Fluid Therapy ; Humans ; Rehydration Solutions

Fluid Therapy ; Humans ; Rehydration Solutions ; therapeutic use

The objective of this study was to investigate the effect of different rehydration conditions on recovery of the lyophilized red blood cells (RBC) so as to optimize the RBC rehydration. The different conditions, including different rehydration solution, the rehydration temperature, volume change rate of the lyophilized RBC rehydrated by the vapor firstly, were studied, the recovery rate and change of physiological and biochemical properties of the rehydrated RBC were detected. The results indicated that the solution of 10% (w/v) PVP40 in PBS showed the best effect, and the RBC recovery rate increased with increasing of rehydration temperature, and the optimal temperature of rehydration was at 37 degrees C. Pre-rehydration in condition of vapor could raise the RBC recovery rate, and promote the MCV and RDW to close to index of the fresh RBC, the deformability of the rehydrated RBC was no serious as compared with RBC preserved in conventional condition, but the activity level of ATP, G-6-PD, SOD, 2, 3-DPG of the rehydrated RBC less decreased. It is concluded that the optimal rehydration conditions for lyophilized RBC are pre-rehydration in the 37 degrees C with vapor firstly, PBS + 10% (w/v) PVP40 rehydration solution and rehydration temperature at 37 degrees C, but the protection of RBC membrane needs to be furtherly studied.
Blood Preservation ; methods ; Erythrocyte Count ; Erythrocytes ; Freeze Drying ; methods ; Humans ; Rehydration Solutions ; Temperature

OBJECTIVE: To report effects of the pre-procedural rehydration for reduce thromboembolic complications in acute phase aneurysmal subarachnoid hemorrhage coil embolization. MATERIALS AND METHODS: From January 2009 to December 2013, 190 patients with ruptured aneurysmal subarachnoid hemorrhage (aSAH) treated by coil embolization at our institution were consecutively enrolled in this study. In period 1 (from January 2009 to June 2012, n = 122), pre-procedural fluid was not supplied. In period 2 (from July 2012 to December 2013, n = 68), depending on the state of the patient's body weight and degree of dehydration, intravenous fluid was started with infusion of approximately 7 mL/kg of 0.9 percent saline (minimum 300 to maximum 500 mL) over 30 minutes. RESULTS: A total of 190 patients were hospitalized due to aSAH and underwent coil embolization for five years between January 2009 and December 2013. Of these, 122 patients underwent coil embolization based on the old protocol before June 2012 (period 1) and 68 underwent the procedure based on the new protocol after the period 2. Neck size, width, maximum diameter of the aneurysm and procedure time were associated with procedure related thromboembolic complications in entire periods (multivariate analysis, p < 0.05, in respectively). The frequency of thromboembolism showed a drastic decrease in period 2 (re-hydration period), from 18.0% (22/123) to 4.4% (3/67), which was also statistically significant (p = 0.007, Chi-square test). CONCLUSION: Pre-procedural administration of a sufficient dose of fluid considering the patient's dehydration reduced the frequency of thromboembolism in cases of emergency coil embolization for ruptured aneurysm, without increasing additional specific complications.
Aneurysm ; Aneurysm, Ruptured* ; Body Weight ; Dehydration ; Embolization, Therapeutic ; Emergencies ; Fluid Therapy* ; Humans ; Neck ; Rehydration Solutions ; Subarachnoid Hemorrhage ; Thromboembolism

OBJECTIVETo analyze the clinical value of 24-hour urinary sodium determination in children with postural tachycardia syndrome (POTS).

METHODFifty-eight POTS children and 10 healthy children (control group) from Peking University First Hospital during June 2012 to May 2014 were enrolled. Their 24-hour urinary sodium and plasma sodium levels were compared. Correlation analysis was done between 24-hour urinary sodium and symptom scores in children with POTS. All patients were treated with oral rehydration salts. The POTS patients were divided into hyponatriuria group (urinary sodium < 124 mmol/24 h) and hypernatriuria group (urinary sodium ≥ 124 mmol/24 h). Kaplan-Meier curve was used to analyze the effects of different 24-hour urinary sodium levels in children with POTS receiving rehydration salts therapy.

