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Hemodinámica y fluidoterapia

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12 papers 0 to 25 followers
Koen Ameloot, Pieter-Jan Palmers, Manu L N G Malbrain
PURPOSE OF REVIEW: The present review aims to summarize literature on the accuracy of the finger cuff method to measure cardiac output (CO) and blood pressure, its ability to track hemodynamic changes, and to predict fluid responsiveness. RECENT FINDINGS: Finger cuff is an easy-to-use hemodynamic monitoring technique. Different devices are currently available, which provide continuous arterial blood pressure (Finapress), whereas only ClearSight (previously known as Nexfin; BMEYE) provides an estimate of CO...
June 2015: Current Opinion in Critical Care
J A Myburgh
The administration of intravenous fluids for resuscitation is the most common intervention in acute medicine. There is increasing evidence that the type of fluid may directly affect patient-centred outcomes. There is a lack of evidence that colloids confer clinical benefit over crystalloids and they may be associated with harm. Hydroxyethyl starch preparations are associated with increased mortality and use of renal replacement therapy in critically ill patients, particularly those with sepsis; albumin is associated with increased mortality in patients with severe traumatic brain injury...
January 2015: Journal of Internal Medicine
A Perner, E Junttila, M Haney, K Hreinsson, R Kvåle, P O Vandvik, M H Møller
BACKGROUND: The task force on Acute Circulatory Failure of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine produced this guideline with recommendations concerning the use of crystalloid vs. colloid solutions in adult critically ill patients with acute circulatory failure. METHODS: Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology was used to grade the quality of evidence and to determine the strengths of the recommendations...
March 2015: Acta Anaesthesiologica Scandinavica
Faheem W Guirgis, Deborah J Williams, Matthew Hale, Abubakr A Bajwa, Adil Shujaat, Nisha Patel, Colleen J Kalynych, Alan E Jones, Robert L Wears, Sunita Dodani
BACKGROUND: Previous studies suggest a relationship between chloride-rich intravenous fluids and acute kidney injury in critically ill patients. OBJECTIVES: The aim of this study was to evaluate the relationship of intravenous fluid chloride content to kidney function in patients with severe sepsis or septic shock. METHODS: A retrospective chart review was performed to determine (1) quantity and type of bolus intravenous fluids, (2) serum creatinine (Cr) at presentation and upon discharge, and (3) need for emergent hemodialysis (HD) or renal replacement therapy (RRT)...
March 2015: American Journal of Emergency Medicine
Nalan Gökçe Çelebi Yamanoğlu, Adnan Yamanoğlu, İsmet Parlak, Pelin Pınar, Ali Tosun, Burak Erkuran, Gizem Aydınok, Fatih Torlak
OBJECTIVES: This study aims to determine the site of and the best sonographic method for measurement of inferior vena cava (IVC) diameter in volume status monitoring. METHODS: This observational before-and-after study was performed at the intensive care unit of the emergency department. It included hypotensive adult patients with suspected sepsis who were recommended to receive at least 20 mg/kg fluid replacement by the emergency physician. The patients were fluid replaced at a rate of 1000 mL/h, and maximum and minimum IVC diameters were measured and the Caval index calculated sonographically via both B-mode and M-mode...
March 2015: American Journal of Emergency Medicine
Zen'ichiro Wajima, Toshiya Shiga, Kazuyuki Imanaga
PURPOSE: Stroke volume variation (SVV) is affected by many factors. Although elevated intra-abdominal pressure and a pneumoperitoneum have been shown to increase SVV in animals, a recent human study showed that SVV did not change as a pneumoperitoneum was established. However, we considered the results of this study questionable, and we therefore attempted to study whether SVV changes both before and after pneumoperitoneums in humans. METHODS: We performed a prospective observational study in 19 patients undergoing cholecystectomy or colectomy while on mechanical ventilation...
August 2015: Journal of Anesthesia
Sarah J Lee, Kannan Ramar, John G Park, Ognjen Gajic, Guangxi Li, Rahul Kashyap
BACKGROUND: The surviving sepsis guidelines recommend early aggressive fluid resuscitation within 6 h of sepsis onset. Although rapid fluid administration may offer benefit, studies on the timing of resuscitation are lacking. We hypothesized that there is an association between quicker, adequate fluid resuscitation and patient outcome from sepsis onset time. METHODS: This is a retrospective cohort study of consecutive adults with severe sepsis and septic shock admitted to a quaternary care medical ICU between January 2007 and December 2009...
