Volume Kinetics of Intravenous Fluid Therapy in the Prehospital Setting

2001 ◽  
Vol 16 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Christer Svensén ◽  
Fredrik Sjöstrand ◽  
Robert G. Hahn
Keyword(s):  
Kinetic Analysis ◽  
Fluid Therapy ◽  
Elimination Rate ◽  
Volume Effect ◽  
The Body ◽  
Control Group ◽  
Trauma Patients ◽  
Acetate Solution ◽  
Crystalloid Fluid ◽  
Ringer’S Acetate Solution

AbstractIntroduction:To study the volume effect of isotonic and hypertonic crystalloid fluid during ambulance transports after mild trauma, a prospective case-control study was initiated, using the ambulance and helicopter transport system in Stockholm.Methods:The hemodilution resulting from intravenous infusion of 1.0 L of Ringer's acetate solution (n = 7) or 250 ml of 7.5% sodium chloride (n = 3) over 30 minutes (min) was measured every 10 min during 1 hour when fluid therapy was instituted at the scene of an accident, or on arrival at the hospital. The dilution was studied by volume kinetic analysis and compared to that of matched, healthy controls who received the same fluid in hospital.Result:The hemodilution at the end of the infusions averaged 7.7% in the trauma patients and 9.1% in the controls, but the dilution was better maintained after trauma. The kinetic analysis showed that the size of the body fluid space expanded by Ringer's solution was 4.6 L and 3.8 L for the trauma and the control patients, respectively, while hypertonic saline expanded a slightly larger space. For both fluids, trauma reduced the elimination rate constant by approximately 30%.Conclusion:Mild trauma prolonged the intravascular persistence of isotonic and hypertonic crystalloid fluid as compared to a control group.

Volume Kinetics of Ringer Solution, Dextran 70, and Hypertonic Saline in Male Volunteers 

1997 ◽  
Vol 87 (2) ◽  
pp. 204-212 ◽  
Author(s):  
Christer Svensen ◽  
Robert G. Hahn
Keyword(s):  
Serum Albumin ◽  
Hypertonic Saline ◽  
Fluid Therapy ◽  
Elimination Rate ◽  
The Body ◽  
Acetate Solution ◽  
Male Volunteers ◽  
Dextran 70 ◽  
Volume Kinetics ◽  
Kinetics Of

Background A knowledge of the distribution of different fluids given by intravenous infusion is basic to the understanding of the effects of fluid therapy. Therefore, a mathematical model was tested to analyze the volume kinetics of three types of fluids. Methods The authors infused 25 ml/kg of Ringer acetate solution, 5 ml/kg of 6% dextran 70 in 0.9% NaCl, and 3 ml/kg of 7.5% NaCl over 30 min in 8 male volunteers aged from 25 to 36 years (mean, 31 years) and measured the changes in total hemoglobin, serum albumin, and total blood water over time. The changes were expressed as fractioned dilution and then plotted against time. The curves were fitted to a one-volume and a two-volume model, which allowed an estimation of the size of the body fluid space expanded by the fluid (V) and the elimination rate constant (k(r) to be made. Results The changes in blood water concentration indicated a mean size of V of 5.9 1 (+/- 0.8, SEM) for Ringer's solution, 2.6 (+/- 0.3) 1 for dextran, and 1.2 (+/- 0.1) 1 for hypertonic saline. The corresponding values of k(r) were 94 (+/- 42), 12 (+/- 6), and 30 (+/- 4) ml/min, respectively. Blood hemoglobin indicated a degree of dilution similar to that indicated by blood water. Serum albumin indicated a more pronounced dilution, which resulted in a larger expandable volume and a greater mean square error for the curvefitting. The larger volume obtained for serum albumin can probably be explained by a loss of intravascular albumin into the tissues along with the infused fluid. Conclusions The distribution of intravenous fluids can be analyzed by a kinetic model adapted for fluid spaces, but slightly different results are obtained, depending on the marker used to indicate dilution of the primary fluid space. Analysis and simulation of plasma volume expansion by this model is a tool that can help the anesthetist to better plan fluid therapy.

