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Albumin, fluid resuscitation

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https://www.readbyqxmd.com/read/28757925/passive-leg-raising-simple-and-reliable-technique-to-prevent-fluid-overload-in-critically-ill-patients
#1
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
#2
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...
July 21, 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
#3
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
#4
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
#5
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
#6
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, a hormone involved in hemodynamic homeostasis, is controversial in sepsis, since administration of either the peptide or an antibody against it may be beneficial. METHODS: Plasma 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 (ALBIOS) trial. We tested the association of bio-ADM and its time-dependent variation with fluid therapy, vasopressor administration, organ failures and mortality...
April 11, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27890467/use-of-hyperbaric-oxygen-therapy-and-pegylated-carboxyhemoglobin-bovine-in-a-jehovah-s-witness-with-life-threatening-anemia-following-postpartum-hemorrhage
#13
K Thenuwara, J Thomas, M Ibsen, U Ituk, K Choi, E Nickel, M J Goodheart
We present a case of a Jehovah's Witness patient who refused blood products, with the exception of albumin and clotting factors, and underwent cesarean section under spinal anesthesia complicated by postpartum hemorrhage. She was fluid resuscitated and treated with multiple uterotonics and internal iliac artery embolization. Because of agitation she required emergency tracheal intubation. Her hemoglobin concentration dropped from a preoperative value of 12mg/dL to 3mg/dL on postoperative day one. She was acidotic, requiring vasopressors for hemodynamic stability and remained ventilated and sedated...
February 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/27864924/pentraxin-3-in-patients-with-severe-sepsis-or-shock-the-albios-trial
#14
Pietro Caironi, Serge Masson, Tommaso Mauri, Barbara Bottazzi, Roberto Leone, Michela Magnoli, Simona Barlera, Filippo Mamprin, Andrea Fedele, Alberto Mantovani, Gianni Tognoni, Antonio Pesenti, Luciano Gattinoni, Roberto Latini
BACKGROUND: The long pentraxin PTX3 is a key component of the humoral arm of innate immunity related to sepsis severity and mortality. We evaluated the clinical and prognostic significance of circulating PTX3 in the largest cohort ever reported of patients with severe sepsis or septic shock. MATERIALS AND METHODS: Plasma PTX3 was measured on days 1, 2 and 7 after randomization of 958 patients to albumin or crystalloids for fluid resuscitation in the multicentre Albumin Italian Outcome Sepsis (ALBIOS) trial...
January 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/27863270/fluid-resuscitation-mediates-the-association-between-inhalational-burn-injury-and-acute-kidney-injury-in-the-major-burn-population
#15
Avinash B Kumar, William Andrews, Yaping Shi, Matthew S Shotwell, Scott Dennis, Jonathan Wanderer, Blair Summitt
BACKGROUND: It is known that acute respiratory distress syndrome and acute lung injury are independent risk factors for developing acute kidney injury (AKI) through complex pathophysiologic mechanisms. Our specific aim is to evaluate the risk factors for AKI postburn injury and whether inhalation thermal injury is an independent risk factor for developing AKI in the major burn population. METHODS: This is an institutional review board-approved, retrospective cohort study of patients admitted to a tertiary burn intensive care unit between 2011 and 2013...
April 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27848268/use-of-intravenous-fluids-solutions-a-narrative-review
#16
N El Gkotmi, C Kosmeri, T D Filippatos, M S Elisaf
OBJECTIVE: Intravenous fluids are broadly categorized into colloids and crystalloids. The aim of this review is to present under a clinical point of view the characteristics of intravenous fluids that make them more or less appropriate either for maintaining hydration when enteral intake is contraindicated or for treating hypovolemia. METHODS: We considered randomized trials and meta-analyses as well as narrative reviews evaluating the effects of colloids or crystalloids in patients with hypovolemia or as maintenance fluids published in the PubMed and Cochrane databases...
March 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27822741/isolated-brain-trauma-in-cats-triggers-rapid-onset-of-hypovolemia
#17
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...
June 2017: Neurocritical Care
https://www.readbyqxmd.com/read/27779578/does-small-volume-resuscitation-with-crystalloids-or-colloids-influence-hemostasis-and-survival-of-rabbits-subjected-to-lethal-uncontrolled-hemorrhage
#18
Bijan Shams Kheirabadi, Nahir Miranda, Irasema B Terrazas, Mary D Gonzales, Rose C Grimm, Michael A Dubick
BACKGROUND: Prehospital, small-volume resuscitation of combat casualties with a synthetic colloid (6% hydroxyethyl starch [HES] 670/0.75) has been recommended when blood or blood components are unavailable. We studied hemostatic effects of a newer synthetic colloid (6% HES, 130/0.4) compared with either a natural colloid (albumin) or to crystalloids in an uncontrolled hemorrhage model. METHODS: Spontaneously breathing New Zealand white rabbits (3.4 ± 0.1 kg) were anesthetized, instrumented, and subjected to a splenic injury with uncontrolled bleeding...
January 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27760056/experimental-study-on-the-efficacy-of-site-specific-pegylated-human-serum-albumins-in-resuscitation-from-hemorrhagic-shock
#19
Xinlei Song, Shu Zhang, Yanna Cheng, Ting Zhao, Qianqian Lian, Lu Lu, Fengshan Wang
OBJECTIVES: To evaluate the resuscitative efficacy and the effect on reperfusion injury of two site-specific PEGylated human serum albumins modified with linear or branched PEG20kDa, compared with saline, 8% human serum albumin and 25% human serum albumin, in a hemorrhagic shock model. SETTING: Laboratory. SUBJECTS: Male Wistar rats. DESIGN: Prospective study. INTERVENTIONS: Rats were bled to hemorrhagic hypovolemic shock and resuscitated with different resuscitation fluids...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27665246/in-view-of-standardization-part-2-management-of-challenges-in-the-initial-treatment-of-burn-patients-in-burn-centers-in-germany-austria-and-switzerland
#20
Benjamin Ziegler, Christoph Hirche, Johannes Horter, Jurij Kiefer, Paul Alfred Grützner, Thomas Kremer, Ulrich Kneser, Matthias Münzberg
INTRODUCTION: Initial therapy of severe burns in specialized burn trauma centers is a challenging task faced by the treating multi-professional and interdisciplinary team. A lack of consistent operating procedures and varying structural conditions was recently demonstrated in preliminary data of our group. These results raised the question on how specific treatment measures in acute burn care are met in the absence of standardized guidelines. MATERIAL AND METHODS: A specific questionnaire containing 57 multiple-choice questions was sent to all 22 major burn centers in Germany, Austria and Switzerland...
March 2017: Burns: Journal of the International Society for Burn Injuries
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