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Resuscitation, fluid therapy, RCT

Chao Liu, Guangming Lu, Dong Wang, Yi Lei, Zhi Mao, Pan Hu, Jie Hu, Rui Liu, Dong Han, Feihu Zhou
INTRODUCTION: Fluid resuscitation is a fundamental component of the management of critically ill patients, but whether choice of crystalloid affects patient outcomes remains controversial. Therefore, we performed this meta-analysis to compare the efficacy and safety of balanced crystalloids with normal saline. METHODS: We searched the MEDLINE, Cochrane Central and EMBASE up to October 2018 to identify randomized controlled trials (RCTs) that compared balanced crystalloids versus normal saline in critically ill patients...
March 1, 2019: American Journal of Emergency Medicine
Min-Jeong Lee, Young Gi Min
RATIONALE: Glyphosate-surfactant herbicides (GlySH) are non-selective herbicides that are extensively used worldwide. A recent case report on GlySH poisoning suggested successful resuscitation upon using intravenous lipid emulsion (ILE) for refractory hypotension. The efficacy of ILE in GlySH poisoning remains unproven due to a lack of randomized controlled trials, and further evidence is required to clarify the mechanism by which ILE may reverse hypotension in GlySH poisoning. PATIENT CONCERNS: A 46-year-old man presented to the emergency department 45 min following ingestion of approximately 200 cc of GlySH...
January 2019: Medicine (Baltimore)
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)
Yan Zou, Ke Ma, Ji-Bin Xiong, Cai-Hua Xi, Xiao-Jun Deng
BACKGROUND: This study aimed to compare the effects on mortality of albumin and crystalloid, used for fluid resuscitation among adult patients with septic shock, through conducting a meta-analysis and trial sequential analysis (TSA). DESIGN AND SETTING: Meta-analysis and TSA conducted at Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China. METHODS: Data were collected from several major databases including MEDLINE, EMBASE, Clinical Trials...
September 2018: São Paulo Medical Journal, Revista Paulista de Medicina
Obeid Shafi, Virendra Kumar
INTRODUCTION: The optimal fluid therapy in children with DKA is a matter of debate, especially if we take into account its association with cerebral edema, the most important complication. Hypertonic Saline Solution is used in the treatment of cerebral edema, and also has been used for volume resuscitation in children with shock. AIM OF STUDY: To compare the effects of 3% saline and 0.9% saline solutions on changes in vital parameters, sodium and chloride levels, lactate and pH; time needed for the correction of hyperglycemia; time needed for the control of ketoacidosis and incidence of cerebral edema...
2018: Pediatric Endocrinology, Diabetes, and Metabolism
Yuanfeng Shi, Ruihong Yin, Yanli Wang, Jiguang Li, Xiaobing Chen, Yongpeng Xie, Caihong Gu, Xiuzhen Zou, Kexi Liu
OBJECTIVE: To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Yutang Li, Chunwen Guo, Hui Liu, Zhihao Yuan, Hui Lin, Yan Wang, Hong Yan
OBJECTIVE: To study the effect of low molecular weight heparin sodium ( LMWHS ) therapy for exertional heat stroke ( EHS ) patients with pre-disseminated intravascular coagulation ( pre-DIC ). METHODS: A prospective randomized controlled trial ( RCT ) was conducted. Thirty-six patients with EHS with pre-DIC admitted to Department of Critical Care Medicine of 180th Hospital of Chinese PLA from April 2012 to November 2014 were divided into heparin sodium group ( n = 20 ) and LMWHS group ( n = 16 ) in accordance with the random number table...
August 2015: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Newton Opiyo, Elizabeth Molyneux, David Sinclair, Paul Garner, Mike English
OBJECTIVE: To evaluate the effects of intravenous fluid bolus compared to maintenance intravenous fluids alone as part of immediate emergency care in children with severe febrile illness and signs of impaired circulation in low-income settings. DESIGN: Systematic review of randomised controlled trials (RCTs), and observational studies, including retrospective analyses, that compare fluid bolus regimens with maintenance fluids alone. The primary outcome measure was predischarge mortality...
