OBJECTIVES: In recent years, it has been reported that the anti-shock effect of plasma substitutes in adult patients with major burn in shock stage is not good. However, due to the shortage of clinical frozen plasma supply, it is impossible to guarantee that frozen plasma is used as colloidal solution for anti-shock treatment. The purpose of this study is to explore the effect of the infusion ration between frozen plasma and plasma substitutes on the prognosis of adult patients with major burn in shock stage. METHODS: This study enrolled 586 adult patients with major burn by selecting the hospitalization burn patients, who had been hospitalized at the Jiangxi province burn center from September 2014 to April 2019. The patients with the infusion ratio of frozen plasma to plasma substitutes ≥2꞉1 at 48 hours after admission were included in the experimental group, otherwise they were included in the control group. The basic clinical data and clinical prognosis indicator in the 2 groups were compared. Logistic univariate regression analysis was used to screen the influential factors of 30-day mortality in adult patients with major burn, and logistic multivariate regression analysis was used to obtain independent risk and protective factors; Kaplan-Meier method was used to draw the survival curve of the 2 groups, and log-rank test was used to compare the 30-day survival rate of the 2 groups. RESULTS: There were significant differences in the infusion volume of frozen plasma and plasma substitutes between the 2 groups at 48 hours after admission (both CONCLUSIONS Infusion ration between frozen plasma to plasma substitutes at 48 hours after admission is an independent protective factor for 30-day mortality of adult patients with major burn. In the early stage of adult patients with major burn, frozen plasma should be used as the anti-shock therapy as far as possible (frozen plasma꞉plasma substitute ≥2꞉1) to improve the prognosis and reduce the of 30-day mortality.
Adult ; Hospitalization ; Humans ; Plasma Substitutes ; Prognosis ; Retrospective Studies ; Shock

PURPOSE: To determine the benefits of autogenous tooth bone (ATB) graft in combination with platelet-rich plasma (PRP) in the rates of success and survival of dental implants placed simultaneously with maxillary sinus floor augmentation (MSFA). MATERIALS AND METHODS: Patients who visited the Department of Oral and Maxillofacial Surgery at Ulsan University Hospital from 2012 to 2014 and underwent simultaneous placement of implants with MSFA using ATB plus PRP were included in the study. Success and survival rates of the implants were evaluated based on the parameters of age and sex of the patient, site, follow-up period, residual bone height before surgery, diameter, and length of implant, sinus mucosa impairment, and postoperative complications. RESULT: A total of 23 patients and 67 implants were included in this study. The average age of the patients was 53.78±10.00 years. The average follow-up period after installation of the prosthesis was 53±5 months. The success and survival rates of the implants after placement of prosthesis were 95.52% and 97.01%, respectively. CONCLUSION: Combination of ATB and PRP showed high overall success rate, and it can be concluded that this combination is a predictable bone graft procedure for MSFA.
Bone Substitutes ; Dental Implantation ; Dental Implants ; Follow-Up Studies ; Humans ; Maxillary Sinus ; Mucous Membrane ; Platelet-Rich Plasma ; Postoperative Complications ; Prostheses and Implants ; Sinus Floor Augmentation ; Surgery, Oral ; Survival Rate ; Tooth ; Transplants ; Ulsan

Injection pain of propofol remains a common clinical problem. Previous studies demonstrated that propofol injection pain was alleviated by applying nitroglycerin ointment to the skin of injection site, which inspires us to test whether venous vasodilation induced by fluid preload could alleviate the pain. Different types or volumes of fluid preload were compared. 200 ASA I-II adult patients were randomly assigned to five groups of 40 each. A 20 G cannula was established on the dorsum or wrist of the hand. When fluid preload given with Plasma-Lyte A 100 mL (P100 group), 250 mL (P250 group), 500 mL (P500 group), 0.9% saline 500 mL (N500 group) or Gelofusine 500 mL (G500 group) was completed within 30 min, respectively, Propofol (0.5 mg/kg, 1%) was injected at a rate of 0.5 mL/s. A blind investigator assessed the pain using a four-point scale. Incidence of pain in P100, P250, and P500 groups was 87.5%, 57.5% and 35%, respectively (P<0.05). The median pain intensity score was significantly lower in P500 group than that in P250 and P100 groups (P<0.05 and P<0.01, respectively). Comparison of the effect of different types of solution preload indicated that the highest incidence of pain was in N500 group (62.5%) (N500 vs. P500, P=0.014; N500 vs. G500, P=0.007). The median pain intensity score in N500 group was higher than that in P500 group (P<0.05) and G500 group (P<0.05). There was no significant difference between P500 and G500 groups. It is suggested that Plasma-Lyte A or Gelofusine preload with 500 mL before propofol injection is effective in alleviating propofol-induced pain.
Adolescent ; Adult ; Aged ; Electrolytes ; administration & dosage ; therapeutic use ; Female ; Humans ; Injections, Intravenous ; adverse effects ; methods ; Male ; Middle Aged ; Pain ; drug therapy ; etiology ; prevention & control ; Plasma Substitutes ; administration & dosage ; therapeutic use ; Polygeline ; administration & dosage ; therapeutic use ; Propofol ; administration & dosage ; adverse effects

