SOLUTIONS ISOTONIC SOLUTIONS HYPERTONIC SOLUTIONS SODIUM CHLORIDE

The study involved 20 patients aged 15-50 years of old with the body weight are more than 30kg, Hb 12g/L and hematocrite 35%. Isotonic solutions (Ringerlactar, mantital 20%, Nabicarbonats, HÌparim 20mg) were used as enticement. Use isotonic solutions as enticement is an effective method to decrease the use of high-weigh molecular solutions or blood products, reduce cost of operation and prevent blood-born diseases
Isotonic Solutions ; Blood-Borne Pathogens

Hemorrhage is the second most common cause of death among trauma patients and almost half of the deaths occur within 24 hours after arrival. Damage control resuscitation is a new paradigm for patients with massive bleeding. It consists of permissive hypotension, hemostatic resuscitation and transfusion strategies, and damage control surgery. Permissive hypotension seems to have better results before the bleeding is controlled. The strategy of fluid resuscitation is minimizing crystalloid infusion and increasing early transfusion with a high ratio of fresh frozen plasma to packed red cells. Damage control surgery is done when the patient's condition is unfit for definitive surgery. Hemorrhage and contamination control with temporary abdominal closure is performed before transferring the patients to intensive care unit and the operating room for a permanent laparotomy.
Blood Transfusion ; Fluid Therapy ; methods ; Hemorrhage ; therapy ; Humans ; Isotonic Solutions

OBJECTIVESTo compare the cardioprotection effect between blood and crystalloid cardioplegia during cardiac surgery in adult patients, and provide a theoretical basis for optimal myocardial protection strategies.

METHODSA meta-analysis of randomized controlled trials (RCT) studies about comparing blood and crystalloid cardioplegia in adult patients undergoing cardiac surgery were performed. Cochrane library (Issue 3, 2011), MEDLINE, EMBase, PubMed, HighWire, CBM and CNKI were searched from January 1985 to December 2011. Studies were assessed according to the Cochrane Handbook for systematic reviews. Data were extracted from these trials and analyzed by RevMan5.1 software.

RESULTSSixteen trials involved 3934 patients were included, 2004 cases were in blood group, and 1930 were in crystalloid group. There was no statistical heterogeneity between studies using a fixed effects model. Meta-analysis indicated that, there were no significant differences between blood and crystalloid group in the incidence of postoperative 30 days mortality (OR = 1.11, 95%CI: 0.59 - 2.08, P = 0.74), the incidence of postoperative low cardiac output (OR = 0.98, 95%CI: 0.41 - 2.33, P = 0.85), the incidence of perioperative myocardial infarctions (OR = 0.85, 95%CI: 0.55 - 1.29, P = 0.44), and inotropic support requirement (OR = 1.05, 95%CI: 0.81 - 1.38, P = 0.70).

CONCLUSIONThe blood cardioplegia is no difference with crystalloid cardioplegia in adult patients undergoing cardiac surgery.

BACKGROUND: If the skin is kept in continuous contact with water or other solutions after acute barrier perturbation, the pattern of barrier recovery will be different from that of the air exposure state at room temperature. Changes in the concentration of the solution also make a difference in the pattern of barrier recovery. However, there have been only a few studies on the difference of the barrier recovery or the changes in stratum corneum lipid between cases in the water immersion state and the air exposure state. OBJECTIVE: We studied the effect of immersion on the recovery of the epidermal barrier after acute perturbation so as to give aid to the basic research of the epidermal barrier and clinical application in prevention and treatment of contact dermatitis, hand eczema, and other occupational dermatoses. METHODS: After disruption of the epidermal barrier by tape stripping, hairless mice were immersed in temperature regulated hypotonic, isotonic, or hypertonic solutions, respectively. The pattern of barrier recovery with time was evaluated and compared with that of the air exposure group by means of TEWL measurement, and histochemical stain with Nile red. RESULTS: Immersion into water or solution without time to recovery after epidermal barrier disruption makes the recovery rate slower than that of the air exposure group except for the isotonic solution immersing group. CONCLUSION: For the normal recovery or prevention of the deterioration of the epidermal barrier, we should keep in mind to avoid the exposure to water or other solutions when acute or chronic barrier perturbation has developed. In addition, it would be better to use normal saline or other isotonic solutions, which do not disturb the normal barrier recovery process, to decrease damage to the epidermal barrier when it cannot help immersing into the solution.
Animals ; Dermatitis, Contact ; Eczema ; Hand ; Hypertonic Solutions ; Immersion* ; Isotonic Solutions ; Mice ; Mice, Hairless ; Skin ; Skin Diseases ; Water

Fluid resuscitation is an essential intervention in critically ill patients, and its ultimate goal is to restore tissue perfusion. Critical illnesses are often accompanied by glycocalyx degradation caused by inflammatory reactions, hypoperfusion, shock, and so forth, leading to disturbed microcirculatory perfusion and organ dysfunction. Therefore, maintaining or even restoring the glycocalyx integrity may be of high priority in the therapeutic strategy. Like drugs, however, different resuscitation fluids may have beneficial or harmful effects on the integrity of the glycocalyx. The purpose of this article is to review the effects of different resuscitation fluids on the glycocalyx. Many animal studies have shown that normal saline might be associated with glycocalyx degradation, but clinical studies have not confirmed this finding. Hydroxyethyl starch (HES), rather than other synthetic colloids, may restore the glycocalyx. However, the use of HES also leads to serious adverse events such as acute kidney injury and bleeding tendencies. Some studies have suggested that albumin may restore the glycocalyx, whereas others have suggested that balanced crystalloids might aggravate glycocalyx degradation. Notably, most studies did not correct the effects of the infusion rate or fluid volume; therefore, the results of using balanced crystalloids remain unclear. Moreover, mainly animal studies have suggested that plasma may protect and restore glycocalyx integrity, and this still requires confirmation by high-quality clinical studies.
Animals ; Colloids ; Crystalloid Solutions/therapeutic use* ; Fluid Therapy ; Glycocalyx ; Humans ; Hydroxyethyl Starch Derivatives ; Isotonic Solutions ; Microcirculation ; Resuscitation

