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: The possibility that large fluid volumes reduce postoperative nausea and vomiting (PONV) remains unclear due to conflicting data. We examined if administering large fluid volumes to high risk patients would decrease the incidence of PONV and compared the results with ondansetron administration. METHODS: Ninety ASA I, II patients who presented for laparoscopic cholecystectomy were randomized to 1 of 3 groups. They received either (group I) 5 ml/kg/hr of Hartmann's solution, (group II) 30 ml/kg/hr of Hartmann's solution or (group III) 4 mg of ondansetron and 5 ml/kg/hr of Hartmann's solution. The incidence of PONV and severity of pain were assessed at 1, 12 and 24 hours postoperatively. RESULTS: The number of PONV episodes was significantly reduced in group II and III compared to group I during the 1-12 hr postoperative period and for total incidence. However, there was no significant difference between group II and III. There were no differences among groups regarding the severity of pain. CONCLUSIONS: Intraoperative correction of intravascular volume deficits with 30 ml/kg/hr of Hartmann's solution decreases the incidence of PONV as effectively as administration of ondansetron.
Cholecystectomy, Laparoscopic ; Humans ; Incidence ; Isotonic Solutions ; Ondansetron ; Postoperative Nausea and Vomiting ; Postoperative Period

BACKGROUND: It has been reported that etomidate has the relaxant effects on vascular, tracheal, and non-pregnant uterine smooth muscle in vitro. The purpose of this study was to investigate the relaxant effects of etomidate on the contraction of the pregnant rat uterine smooth muscle. METHODS: Uterine muscle tissues were obtained from pregnant rats (n = 15). The uterine segments were mounted in organ baths filled with Krebs solution. After oxytocin-induced contractile activity had been established, etomidate in incremental concentrations (10(-7) to 10(-3) M) was added cumulatively to the bath, each administered 20 min apart, and resultant changes in contractile activity were continuously recorded. EC5 (effective concentration of 5% reduction), EC25, EC50, EC75, and EC95 on active tension were calculated using a probit model. RESULTS: Etomidate (10(-7) to 10(-3) M) induced dose-dependent decreases in amplitude and frequency of uterine contraction. The EC50 of etomidate on active tension were 5.91 x 10(-5) M. CONCLUSIONS: These results demonstrate that etomidate had inhibitory effects on pregnant rat uterine muscle at supraclinical concentration (5.91 x 10(-5) M).
Animals ; Baths ; Contracts ; Etomidate ; Female ; Isotonic Solutions ; Mice ; Muscle, Smooth ; Myometrium ; Oxytocin ; Rats ; Uterine Contraction