Articles: hypovolemia-prevention-control.
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Observational Study
Tidal volume challenge to predict fluid responsiveness in the operating room: A prospective trial on neurosurgical patients undergoing protective ventilation.
Pulse pressure variation (PPV) and stroke volume variation (SVV) do not predict fluid responsiveness when using a protective ventilation strategy: the use of functional haemodynamic tests can be useful to overcome this limitation. ⋯ The changes in PPV and SVV obtained after VTC are reliable and comparable to the changes in CI and SVI obtained after EEOT performed at 8 ml kg PBW in predicting fluid responsiveness in neurosurgical patients.
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Randomized Controlled Trial Comparative Study
Comparison of 6% hydroxyethyl starch and 5% albumin for volume replacement therapy in patients undergoing cystectomy (CHART): study protocol for a randomized controlled trial.
The use of artificial colloids is currently controversial, especially in Central Europe Several studies demonstrated a worse outcome in intensive care unit patients with the use of hydroxyethyl starch. This recently even led to a drug warning about use of hydroxyethyl starch products in patients admitted to the intensive care unit. The data on hydroxyethyl starch in non-critically ill patients are insufficient to support perioperative use. ⋯ There is a general lack of evidence on the relative safety and effects of hydroxyethyl starch compared with human albumin for volume replacement in a perioperative setting. Previously conducted studies of surgical patients in which researchers have compared different hydroxyethyl starch products included too few patients to properly evaluate clinical important outcomes such as renal function. In the present study in a high-risk patient population undergoing a major surgical intervention, we will determine if perioperative fluid replacement with human albumin 5% will have a long-term advantage over a third-generation hydroxyethyl starch 130/0.4 on the progression of renal dysfunction until 90 days after surgery.
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Anesteziol Reanimatol · Jan 2015
[Optimization of infusion therapy in patients with ovarian cancer].
We investigated the clinical observations and the results of a comprehensive survey of 70 patients with ovarian cancer stage III-IV aged 30 to 70 years with the presence of endotoxemia. Integral assessment of prognosis and severity of the condition was performed according to SAPS II and SOFA. Infusion program included a preliminary correction of hypovolemia prior to surgery on the operating table in equal parts, HES and balanced crystalloid solutions, with in- creased infusion of 15% of blood volume based on the method of anesthesia. ⋯ Analysis of the results revealed that premorbid background in patients with ovarian cancer stage III-IV was characterized by hypovolemia, phenomena hepatopathy, and endotoxemia, and mixed forms of hypoxia of varying severity. Differentiated approach to the choice of pathogenesis-based perioperative infusion according to premorbid condition, anesthesia and blood loss contributed to the elimination of hypovolemia, favored efficient oxygen delivery and consumption, the ade- quacy of tissue oxygenation. Remaxol inclusion in the perioperative infusion programs in patients with ovarian cancer enhanced their clinical efficiency, reduced cytolytic and cholestatic syndromes, recovered of protein and synthetic liver function, reduced the appearance of mixedforms of hypoxia and endogenous intoxication.
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Critical care medicine · Jun 2014
Multicenter StudyOptimal Range of Global End-Diastolic Volume for Fluid Management After Aneurysmal Subarachnoid Hemorrhage: A Multicenter Prospective Cohort Study.
Limited evidence supports the use of hemodynamic variables that correlate with delayed cerebral ischemia or pulmonary edema after aneurysmal subarachnoid hemorrhage. The aim of this study was to identify those hemodynamic variables that are associated with delayed cerebral ischemia and pulmonary edema after subarachnoid hemorrhage. ⋯ Our findings suggest that global end-diastolic volume index impacts both delayed cerebral ischemia and pulmonary edema after subarachnoid hemorrhage. Maintaining global end-diastolic volume index slightly above normal levels has promise as a fluid management goal during the treatment of subarachnoid hemorrhage.