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balanced crystalloids

Ming Xue, Xiwen Zhang, Feng Liu, Wei Chang, Jianfeng Xie, Jingyuan Xu, Yi Yang, Haibo Qiu
BACKGROUND: Intravenous crystalloid solutions are administered commonly for critically ill patients. We performed this meta-analysis of randomized trials with trial sequential analysis (TSA) to evaluate effects of chloride content of intravenous crystalloid solutions on clinical outcomes among critically ill adult patients. METHODS: Electronic databases were searched up to June 1, 2018, for randomized trials of use of balanced crystalloids versus 0.9% saline solutions in critically ill adult patients...
February 13, 2019: Annals of Intensive Care
Kuan-Fu Chen, Meng-Ying Tsai, Chin-Chieh Wu, Shih-Tsung Han
Sepsis is a major cause of morbidity and mortality worldwide. With the advance of medical care, the mortality of sepsis has decreased in the past decades. Many treatments and diagnostic tools still lack supporting evidence. We conducted a retrospective population-based cohort study with propensity score matched subcohorts based on a prospectively collected national longitudinal health insurance database in Taiwan. Severe sepsis-associated hospital admissions from 2000 to 2011 based on International Classification of Diseases, Ninth Revision, Clinical Modification codes of infections and acute organ dysfunction were identified...
January 30, 2019: Journal of Intensive Care Medicine
Matthew W Semler, David R Janz, Jonathan D Casey, Wesley H Self, Todd W Rice
RATIONALE: The feasibility and clinical outcomes of conservative fluid management after sepsis resuscitation remain unknown. OBJECTIVES: To evaluate the effect of a conservative fluid management protocol on fluid balance and intensive care unit (ICU)-free days among patients with sepsis. METHODS: In a single-center phase II/III randomized trial, we enrolled adults with suspected infection, ≥2 systemic inflammatory response syndrome criteria, and either shock (mean arterial pressure <60 mm Hg or vasopressors) or respiratory insufficiency (mechanical ventilation or oxygen saturation <97% and fraction of inspired oxygen ≥0...
January 10, 2019: Journal of Intensive Care Medicine
Thomas Standl, Thorsten Annecke, Ingolf Cascorbi, Axel R Heller, Anton Sabashnikov, Wolfram Teske
BACKGROUND: A severe mismatch between the supply and demand of oxygen is the common feature of all types of shock. We present a newly developed, clinically oriented classification of the various types of shock and their therapeutic implications. METHODS: This review is based on pertinent publications (1990-2018) retrieved by a selective search in PubMed, and on the relevant guidelines and meta-analyses. RESULTS: There are only four major categories of shock, each of which is mainly related to one of four organ systems...
November 9, 2018: Deutsches Ärzteblatt International
Peifen Ma, Bo Wang, Jun Zhang, Xiping Shen, Liping Yu, Xinman Dou
BACKGROUND: The balanced crystalloids have become a substitute for saline for fluid resuscitation. Some studies have investigated the clinical effect and adverse event of differently balanced crystalloids, but they have no consistent conclusions. This study aims to assess and compare the effect of differently balanced crystalloids for intravenous fluid therapy in critically ill and non-critically ill patients using network meta-analysis (NMA). METHODS: Electronic databases including PubMed, EMBASE, Cochrane Library, Web of Science, Clinical Trials...
December 2018: Medicine (Baltimore)
Ana Cvetkovic, Nevena Kalezic, Biljana Milicic, Srdjan Nikolic, Milan Zegarac, Dusica Gavrilovic, Dejan Stojiljkovic
PURPOSE: The purpose of this study was to compare two groups in postoperative recovery, whether there were any complications and whether the length of their hospital stay differed. One group received intraoperatively a combination of crystalloids and a small colloid dose, while the other group received only the crystalloids intraoperatively. METHODS: This randomized prospective study included 80 patients with colorectal cancer prepared for major elective colorectal surgery...
September 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
Shan Zhang, Xiaoke Dai, Chunbao Guo
Intravenous fluid prescription plays an important role in sepsis management, which may be associated with patient prognosis. The objective of the present study was to determine if the administration of crystalloid fluids is associated with clinical outcome for patients with severe sepsis and septic shock.The medical records of 79 patients with severe sepsis or septic shock at an academic tertiary care hospital between 2011 and 2016 were reviewed retrospectively. The patients were dichotomized based on the median 3-day amount of corrected crystalloid fluids as low (<193 mL/kg) versus high (>193 mL/kg)...
