUND: Fluid resuscitation is a crucial therapy for sepsis, and the use of balanced fluids and/or isotonic albumin may improve patient survival. We have previously demonstrated that resuscitation with normal saline results in increased hepatic leukocyte recruitment in a murine model of sepsis. Given that clinical formulations of albumin are in saline, our objectives were to develop a novel balanced electrolyte solution specifically for sepsis and to determine if supplementing this solution with albumin would improve the inflammatory response in sepsis...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28009701/burn-shock-and-resuscitation-proceedings-of-a-symposium-conducted-at-the-meeting-of-the-american-burn-association-chicago-il-21-april-2015
#19
Maria L Serio-Melvin, José Salinas, Kevin K Chung, Clayton Collins, John C Graybill, David T Harrington, David N Herndon, David G Greenhalgh, George C Kramer, Alicia Lintner, Michael J Mosier, Ashish Nagpal, Leopoldo C Cancio
The Special Interest Groups of the American Burn Association provide a forum for interested members of the multidisciplinary burn team to congregate and discuss matters of mutual interest. At the 47th Annual Meeting of the American Burn Association in Chicago, IL, the Fluid Resuscitation Special Interest Group sponsored a special symposium on burn resuscitation. The purpose of the symposium was to review the history, current status, and future direction of fluid resuscitation of patients with burn shock. The reader will note several themes running through the following presentations...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27923389/the-importance-of-albumin-infusion-rate-for-plasma-volume-expansion-following-major-abdominal-surgery-air-study-protocol-for-a-randomised-controlled-trial
#20
Svajunas Statkevicius, Johan Bonnevier, Björn P Bark, Erik Larsson, Carl M Öberg, Päivi Kannisto, Bobby Tingstedt, Peter Bentzer
BACKGROUND: Administration of fluids to restore normovolaemia is one of the most common therapeutic interventions performed peri-operatively and in the critically ill, but no study has evaluated the importance of infusion rate for the plasma volume-expanding effect of a resuscitation fluid. The present study is designed to test the hypothesis that a slow infusion of resuscitation fluid results in better plasma volume expansion than a rapid infusion. METHODS/DESIGN: The study is a single-centre, assessor-blinded, parallel-group, randomised prospective study...
December 7, 2016: Trials
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