October 2014: Chest
Giovanni Volpicelli, Stefano Skurzak, Enrico Boero, Giuseppe Carpinteri, Marco Tengattini, Valerio Stefanone, Luca Luberto, Antonio Anile, Elisabetta Cerutti, Giulio Radeschi, Mauro F Frascisco
BACKGROUND: Pulmonary congestion is indicated at lung ultrasound by detection of B-lines, but correlation of these ultrasound signs with pulmonary artery occlusion pressure (PAOP) and extravascular lung water (EVLW) still remains to be further explored. The aim of the study was to assess whether B-lines, and eventually a combination with left ventricular ejection fraction (LVEF) assessment, are useful to differentiate low/high PAOP and EVLW in critically ill patients. METHODS: The authors enrolled 73 patients requiring invasive monitoring from the intensive care unit of four university-affiliated hospitals...
August 2014: Anesthesiology
A A Smetkin, A Hussain, V V Kuzkov, L J Bjertnæs, M Y Kirov
BACKGROUND: Cardiac output monitoring, as a part of a goal-directed haemodynamic management, has been shown to improve perioperative outcome in high-risk patients undergoing major surgical interventions. However, thorough validation of cardiac output monitoring devices in different clinical conditions is warranted. The aim of our study was to compare the reliability of a novel system for cardiac index (CI) monitoring based on uncalibrated pulse contour analysis (UPCA) with transpulmonary thermodilution (TPTD) during off-pump coronary artery bypass grafting (OPCAB)...
June 2014: British Journal of Anaesthesia
C Roger, L Muller, P Deras, G Louart, E Nouvellon, N Molinari, L Goret, J C Gris, J Ripart, J E de La Coussaye, J Y Lefrant
BACKGROUND: The optimal resuscitation fluid for the early treatment of severe bleeding patients remains highly debated. The objective of this experimental study was to compare the rapidity of shock reversal with lactated Ringer (LR) or hydroxyethyl starch (HES) 130/0.4 at the early phase of controlled haemorrhagic shock. To assess the influence of vascular permeability in this model, we measured plasma vascular endothelial growth factor (VEGF) levels during the experiment. METHODS: Thirty-six anaesthetized and mechanically ventilated piglets were bled (<30 ml kg(-1)) to hold mean arterial pressure (MAP) at 40 mm Hg for more than 30 min and were resuscitated in two randomized groups: LR (n=14) or HES (n=14) at 1 ml kg(-1) min(-1) until MAP reached its baseline value of ±10%...
June 2014: British Journal of Anaesthesia
Pablo Perel, Ian Roberts
BACKGROUND: Colloid solutions are widely used in fluid resuscitation of critically ill patients. There are several choices of colloid and there is ongoing debate about the relative effectiveness of colloids compared to crystalloid fluids. OBJECTIVES: To assess the effects of colloids compared to crystalloids for fluid resuscitation in critically ill patients. SEARCH METHODS: We searched the Cochrane Injuries Group Specialised Register (searched 16 March 2012), Cochrane Central Register of Controlled Trials 2011, issue 3 (The Cochrane Library), MEDLINE (Ovid) 1946 to March 2012, Embase (Ovid) 1980 to March 2012, ISI Web of Science: Science Citation Index Expanded (1970 to March 2012), ISI Web of Science: Conference Proceedings Citation Index-Science (1990 to March 2012), PubMed (searched 16 March 2012), www...
June 13, 2012: Cochrane Database of Systematic Reviews
Daniel De Backer, Patrick Biston, Jacques Devriendt, Christian Madl, Didier Chochrad, Cesar Aldecoa, Alexandre Brasseur, Pierre Defrance, Philippe Gottignies, Jean-Louis Vincent
BACKGROUND: Both dopamine and norepinephrine are recommended as first-line vasopressor agents in the treatment of shock. There is a continuing controversy about whether one agent is superior to the other. METHODS: In this multicenter, randomized trial, we assigned patients with shock to receive either dopamine or norepinephrine as first-line vasopressor therapy to restore and maintain blood pressure. When blood pressure could not be maintained with a dose of 20 microg per kilogram of body weight per minute for dopamine or a dose of 0...
March 4, 2010: New England Journal of Medicine
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