November 2018: Medicine (Baltimore)
Emmanuel Weiss, Catherine Paugam-Burtz, Samir Jaber
Liver failure can occur in patients with or without underlying chronic liver disease (mainly cirrhosis) and is, respectively, termed acute on chronic liver failure or acute liver failure (ALF). In both cases, it is associated with marked systemic inflammation and profound hemodynamic disturbances, that is, increased cardiac output, peripheral vasodilation, and decreased systemic vascular resistance, on top of several superimposed etiologies of shock. In patients with cirrhosis, sepsis is the main cause of intensive care unit admission but portal hypertension-related gastrointestinal hemorrhage is also common...
October 2018: Seminars in Respiratory and Critical Care Medicine
Rachael Dawson, Andrew Wignell, Paul Cooling, David Barrett, Harish Vyas, Patrick Davies
BACKGROUND: Plasma-Lyte 148 ® is a balanced, crystalloid intravenous (IV) fluid which is both calcium-free and isotonic. It prevents the hyperchloraemic metabolic acidosis and iatrogenic hyponatraemia seen with use of 0.9% sodium chloride and hypotonic solutions respectively. However, data on compatibility with commonly used drugs is lacking. AIM: To investigate the stability of Plasma-Lyte 148 ® and Plasma-Lyte 148 ® + 5% Glucose with eight commonly used therapeutic agents when compared with 5% Glucose and 0...
November 25, 2018: Paediatric Anaesthesia
Philippe Guerci, Bulent Ergin, Zuhre Uz, Yasin Ince, Martin Westphal, Michal Heger, Can Ince
BACKGROUND: Glycocalyx shedding after traumatic hemorrhagic or septic shock, as well as different resuscitation fluids, has been causally linked to increased vascular barrier permeability (VBP) resulting in tissue edema. In nontraumatic hemorrhagic shock (NTHS), it remains questionable whether glycocalyx degradation in itself results in an alteration of VBP. The composition of fluids can also have a modulatory effect on glycocalyx shedding and VBP. We hypothesized that the shedding of the glycocalyx during NTHS has little effect on VBP and that the composition of fluids can modulate these effects...
November 16, 2018: Anesthesia and Analgesia
Alexandre Joosten, Amélie Delaporte, Julien Mortier, Brigitte Ickx, Luc Van Obbergh, Jean-Louis Vincent, Maxime Cannesson, Joseph Rinehart, Philippe Van der Linden
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: The authors recently demonstrated that administration of balanced hydroxyethyl starch solution as part of intraoperative goal-directed fluid therapy was associated with better short-term outcomes than administration of a balanced crystalloid solution in patients having major open abdominal surgery. In the present study, a 1-yr follow-up of renal and disability outcomes in these patients was performed...
November 9, 2018: Anesthesiology
Matthew W Semler, John A Kellum
Intravenous fluid therapy is the most common intervention received by acutely ill patients. Historically, saline (0.9% sodium chloride) has been the most frequently administered intravenous fluid, especially in North America. Balanced crystalloid solutions (e.g., lactated Ringer's, Plasma-Lyte) are an increasingly used alternative to saline. Balanced crystalloids have a sodium, potassium, and chloride content closer to that of extra-cellular fluid and, when given intravenously, have fewer adverse effects on acid-base balance...
November 8, 2018: American Journal of Respiratory and Critical Care Medicine
Myung-Soo Jang, Jin-Hee Han, SangHo Lee, Sung-Eun Kim
STUDY DESIGN: Retrospective analysis. OBJECTIVE: The objective of this study was to investigate the effects of intraoperative balanced 6% hydroxyethyl starch (HES) 130/0.4 on postoperative blood loss and the coagulation profile. SUMMARY OF BACKGROUND DATA: The safety of colloid versus crystalloid transfusion for bleeding and coagulation during major spine surgery remains controversial and only a few studies exist. Thus, we compared the effects of balanced 6% HES 130/0...