Volume Kinetics of Ringer's Solution in Hypovolemic Volunteers 

1999 ◽  
Vol 90 (1) ◽  
pp. 81-91 ◽  
Author(s):  
Dan Drobin ◽  
Robert G. Hahn
Keyword(s):  
Rate Constant ◽  
Body Fluid ◽  
Elimination Rate ◽  
Elimination Rate Constant ◽  
The Body ◽  
Data Sets ◽  
Acetate Solution ◽  
Plasma Albumin ◽  
Ringer’S Solution ◽  
Ringer’S Acetate Solution

Background The amount of Ringer's solution needed to restore normal blood volumes is thought to be three to five times the volume of blood lost. This therapy can be optimized by using a kinetic model that takes accounts for the rates of distribution and elimination of the infused fluid. Methods The authors infused 25 ml/kg Ringer's acetate solution into 10 male volunteers who were 23 to 33 yr old (mean, 28 yr) when they were normovolemic and after 450 ml and 900 ml blood had been withdrawn. One-volume and two-volume kinetic models were fitted to the dilution of the total venous hemoglobin and plasma albumin concentrations. Results Withdrawal of blood resulted in a progressive upward shift of the dilution-time curves of both markers. The two-volume model was statistically justified in 56 of the 60 analyzed data sets. The hemoglobin changes indicated that the body fluid space expanded by the infused fluid had a mean total volume of 10.7 l(+/-0.9 SEM). The elimination rate constant (kr) decreased with the degree of hypovolemia and was 133 ml/min (22 ml/min [SEM]), 100 ml/min (39 ml/min [SEM]), and 34 ml/min (7 ml/min [SEM]), respectively (P < 0.01). Plasma albumin indicated a slightly larger body fluid space expanded by the infused fluid, but kr was less (P < 0.02). Hypovolemia reduced the systolic and diastolic blood pressures by approximately 10 mmHg (P < 0.05). Conclusions The dilution of the blood and the retention of infused Ringer's solution in the body increases in the presence of hypovolemia, which can be attributed chiefly to a reduction of the elimination rate constant.

Distribution and elimination of crystalloid fluid in pre-eclampsia

2004 ◽  
Vol 106 (3) ◽  
pp. 307-313 ◽  
Author(s):  
Dan DROBIN ◽  
Robert G. HAHN
Keyword(s):  
Pregnant Women ◽  
Body Fluid ◽  
Time Course ◽  
Central Body ◽  
Venous Blood ◽  
Acetate Solution ◽  
Crystalloid Fluid ◽  
Volume Load ◽  
Gestational Week ◽  
Ringer’S Acetate Solution

Pre-eclampsia (PE) is a disease of pregnancy associated with peripheral oedema and hypovolaemia, but few details are known about how women with PE handle a volume load of crystalloid fluid compared with healthy pregnant women. To study this issue, Ringer's acetate solution (12.5 ml/kg of body weight) was given by intravenous infusion over 30 min to eight women with PE and to eight healthy pregnant women matched with respect to gestational week (mean, 34 weeks). Venous blood was sampled and excreted urine was collected over 90 min to study the time course of the volume expansion by means of volume kinetic analysis. The results show that the size of the central body fluid space expanded by the infused fluid was smaller in PE (mean, 2940 ml compared with 4240 ml respectively; P<0.04), and the clearance constants for distribution (100 ml/min compared with 43 ml/min; P<0.04) and elimination (125 ml/min compared with 36 ml/min; P<0.02) were higher in the women with PE than in the controls. Less excess volume accumulated in the central body fluid space in the presence of PE, whereas the rates of distribution and elimination were higher during and for 15 min after the infusion. It is concluded that Ringer's acetate solution fluid is both distributed and eliminated faster in women with PE than in matched pregnant controls.

scholarly journals Management of Shivering in Post-Spinal Anesthesia Using Warming Blankets and Warm Fluid Therapy

Jurnal NERS ◽  
2020 ◽  
Vol 14 (3) ◽  
pp. 305
Author(s):  
Arina Qona'ah ◽  
Novi Enis Rosuliana ◽  
I Made Amartha Bratasena ◽  
Wahyu Cahyono
Keyword(s):  
Body Temperature ◽  
Spinal Anesthesia ◽  
Fluid Therapy ◽  
T Test ◽  
The Body ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Warming Blanket ◽  
Equivalent Control ◽  
The Mean