Parkland formula is the most widely used resuscitation formula in burn care. However, a growing number of disputes have been raised along with the development of medical technology, among which its total volume and composition of the fluid are the two foci. Firstly, Parkland formula may lead to an untoward phenomenon nicknamed "fluid creep", which may lead to complications such as abdominal compartment syndrome. Secondly, along with the deeper understanding of how permeability of blood vessels changes after burn injury, colloid is recommended to be given after the third 8 h post-burn. Additionally, controversy exists in the choice of different colloid solutions. The safety of different colloid solutions remains to be further elucidated. This article will deal with all of the above-mentioned problems.
Burns ; physiopathology ; therapy ; Fluid Therapy ; methods ; Humans ; Isotonic Solutions ; therapeutic use ; Resuscitation ; methods ; Treatment Outcome

BACKGROUND: Propranolol potentiates the effect of neuromuscular blocking agents and induces myasthenic syndromes through curare-like and local anesthetic activities.The purpose of this study was to determine if propranolol potentiated the neuromuscular block caused by rocuronium during both single (0.1 Hz) and tetanic stimulation (50 Hz for 1.9 seconds). METHODS: Left phrenic nerve-hemidiaphragms (Male Sprague-Dawley rats, 150-250 g) were mounted in Krebs solution, and three consecutive single twitches and one tetanic tension were obtained prior to each treatment. Each preparation was exposed to one of 4 propranolol concentrations (0, 1.0, 2.5, 5micrometer), 5micrometer propranolol with 2micrometer norepinephrine or 2micrometer norepinephrine alone and the concentration of rocuronium was then increased cumulatively until a 80% reduction of single twitch occurred.The effects of the drugs used were allowed to reach a steady state by waiting for 20 minutes at each concentration before measuring the tension. Effective concentrations of rocuronium at each treatment were calculated using a probit model.Differences between treatments were tested with student's t-test and Bonferroni's correction with a P < 0.05 being regarded as significant. RESULTS: The neuromuscular block caused by rocuronium was augmented by propranolol, however the augmentation caused by propranolol was not reversed by norepinephrine. CONCLUSIONS: The results of this study indicate that the potentiation by propranolol of the neuromuscular block caused by rocuronium is independent of its adrenoceptor blocking action.
Androstanols ; Isotonic Solutions ; Neuromuscular Blockade ; Neuromuscular Blocking Agents ; Norepinephrine ; Propranolol ; Rats, Sprague-Dawley

This experimental work was performed on 4 rabbits to demonstrate that administrations of oxygenated Ringer's lactate through the central venous infusion could be used as a means of oxygenation. The oxygen tensions of Ringer's lactate were determined upon changing the amount of oxygen being bubbled and the solutions with the mean PO2 and pH of 575.5 mmHg and 6.34 were used in this study. We did not use the solutions having the values below 416.6 mmHg PO2 and pH 6.08. After the infusion of the oxygenated solution through central vein, PaO2 values throughout the 1 hour experimental procedure were significantly increased above the control value. Other parameters such as pH, PaCOs, HCO3-, BE, O2 saturation did not show any statistically significant changes. Some degree of oxygenation could be obtained by infusing the oxygenated Ringer's solution. This suggested that oxygenation by infusion through the central venous line could used clinically in the treatment of some forms of hypoxia with hypovolemia.
Analysis of Variance ; Animals ; Blood Gas Analysis ; Infusions, Intravenous ; Isotonic Solutions/*administration & dosage ; Oxygen/*administration & dosage ; Rabbits

BACKGROUND: Hydroxyethylstarch (HES) solutions are commonly used for intravascular volume expansion with varying effect on coagulation depending on molecular weight and mode of hydroxyl substitution.Clopidogrel and aspirin have been shown to reduce cardiovascular complications in patients with coronaryartery occlusive disease which renders patients to higher risk of bleeding complications who require surgery.The purpose of this study was to evaluate the effect of HES 200/0.5, 130/0.4 and crystalloid on blood loss and transfusion requirement in patients with recent antiplatelet therapy undergoing off-pump coronary bypass surgery (OPCAB) in a prospective, randomized trial. METHODS: Sixty patients scheduled for OPCAB, who received clopidogrel and aspirin within 5 days of surgery were randomly allocated into 3 groups:HES 200/0.5 (n = 20), HES 150/0.4 (n = 20), and Crystalloid (n = 20).Routine coagulation profile were measured before and 2 days after the surgery.Amount of perioperative blood loss, transfusion requirement and fluids input and output were recorded until 2 days postoperatively. RESULTS: The 3 groups were similar with regard to patients and operative characteristics.There were no significant differences in the amount of perioperative blood loss and transfusion requirement among the 3 groups. CONCLUSIONS: Both HES solutions were safe to use in terms of blood loss and transfusion requirement in patients undergoing OPCAB who received antiplatelet agents within 5 days of surgery.
Aspirin ; Hemorrhage ; Hetastarch ; Humans ; Isotonic Solutions ; Molecular Weight ; Platelet Aggregation Inhibitors ; Prospective Studies ; Ticlopidine