October 16, 2018: Clinical Spine Surgery
K Bhaskaran, Ganapathy Arumugam, P V Vinay Kumar
Context and Aims: Off-pump coronary artery bypass graft (OPCABG) is a form of CABG surgery. It is performed without the use of cardiopulmonary bypass machine as a surgical treatment for coronary heart disease. Acute kidney injury (AKI) is one of the common postoperative complications of OPCABG. Previous studies suggest important differences related to intravenous fluid (IVF) chloride content and renal function. We hypothesize that perioperative use of chloride restricted IVFs may decrease incidence and severity of postoperative AKI in patients undergoing OPCABG...
October 2018: Annals of Cardiac Anaesthesia
Xiaoming Wang, Zhou Yuan, Qihong Chen, Jiangquan Yu, Ruiqiang Zheng
OBJECTIVE: To compare the effect of 0.9% NaCl solution, Ringer solution, and acetate sodium potassium magnesium calcium glucose solution (ASPMCG solution) on internal environment in patients with septic shock receiving early fluid resuscitation. METHODS: A prospective randomized controlled trial was conducted. From June 2016 to January 2018, a total of 280 patients with septic shock admitted to intensive care unit (ICU) of Northern Jiangsu People's Hospital were enrolled...
September 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Luke A Gatta, Evelyn L Lockhart, Andra H James
A critical tool in the successful management of patients with abnormal placentation is an established massive transfusion protocol designed to rapidly deliver blood products in obstetrical and surgical hemorrhage. Spurred by trauma research and an understanding of consumptive coagulopathy, the past 2 decades have seen a shift in volume resuscitation from an empiric, crystalloid-based method to balanced, targeted transfusion therapy. The present article reviews patient blood management in abnormal placentation, beginning with optimizing the patient's status in the antenatal period to the laboratory assessment and transfusion strategy for blood products at the time of hemorrhage...
December 2018: Clinical Obstetrics and Gynecology
Shuyan Wei, Lillian S Kao, Henry E Wang, Ronald Chang, Jeanette Podbielski, John B Holcomb, Charles E Wade
Background: Septic shock is a public health problem with high mortality. There remains a knowledge gap regarding the optimal resuscitation fluid to improve clinical outcomes, and the underlying mechanism by which fluids exert their effect. Shock-induced endotheliopathy (SHINE) is thought to be a shared pathophysiologic mechanism associated with worsened outcomes in critically ill trauma and sepsis patients. SHINE is characterized by breakdown of the glycocalyx-a network of membrane-bound proteoglycans and glycoproteins that covers the endothelium...
2018: Trauma surgery & acute care open
Chao Liu, Zhi Mao, Pan Hu, Xin Hu, Hongjun Kang, Jie Hu, Zhifang Yang, Penglin Ma, Feihu Zhou
Objective: The aim of this study was to compare the effectiveness of different fluids on critically ill patients who need fluid resuscitation through a systematic review and network meta-analysis (NMA). Data sources: Electronic databases were searched up to March 2018 for randomized controlled trials comparing the effectiveness of different fluids in critically ill patients. The primary outcome was mortality, and the secondary outcomes were the incident of acute kidney injury (AKI) and risk of receiving renal replacement therapy (RRT)...
2018: Therapeutics and Clinical Risk Management
Jonathan D Casey, Ryan M Brown, Matthew W Semler
PURPOSE OF REVIEW: Intravenous fluid administration is a fundamental therapy in critical care, yet key questions remain unanswered regarding optimal fluid composition and dose. This review evaluates recent evidence regarding the effects of fluid resuscitation on pathophysiology, organ function, and clinical outcomes for critically ill patients. RECENT FINDINGS: Recent findings suggest that intravenous fluid composition affects risk of kidney injury and death for critically ill adults...
December 2018: Current Opinion in Critical Care
Daniel Martin, Panagis M Lykoudis, Gabriel Jones, David Highton, Alan Shaw, Sarah James, Qiang Wei, Giuseppe Fusai
BACKGROUND: The impact of perioperative intravenous fluid administration on surgical outcomes has been documented in literature, but not specifically studied in the context of hepato-pancreato-biliary (HPB) surgery. This study aimed to investigate the impact of postoperative intravenous fluid administration on intensive care unit (ICU), in this subgroup of patients. METHODS: A single-center retrospective cohort of 241 HPB patients was assessed, focusing on intravenous fluid administration in ICU, during the first 24 h...
October 2018: Hepatobiliary & Pancreatic Diseases International: HBPD INT
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