No abstract available.
Aged ; Anti-Inflammatory Agents/therapeutic use ; Carotid Artery Diseases/*complications/diagnosis/therapy ; Cerebral Angiography/methods ; Diagnosis, Differential ; Female ; Glucocorticoids/therapeutic use ; Humans ; Hydrocortisone/therapeutic use ; Hypopituitarism/diagnosis/*etiology/therapy ; Intracranial Aneurysm/*complications/diagnosis/therapy ; Magnetic Resonance Imaging ; Plasma Substitutes/administration & dosage ; Predictive Value of Tests ; Prednisolone/therapeutic use ; Sella Turcica ; Thyroid Hormones/therapeutic use ; Tomography, X-Ray Computed ; Treatment Outcome

Fluid therapy remains an important therapeutic maneuver in managing surgical, medical, and the critically ill intensive care patient. However, the ideal volume replacement strategy remains under debate. The debate on whether patients should be managed with crystalloids, colloids, or both has for many years been mainly a debate about effectiveness. The dispute over crystalloids versus colloids has been enlarged to a colloid versus colloid debate because of the varying properties of different colloids. The natural colloid albumin and artificial colloids such as gelatin, dextran, and hydroxyethyl starch continue to enjoy widespread usage for clinical fluid management. Colloid is an effective plasma volume expander and is able to restore the hemodynamic profile with less total volume than crystalloid. However, colloid is associated with coagulation abnormalities, renal impairment, and allergic reactions. Albumin is considered to be one of the safe colloids. However, due to its cost, albumin cannot be recommended for hypovolemia. Gelatin and dextran can also cause coagulation abnormalities and renal impairment. Dextran is not used anymore due to its high anaphylactic potency. Each hydroxyethyl starch has different properties by concentration, mean molecular weight, molar substitution, and its C2/C6 ratio. New hydroxyethyl starches with a lower mean molecular weight and molar substitution than the old hydroxyethyl starch may be promising by improving volume management therapy with lower risks of coagulation abnormalities and renal impairment. The selection of colloid for plasma volume expansion should be based on the patients' clinical conditions and the characteristics of each colloid.
Colloids ; Critical Illness ; Critical Care ; Dextrans ; Dissent and Disputes ; Fluid Therapy ; Gelatin ; Hemodynamics ; Hetastarch ; Humans ; Hypersensitivity ; Hypovolemia ; Isotonic Solutions ; Molar ; Molecular Weight ; Plasma ; Plasma Substitutes ; Plasma Volume

Starting from the form of red blood cells and the hematocrit (Hct, about 45 vol% of whole blood), we tried to prepare a kind of microspheres suspension to imitate non-Newtonian fluid property of whole blood, exploring its potentiality to be applied in blood viscosity quality control substance. In our study, we produced Ca-alginate hydrogel microspheres using emulsion polymerization, then we suspended the microspheres in 0.9 wt% NaCl solution to obtain a kind of liquid sample with the microspheres taking 45% volume. Then we used two types of viscometers to measure and analyse the changes of sample viscosity at different shear rate. We observed the forms of Ca-alginate hydrogel microspheres with microscope, and found them to be relatively complete, and their diameters to be normally distributed. Diameters of about 90% of the microspheres were distributed in a range from 6 to 22 micron. The samples were examined with viscometer FASCO-3010 and LG-R-80c respectively, both of which have shown a shear-thinning effect. After 5-week stability test, the CV of viscosity results corresponding to the two instruments were 7.3% to 13.8% and 8.9% to 14.2%, respectively. Although some differences existed among the results under the same shear rate, the general variation trends of the corresponding results were consistent, so the sample had the potentiality to be widely used in calibrating a different type of blood viscometer.
Alginates ; chemistry ; Blood Viscosity ; Calcium ; chemistry ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Humans ; Hydrogel, Polyethylene Glycol Dimethacrylate ; chemistry ; Microspheres ; Plasma Substitutes ; chemistry ; Rheology ; instrumentation ; Suspensions ; chemistry

Albumin has been widely used in patients with cirrhosis in an attempt to improve circulatory and renal functions. The benefits of albumin infusions in preventing the deterioration in renal function associated with large-volume paracentesis, spontaneous bacterial peritonitis, and established hepatorenal syndrome in conjunction with a vasoconstrictor are well established. While some of these indications are supported by the results of randomized studies, others are based only on clinical experience and have not been proved in prospective studies. The paucity of well-designed trials, the high cost of albumin, the lack of a clear-cut survival benefit, and fear of transmitting unknown infections make the use of albumin controversial. The recent development of the molecular adsorbent recirculating system, an albumin dialysis, is an example of the capacity of albumin to act by mechanisms other than its oncotic effect. Efforts should be made to define the indications for albumin use, the dose required, and predictors of response, so that patients gain the maximum benefit from its administration.
Albumins/*administration & dosage/adverse effects ; Ascites/therapy ; End Stage Liver Disease/physiopathology/*therapy ; Evidence-Based Medicine ; Hepatorenal Syndrome/therapy ; Humans ; Liver Cirrhosis/therapy ; Plasma Substitutes/*administration & dosage/adverse effects ; Sorption Detoxification/adverse effects/*methods ; Treatment Outcome

OBJECTIVETo explore the optimal approach to the prevention of hypotension during cesarean section for the benefits of both the parturients and the newborns.

