Vox sanguinis
-
The aim of this review was to summarize the properties of the commonly available resuscitation fluids and highlight where knowledge of the characteristics of individual fluids might guide their use in clinical practice. Some of the current controversies surrounding resuscitation fluids are also discussed. Blood or blood products, or strategies of fluid administration, are not focused upon. ⋯ The clinical trial data does not support the concept of a therapeutic advantage for either crystalloids or colloids, despite claimed theoretical advantages for both classes of fluid. The available colloid solutions have quite distinct profiles of activity, both in terms of their plasma volume expansion profile and other physiological and pharmacological properties. Recent data suggests that physiologically balanced crystalloid and colloid solutions may improve clinical outcomes when compared with saline-based fluids.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Effects of solvent/detergent-treated plasma and fresh-frozen plasma on haemostasis and fibrinolysis in complex coagulopathy following open-heart surgery.
Solvent/detergent-treated plasma (SDP) contains markedly lower protein S (PS) and plasmin inhibitor (PI) activity than standard fresh-frozen plasma (FFP). It has also been reported that SDP contains no alpha(1)-antitrypsin. Despite the lack of clinical data, it is suspected that SDP may be less effective than FFP in the treatment of complex coagulopathies. We therefore conducted a prospective trial to study the impact of SDP and FFP on haemostasis and fibrinolysis in complex coagulopathy after open-heart surgery. ⋯ With the exception of PS and PI, SDP and FFP improved haemostasis and fibrinolysis to a similar degree. The clinical significance of these findings has to be determined in patients with severe acquired PS and PI deficiency requiring plasma transfusions.