RESULTThe 24-hour urinary sodium levels of children with POTS were significantly lower than that of control group ((110. 0 ± 45. 8) vs. (221. 3 ± 103. 6) mmol/24 h, t =3. 339, P = 0. 008), while no statistical significance was found in plasma sodium between the two groups ((139. 7 ± 2. 1) vs. (139. 7 ± 2. 3) mmol/L, t = 0. 082, P = 0. 935). Pearson correlation analysis showed that 24-hour urinary sodium and severity of symptoms in children patients were negatively correlated (r = - 0. 654, P < 0. 001) . Urinary sodium < 124 mmol/24 h was used as the cut-off value, there were 43 cases in hyponatriuria group and 15 cases in hypernatriuria group. The symptom scores were significantly higher in hyponatriuria group (10. 2 ± 3. 7 vs. 5. 0 ± 1. 8, P < 0. 001), there was no significant difference in other basic information and hemodynamic data between groups (P > 0. 05). Logistic regression analysis revealed that urine sodium < 124 mmol/24 h was independent risk factor for effectiveness of rehydration salts in POTS patients (OR = 0. 043, 95% CI:0. 004 - 0. 499, P = 0. 012). Kaplan-Meier survival analysis showed the long-term effect of patients receiving oral rehydration salts in hyponatriuria group was significantly better than that in hypernatriuria group (86. 0 % vs. 60. 0%, χ2 = 8. 471, P = 0. 004).

CONCLUSIONTwenty-four hours urinary sodium is a good indicaor for guiding children with POTS receiving rehydration salts therapy.

Case-Control Studies ; Child ; Fluid Therapy ; Hemodynamics ; Humans ; Postural Orthostatic Tachycardia Syndrome ; urine ; Rehydration Solutions ; Salts ; Sodium ; urine

OBJECTIVETo study the effect of oral fluid resuscitation with pyruvate sodium-glucose-electrolyte solution (PGES) on hemodynamics, organ functions and mortalities during shock stage in dogs with burn.

METHODSIn comparison of oral pyruvate sodium-glucose-electrolyte solution (PGES) with NaHCO₃-glucose-electrolyte solution (HGES), beagle dogs with intubation of the carotid artery, jugular vein and jejunum for 24 hours were subjected to a 50% total body surface area (TBSA) burn, and were divided into three groups: pure burn without fluid resuscitation (NR, n = 8), and two oral fluid resuscitation (each n = 10), in which dogs were given with Pry-GES (OP) or NaHCO₃-GES (OH) according to Parkland formula. The hemodynamic and organ functions were measured serially before burn and 2, 6, 8, 12 and 24 hours after burn at no anaesthesia state A. Twenty-four hours mortality rate following burn was also recorded.

RESULTSTwo hours after burn, the mean arterial pressure of NR, OH and OP group was (45 ± 8), (57 ± 8) and (80 ± 9) mmHg (1 mmHg = 0.133 kPa) respectively, which were significantly reduced (t = 16.967, 14.595 and 10.100, all P < 0.05) compared with those before injury ((42 ± 6), (144 ± 6) and (142 ± 6) mmHg respectively), the change of cardiac output, dp/dtmax of left ventricular contractility and intestinal mucosal blood flow had the same trend as the mean arterial pressure. The systemic vascular resistance and organ parameters (Cr, CK-MB, ALT and DAO) in all groups increased obviously (t = -46.894--2.465, all P < 0.05). All measurements of NR group kept worsening, and all died within 24 hours after burn; while those of two oral resuscitation groups had improved gradually (F = 0.001-1.600, all P < 0.05), OP group was significantly superior to OH group (F = 0.013-0.466, P < 0.05). At 24 hours after burn, 6 (6/10) survived in OP group, 4 (4/10) in OH group and 0 (0/8) in NR group.

CONCLUSIONThe Pyr-GES may be superior to the standard NaHCO₃-GES in the improvement of hemodynamics and organ functions during oral resuscitation in dogs with 50%TBSA full thickness burn.

Animals ; Body Surface Area ; Burns ; complications ; physiopathology ; therapy ; Disease Models, Animal ; Dogs ; Fluid Therapy ; Hemodynamics ; drug effects ; Male ; Pyruvates ; therapeutic use ; Rehydration Solutions ; Shock ; etiology ; physiopathology ; therapy

OBJECTIVETo investigate the clinical significance of 24-hour blood pressure monitoring (ABPM) for evaluating the treatment outcome of nerve-mediated syncope (NMS) in children.

METHODSTwenty-eight children with NMS confirmed by a head-up tilt table test (HUTT) (12 males and 16 females, aged 6-13 years) and with a chief complaint of unexplained syncope or pre-syncope between February 2010 and August 2012, were included in the study. These children received health education combined with therapy using oral rehydration salts solution and were then reexamined for clinical symptoms as well as HUTT and ABPM results.

RESULTSOf 28 NMS cases, 22 were vasodepressive type, 5 were mixed type, and 1 was cardioinhibitory type. The follow-up showed that 27 (96%) of all cases had improved clinical symptoms, and 18 (64%) had improved HUTT results. The ABPM follow-up revealed no significant changes in 24-hour mean systolic pressure, 24-hour mean diastolic pressure, daytime mean systolic pressure, daytime mean diastolic pressure, nighttime mean systolic pressure, nighttime mean diastolic pressure, day-night difference of systolic pressure, and day-night difference of diastolic pressure after treatment (P>0.05). The percentage of children with a dipper blood pressure pattern increased from 29% (8/28) before treatment to 50% (14/28) after treatment; the percentage of children with a non-dipper blood pressure pattern decreased from 71% (20/28) before treatment to 50% (14/28) after treatment.

