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

Fluid and electrolyte therapies including nutritional support are markedly developing in medicine and many kinds of commercial fluids are being introduced to clinical practice. Understanding the characteristics and usefulness of intravenous fluids is necessary to manage patients properly. Disputes about the usefulness of crystalloid or colloid solutions for specific clinical conditions still continue. To make ideal fluid therapy possible, many kinds of fluids will be developed and applied to clinical practice in the near future by mimicking the composition and functions of human body fluids. The selection of crystalloid and colloid solutions for fluid therapy should be performed by considering patients' clinical and pathophysiological conditions and the characteristics and usefulness of each intravenous fluid.
Colloids ; Dissent and Disputes ; Fluid Therapy ; Human Body ; Humans ; Isotonic Solutions ; Nutritional Support

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

BACKGROUND: Fasting during the preoperative period is known to be a risk of perioperative hypoglycemia. Also, the administration of fluids containing glucose often causes postoperative hyperglycemia. So, we investigated what is the ideal fluid which does not lead to hyperglycemia as well as hypoglycemia in fasted children. METHODS: Eighty ASA physical status I and II pediatric patients (1-7 years) were randomly divided into the four groups; Group I, II, III, and IV with twenty patients of each group. Patients in Group I, II, III, and IV received lactated Ringer's solution, 1 : 2 : 3 SD solution, 1 : 2 SD solution, and 1 : 3 SD solution, respectively during the perioperative period. Blood glucose levels were checked at pre-induction, 1 hr after induction and 1 hr, 4 hr, 8 hr after end of operation. NPO time and total amounts of fluids administered were measured. RESULTS: There was no patient with preoperative hypoglycemia. There were no significant differences in the perioperative blood glucose level among the groups. There was no relationship between blood glucose level and fasting time or age. CONCLUSIONS: We conclude that all of the four fluids with different glucose concentrations in this study were appropriate to the fasted children.
Blood Glucose ; Child ; Fasting ; Glucose ; Humans ; Hyperglycemia ; Hypoglycemia ; Isotonic Solutions ; Perioperative Period ; Preoperative Period

Fluid resuscitation, hemostasis, and transfusion is essential in care of hemorrhagic shock. Although estimation of the residual blood volume is crucial, the standard measuring methods are impractical or unsafe. Vital signs, central venous or pulmonary artery pressures are inaccurate. We hypothesized that the residual blood volume for acute, non-ongoing hemorrhage was calculable using serial hematocrit measurements and the volume of isotonic solution infused. Blood volume is the sum of volumes of red blood cells and plasma. For acute, non-ongoing hemorrhage, red blood cell volume would not change. A certain portion of the isotonic fluid would increase plasma volume. Mathematically, we suggest that the residual blood volume after acute, non-ongoing hemorrhage might be calculated as 0·25N/[(Hct1/Hct2)-1], where Hct1 and Hct2 are the initial and subsequent hematocrits, respectively, and N is the volume of isotonic solution infused. In vivo validation and modification is needed before clinical application of this model.
Blood Volume ; Hematocrit ; Humans ; Isotonic Solutions/*therapeutic use ; *Models, Theoretical ; Shock, Hemorrhagic/*prevention & control/*therapy