METHODSForty singleton full-term pregnant women undergoing elective cesarean delivery were randomly allocated into two equal groups. For prevention of hypotension during spinal anesthesia, ephedrine or pre-anesthetic volume with Voluven was administered. The changes of blood pressure, heart rate, and Apgar scores of the newborns were monitored and recorded, and the umbilical arterial blood gas variables were compared between the two groups. The placental samples were collected and immunohistochemistry for CD34 was performed for stereological study of the placental villous capillaries.

RESULTSThe umbilical arterial PaCO(2), PaO(2) and Apgar scores showed no significant differences between the two groups (P<0.05). The heart rate, incidence of hypotension and the lactic acid value were significantly higher, and the umbilical arterial pH significantly lower in ephedrine group than in the Voluven group (P>0.05). While the length density of the villous capillaries was comparable between the two groups (P>0.05), the volume density of the villous capillaries was significantly decreased in ephedrine group (P<0.05).

CONCLUSIONPre-anesthetic volume expansion with Voluven can maintain stable hemodynamics during spinal anesthesia and also efficiently improve the tissue perfusion, microcirculation and uteroplacental blood flow, thus increasing the oxygen supply to the fetus.

Adult ; Anesthesia, Obstetrical ; adverse effects ; Anesthesia, Spinal ; adverse effects ; Cesarean Section ; Elective Surgical Procedures ; Female ; Humans ; Hydroxyethyl Starch Derivatives ; administration & dosage ; Hypotension ; etiology ; prevention & control ; Placenta ; anatomy & histology ; blood supply ; Placental Circulation ; drug effects ; Plasma Substitutes ; administration & dosage ; Pregnancy

PURPOSE: The performance of implant surgery in the posterior maxilla often poses a challenge due to insufficient available bone. Sinus floor elevation was developed to increase the needed vertical height to overcome this problem. However, grafting materials used for the sinus lift technique eventually show resorption. The present study radiographically compared and evaluated the changes in height of the grafting materials after carrying out maxillary sinus elevation with a window opening procedure. This study also evaluated the difference between two xenogenic bone materials when being used for the sinus lifting procedure. METHODS: Twenty-one patients were recruited for this study and underwent a sinus lift procedure. All sites were treated with either bovine bone (Bio-Oss(R)) with platelet-rich plasma (PRP) or bovine bone (OCS-B(R))/PRP. A total of 69 implants were placed equally 6-8 months after the sinus lift. All sites were clinically and radiographically evaluated right after the implant surgery, 7-12 months, 13-24 months, and 25-48 months after their prosthetic loading. RESULTS: Changes of implant length/bone length with time showed a statistically significant decreasing tendency (P < 0.05). There was no significant change in the Bio-Oss(R) group (P > 0.05). In contrast, the OCS-B(R) group showed a significant decrease with time (P < 0.05). However, no significant difference was observed between the two groups (P > 0.05). CONCLUSIONS: The results showed that there was significant reduction in comparison with data right after placement, after 7 to 12 months, 13 to 24 months, and over 25 months; however, reduction rates between each period have shown to be without significance. No significant difference in height change was observed between the Bio-Oss(R) and the OCS-B(R) groups.
Bone Substitutes ; Floors and Floorcoverings ; Humans ; Lifting ; Maxilla ; Maxillary Sinus ; Platelet-Rich Plasma ; Transplants

Maxillary sinus lift and bone graft are used to reconstruct atrophic maxilla molar area for endosseous dental implants. Many different grafting materials and techniques can be used for maxillary sinus bone graft. Bio-Oss(R) has been proposed as bone substitute and successfully utilized as osteoconductive filler. Platelet rich plasma (PRP) is an autologous material with many growth factors, such as PDGF, TGF-beta, IGF, VEGF, facilitating bone healing process. And Platelet poor plasma (PPP) is the by-product in procedure of producing PRP. Six rabbits were used as experimental animal. Both maxillary sinus were grafted with Bio-Oss(R) and PRP, and Bio-Oss(R) and PPP. Rabbits were sacrificed at 4, 8 and 12 weeks. The grafting sites were evaluated by histomorphometric analysis. As a result, using PRP showed excellent bone formation in the early stage, but no further significant effect after that. In late stage, the ability of bone formation of using PRP was even worse than using PPP. The further studies need to be considered in this case.
Animals ; Blood Platelets ; Bone Substitutes ; Dental Implants ; Intercellular Signaling Peptides and Proteins ; Maxilla ; Maxillary Sinus ; Molar ; Osteogenesis ; Plasma ; Platelet-Rich Plasma ; Rabbits ; Transforming Growth Factor beta ; Transplants ; Vascular Endothelial Growth Factor A