Hypothermia is a common and serious complication of spinal surgery and it is associated with many harmful perioperative outcomes. The aim of this study was to compare the effectiveness of warming blankets and warm fluid therapy to manage shivering. A quasi-experiment with a non-equivalent control group was applied as the research design. There were 60 patients involved in the study. The instrument of this study was a warmer fluid modification, a warming blanket and a cotton blanket. The data was analyzed using an applied paired t-test and independent t-test. After 60 minutes of the intervention, the mean and SD of body temperature of the patients receiving warm fluids was 36.71 ± 0.18, a warming blanket was 36.12 ± 0.35, and the control group was 35.76 ± 0.22. The p values were 0,000. Warm fluid therapy and warming blankets are significant in terms of increasing the body temperature of post-spinal anesthesia patients. Warm fluids are more effective than warming blanket. Warming blankets and warm fluid therapy can be used as a way to increase the body temperature of patients with hypothermia.

scholarly journals Understanding Volume Kinetics: The Role of Pharmacokinetic Modeling and Analysis in Fluid Therapy

2020 ◽  
Vol 7 ◽  
Author(s):  
Xiu Ting Yiew ◽  
Shane W. Bateman ◽  
Robert G. Hahn ◽  
Alexa M. E. Bersenas ◽  
William W. Muir
Keyword(s):  
Veterinary Medicine ◽  
Fluid Therapy ◽  
Volume Effect ◽  
The Body ◽  
Pharmacokinetic Analysis ◽  
Evidence Based ◽  
Intravenous Fluids ◽  
Pharmaceutical Drugs ◽  
Modeling And Analysis ◽  
Volume Kinetics

Fluid therapy is a rapidly evolving yet imprecise clinical practice based upon broad assumptions, species-to-species extrapolations, obsolete experimental evidence, and individual preferences. Although widely recognized as a mainstay therapy in human and veterinary medicine, fluid therapy is not always benign and can cause significant harm through fluid overload, which increases patient morbidity and mortality. As with other pharmaceutical substances, fluids exert physiological effects when introduced into the body and therefore should be considered as “drugs.” In human medicine, an innovative adaptation of pharmacokinetic analysis for intravenous fluids known as volume kinetics using serial hemoglobin dilution and urine output has been developed, refined, and investigated extensively for over two decades. Intravenous fluids can now be studied like pharmaceutical drugs, leading to improved understanding of their distribution, elimination, volume effect, efficacy, and half-life (duration of effect) under various physiologic conditions, making evidence-based approaches to fluid therapy possible. This review article introduces the basic concepts of volume kinetics, its current use in human and animal research, as well as its potential and limitations as a research tool for fluid therapy research in veterinary medicine. With limited evidence to support our current fluid administration practices in veterinary medicine, a greater understanding of volume kinetics and body water physiology in veterinary species would ideally provide some evidence-based support for safer and more effective intravenous fluid prescriptions in veterinary patients.

scholarly journals Implications of Continuous Noninvasive Finger Cuff Arterial Pressure Device Use during Cesarean Delivery for Goal-Directed Fluid Therapy Preload Optimization: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Shan-Han Yang ◽  
Yi-Shiuan Lin ◽  
Chien-Nan Lee ◽  
Ya-Jung Cheng ◽  
Ying-Hsi Chen ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Stroke Volume ◽  
Spinal Anesthesia ◽  
Cesarean Delivery ◽  
Fluid Therapy ◽  
Fluid Challenge ◽  
Fixed Dose ◽  
Control Group ◽  
Crystalloid Fluid ◽  
Goal Directed Fluid Therapy