April 30, 2014: BMJ Open
Patrick Meybohm, Hugo Van Aken, Andrea De Gasperi, Stefan De Hert, Giorgio Della Rocca, Armand R J Girbes, Hans Gombotz, Bertrand Guidet, Walter Hasibeder, Markus W Hollmann, Can Ince, Matthias Jacob, Peter Kranke, Sibylle Kozek-Langenecker, Stephan Alexander Loer, Claude Martin, Martin Siegemund, Christian Wunder, Kai Zacharowski
INTRODUCTION: Hydroxyethyl starch (HES) is a commonly used colloid in critically ill patients. However, its safety has been questioned in recent studies and meta-analyses. METHODS: We re-evaluated prospective randomised controlled trials (RCT) from four meta-analyses published in 2013 that compared the effect of HES with crystalloids in critically ill patients, focusing on the adherence to 'presumably correct indication'. Regarding the definition of 'presumably correct indication', studies were checked for the following six criteria (maximum six points): short time interval from shock to randomisation (<6 h), restricted use for initial volume resuscitation, use of any consistent algorithm for haemodynamic stabilisation, reproducible indicators of hypovolaemia, maximum dose of HES, and exclusion of patients with pre-existing renal failure or renal replacement therapy...
July 26, 2013: Critical Care: the Official Journal of the Critical Care Forum
D O Thomas-Rueddel, V Vlasakov, K Reinhart, R Jaeschke, H Rueddel, R Hutagalung, A Stacke, C S Hartog
PURPOSE: Gelatin is frequently used as a volume expander in critical care. Our goal was to investigate its safety. METHODS: Systematic review of randomized controlled trials (RCT) in patients receiving gelatin for resuscitation in comparison to albumin or crystalloids. RESULTS: We identified 40 RCTs published between 1976 and 2010 with 3,275 patients. Median sample size in the gelatin groups was 15 patients (range 10-249). Median gelatin dose was 17 ml/kg (range 6-57 ml/kg)...
July 2012: Intensive Care Medicine
Jin-ying Cui, Huan-li Xu, Ai-tian Wang, Xi Zhu, Gai-qi Yao, Fang Liu
OBJECTIVE: To compare the effect of albumin as a resuscitation fluid with other fluids in lowering the mortality of patients with sepsis. METHODS: By searching MEDLINE, Embase, Cochrane Central Registration of Controlled Trials databases, the metaRegister of Controlled Trials, the Medical Editors Trial Amnesty Register, and retrieval of the randomized controlled trial (RCT) literature to compare the result of resuscitation using albumin-containing fluid and other fluids...
January 2012: Zhongguo Wei Zhong Bing Ji Jiu Yi Xue, Chinese Critical Care Medicine, Zhongguo Weizhongbing Jijiuyixue
Lauralyn McIntyre, Dean A Fergusson, Brian Rowe, Deborah J Cook, Yaseen Arabi, Sean M Bagshaw, Marcel Emond, Simon Finfer, Alison Fox-Robichaud, Alasdair Gray, Robert Green, Paul Hebert, Eddy Lang, John Marshall, Ian Stiell, Alan Tinmouth, Joe Pagliarello, Alexis Turgeon, Timothy Walsh, Andrew Worster, Ryan Zarychanski
Severe sepsis and septic shock are the most common reasons for admission to an intensive care unit; and the risk of death is substantial, estimated at approximately 40%. Evidence suggests that early resuscitation strategies that include the use of resuscitation fluids, antibiotics, blood, and inotropes reduce death. Although fluid resuscitation is an immediate life-saving intervention, a fundamental question that remains unanswered is whether the type of resuscitation fluid impacts survival when it is initiated very early in the course of septic shock...
October 2012: Transfusion Medicine Reviews
A B Johan Groeneveld, Roberta J Navickis, Mahlon M Wilkes
OBJECTIVE: To provide an updated systematic review on the comparative safety of colloids based on recent clinical studies. BACKGROUND: Recent investigations, including large-scale randomized trials and meta-analyses, have sought to determine the effects of colloids on mortality and morbidity. Hypothesized differences in safety profile between hydroxyethyl starch (HES) solutions have also been evaluated in randomized trials. METHODS: Clinical studies reported since 2002 with safety data for acutely ill patients receiving HES, gelatin, dextran, or albumin were sought by computer searches and other methods...
March 2011: Annals of Surgery
J Dretzke, J Sandercock, S Bayliss, A Burls
OBJECTIVES: To systematically review the evidence on the effectiveness (in terms of mortality and morbidity) of prehospital intravenous (i.v.) fluid replacement, compared with no i.v. fluid replacement or delayed fluid replacement, in trauma patients with no head injury who have haemorrhage-induced hypotension due to trauma. DATA SOURCES: Electronic databases, relevant websites, handsearching, expert contacts. REVIEW METHODS: Search strategies were defined to identify randomised controlled trials (RCTs) and previous systematic reviews relating to the use of i...
June 2004: Health Technology Assessment: HTA
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