CONCLUSIONSAs an effective, objective and non-invasive monitoring means, ABPM is of some clinical significance for evaluating the treatment outcome of NMS in children.

Adolescent ; Blood Pressure Monitoring, Ambulatory ; Child ; Female ; Health Education ; Humans ; Male ; Rehydration Solutions ; administration & dosage ; Syncope ; physiopathology ; therapy ; Tilt-Table Test ; Treatment Outcome

OBJECTIVETo assess the efficacy and safety of reduced osmolarity oral rehydration salts (ROORS) in treatment of mild to moderate dehydration caused by acute diarrhea in children.

METHODSA multicenter, randomized, double-blind, positive drug controlled clinical trial was conducted in 125 cases aged 1 to 17 years. These children with acute diarrhea and signs of dehydration were randomly assigned to receive either ROORS (trial group, n = 62) or oral rehydration salts II (ORS II) (control group, n = 63). The volume of intravenous infusion were recorded. The improvements of systemic symtoms and signs, diarrhea, dehydration and total scores were compared between the two groups. The adverse events and changes of electrolyte and other laboratory tests during treatment were also observed and analyzed.

RESULTSThe overall effective rates in trial group and control group were 96.8% and 96.8%, respectively. The recovery of systemic symptoms, dehydration signs and diarrhea occurred in 96%, 97% and 78% patients in trial groups, and 96%, 98% and 85% patients in control group. The scores of symptoms and signs in both groups decreased significantly after treatment. All the above parameters and the number of cases who needed intravenous infusion (41 vs. 39) were not statistically different between two groups. However, the average volume of intravenously infused fluids in trial group was (450.98 +/- 183.07) ml, 24.5% less than that in the control group (597.30 +/- 343.37) ml (P < 0.05). The mean serum Na(+) concentration elevated from (137.48 +/- 4.55) mmol/L to (139.52 +/- 3.25) mmol/L (P < 0.01) in control group after treatment, but the change was not statistically significant in trail group. Serum K(+), Cl(-), HCO(3)(-) and other laboratory result did not change significantly after treatment. The total scores in both groups decreased obviously after treatment, but no significant difference was demonstrated between two groups (P > 0.05). A case in trial group had mild abdominal distention and recovered spontaneously.

CONCLUSIONROORS was shown to be effective and safe in the treatment of mild and moderate dehydration induced by acute diarrhea. Compared to ORS II, ROORS could decrease the intravenous supplement of fluid and lower the risk of hypernatremia.

Adolescent ; Child ; Child, Preschool ; Chlorides ; blood ; Dehydration ; etiology ; therapy ; Diarrhea ; complications ; therapy ; Double-Blind Method ; Female ; Fluid Therapy ; methods ; Humans ; Infant ; Infusions, Intravenous ; Male ; Osmolar Concentration ; Potassium ; blood ; Rehydration Solutions ; administration & dosage ; Sodium ; blood ; Treatment Outcome ; Water-Electrolyte Balance

Pleural effusion after hepatectomy is associated with significant morbidity and prolonged hospital stays. Several studies have addressed the risk factors for postoperative pleural effusion. However, there are no researches concerning the role of the initial 12-h operative fluid volume. The aim of this study was to evaluate whether the initial 12-h operative fluid volume during liver resection is an independent risk factor for pleural effusion after hepatectomy. In this study, we retrospectively analyzed clinical data of 470 patients consecutively undergoing elective hepatectomy between January 2011 and December 2012. We prospectively collected and retrospectively analyzed baseline and clinical data, including preoperative, intraoperative, and postoperative variables. Univariate and multivariate analyses were carried out to identify whether the initial 12-h operative fluid volume was an independent risk factor for pleural effusion after hepatectomy. The multivariate analysis identified 2 independent risk factors for pleural effusion: operative time [odds ratio (OR)=10.2] and initial 12-h operative fluid volume (OR=1.0003). Threshold effect analyses revealed that the initial 12 h operative fluid volume was positively correlated with the incidence of pleural effusion when the initial 12-h operative fluid volume exceeded 4636 mL. We conclude that the initial 12-h operative fluid volume during liver resection and operative time are independent risk factors for pleural effusion after hepatectomy. Perioperative intravenous fluids should be restricted properly.
Adult ; Aged ; Female ; Fluid Therapy ; adverse effects ; Hepatectomy ; adverse effects ; methods ; Humans ; Male ; Middle Aged ; Operative Time ; Pleural Effusion ; epidemiology ; etiology ; Postoperative Complications ; epidemiology ; etiology ; Rehydration Solutions ; administration & dosage ; adverse effects