Background. Although fixed-volume conventional fluid preloading protocol fails to attenuate postspinal hypotension during cesarean delivery, the effect of goal-directed fluid therapy (GDFT) remains less explored. Continuous noninvasive finger cuff arterial pressure monitoring using devices such as the ClearSight System can provide the noninvasive stroke volume value, enabling clinicians to perform GDFT before spinal anesthesia; however, the efficacy of GDFT requires further elucidation. Method. In total, 71 consecutive full-term pregnant women were randomly divided into a control group ( n = 34 ) and a GDFT group ( n = 37 ). Before spinal anesthesia, the control group received a fixed dose (1000 mL) of crystalloid fluid, but the GDFT group received repeated 3 mL/kg body weight of crystalloid fluid challenges within 3 minutes with a 1-minute interval between each fluid challenge based on the stroke volume incremental changes obtained using the ClearSight System (targeting a stroke volume increase of ≥5% after a fluid challenge). The primary outcome was the incidence of postspinal hypotension. The secondary outcomes were total fluid volume, vasopressor dosage, hemodynamic parameter changes, maternal adverse effects, and neonatal profiles. Result. Women in the GDFT group received more fluid than did those in the control group ( 1132 ± 108 vs. 1247 ± 202  mL; p = 0.0044 ), but the incidence of postspinal hypotension (79.4% vs. 73.0%,; p = 0.5864 ) and norepinephrine dose ( 12.5 ± 10.6 vs. 15.1 ± 12.8  mcg, respectively; p = 0.3512 ) was comparable between the two groups. Fewer women in the GDFT group experienced nausea (61.76% vs. 35.14%; p = 0.0332 ). Neonatal outcomes (Apgar score and umbilical blood analysis) were comparable and typical in both groups. Conclusion. ClearSight-guided GDFT did not ameliorate postspinal hypotension but may reduce nausea. This trial is registered with NCT03013140.

L-Ascorbic Acid Addition to Chitosan Reduces Body Weight in Overweight Women

2014 ◽  
Vol 84 (1-2) ◽  
pp. 5-11 ◽  
Author(s):  
Eun Y. Jung ◽  
Sung C. Jun ◽  
Un J. Chang ◽  
Hyung J. Suh
Keyword(s):  
Ascorbic Acid ◽  
Body Weight ◽  
Fat Body ◽  
Body Weight Gain ◽  
Skinfold Thickness ◽  
The Body ◽  
Control Group ◽  
Percentage Body Fat ◽  
Overweight Women ◽  
Body Weights

Previously, we have found that the addition of L-ascorbic acid to chitosan enhanced the reduction in body weight gain in guinea pigs fed a high-fat diet. We hypothesized that the addition of L-ascorbic acid to chitosan would accelerate the reduction of body weight in humans, similar to the animal model. Overweight subjects administered chitosan with or without L-ascorbic acid for 8 weeks, were assigned to three groups: Control group (N = 26, placebo, vehicle only), Chito group (N = 27, 3 g/day chitosan), and Chito-vita group (N = 27, 3 g/day chitosan plus 2 g/day L-ascorbic acid). The body weights and body mass index (BMI) of the Chito and Chito-vita groups decreased significantly (p < 0.05) compared to the Control group. The BMI of the Chito-vita group decreased significantly compared to the Chito group (Chito: -1.0 kg/m2 vs. Chito-vita: -1.6 kg/m2, p < 0.05). The results showed that the chitosan enhanced reduction of body weight and BMI was accentuated by the addition of L-ascorbic acid. The fat mass, percentage body fat, body circumference, and skinfold thickness in the Chito and Chito-vita groups decreased more than the Control group; however, these parameters were not significantly different between the three groups. Chitosan combined with L-ascorbic acid may be useful for controlling body weight.

Burnout of the Mind – Burnout of the Body?

2018 ◽  
Vol 32 (1) ◽  
pp. 30-42 ◽  
Author(s):  
Claudia Traunmüller ◽  
Kerstin Gaisbachgrabner ◽  
Helmut Karl Lackner ◽  
Andreas R. Schwerdtfeger
Keyword(s):  
Blood Pressure ◽  
Allostatic Load ◽  
Maslach Burnout Inventory ◽  
The Body ◽  
Lower Percentage ◽  
Control Group ◽  
Urinary Catecholamines ◽  
Morning Cortisol ◽  
The Mind ◽  
Cortisol Increase

Abstract. In the present paper we investigate whether patients with a clinical diagnosis of burnout show physiological signs of burden across multiple physiological systems referred to as allostatic load (AL). Measures of the sympathetic-adrenergic-medullary (SAM) axis and the hypothalamic-pituitary-adrenal (HPA) axis were assessed. We examined patients who had been diagnosed with burnout by their physicians (n = 32) and were also identified as burnout patients based on their score in the Maslach Burnout Inventory-General Survey (MBI-GS) and compared them with a nonclinical control group (n = 19) with regard to indicators of allostatic load (i.e., ambulatory ECG, nocturnal urinary catecholamines, salivary morning cortisol secretion, blood pressure, and waist-to-hip ratio [WHR]). Contrary to expectations, a higher AL index suggesting elevated load in several of the parameters of the HPA and SAM axes was found in the control group but not in the burnout group. The control group showed higher norepinephrine values, higher blood pressure, higher WHR, higher sympathovagal balance, and lower percentage of cortisol increase within the first hour after awakening as compared to the patient group. Burnout was not associated with AL. Results seem to indicate a discrepancy between self-reported burnout symptoms and psychobiological load.

Perbandingan Efek Suplementasi Tablet Tambah Darah Dengan Dan Tanpa Vitamin C Terhadap Kadar Hemoglobin Pada Ibu Hamil Dengan Usiakehamilan 16-32 Minggu Di Desa Keniten Kecamatan Mojo Kabupaten Kediri

2017 ◽  
Vol 3 (1) ◽  
pp. 76
Author(s):  
Siti Asiyah ◽  
Dwi Estuning Rahayu ◽  
Wiranti Dwi Novita Isnaeni
Keyword(s):  
Treatment Group ◽  
Vitamin C ◽  
Gestational Age ◽  
Group Treatment ◽  
Sampling Technique ◽  
Hemoglobin Level ◽  
The Body ◽  
Control Group ◽  
Fetal Organ ◽  
And Control

The needed of Iron Tablet in pregnancy was increase than mother who not pregnant.  That  cause of  high metabolism at the pregnancy for formed of  fetal organ and energy. One of effort for prevent anemia in mother pregnant with giving the Iron tablet and vitamin c. The reason of  this research in 4 June – 11 July 2014 is for compare the effect of  iron tablet suplementation with and without vitamin C toward Hemoglobin level in mother pregnant With Gestational Age Of 16-32 Weeks In Desa Keniten Kecamatan Mojo Kabupaten Kediri. This research method using comparative analytical.  Research design type of Quasy Eksperiment that have treatment group and control group. Treatment group will giving by Iron tablet and 100 mg vitamin C, and control group just giving by iron tablet during 21 days. Population in this research are all of mother pregnant with Gestational Age Of 16-32 Weeks with Sampling technique is  cluster random sampling is 29 mother pregnant. Comparison analysis of  iron tablet suplementation effect with and without vitamin C toward Hemoglobin level in mother pregnant With Gestational Age Of 16-32 Weeks, data analysis using Mann Whitney U-test and the calculated U value (44,5) less than U-table (51). So there was difference of iron tablet suplementation effect with and without vitamin C toward Hemoglobin level in mother pregnant With Gestational Age Of 16-32 Weeks Therefore, the addition of vitamin C on iron intake is needed to increase the uptake of iron tablets. When the amount of iron uptake increases, the reserves of iron in the body will also increase, so as to prevent anemia in pregnant women; Keywords : Iron Tablet (Fe), Vitamin C, Hemoglobin level, Mother Pregnant

Influence of DAFS-25+polizon composition on blood and functional state of liver of steers at fattening

2020 ◽  
pp. 15-18
Author(s):  
Inna R. Kilmetova ◽  
◽  
Igor A. Rodin ◽  
Nazira I. Khayrullina ◽  
Nikolay G. Fenchenko ◽  
...  
Keyword(s):  
Functional State ◽  
White Blood Cells ◽  
Live Weight ◽  
The Body ◽  
Farm Animals ◽  
Control Group ◽  
Standard Diet ◽  
The Impact ◽  
Experimental Group ◽  
Stimulation Of

Summary. The disbalanced feeding and the uneven distribution of micro- and macroelements in the environment leads to a trace element, in particular hypomelanosis. To accelerate the growth and preservation of young farm animals include in the diet of various biological additives and drugs, which include selenium. For stimulation of weight gain in the livestock industry, as well as for the prevention and treatment of pathological processes in addition to micro - and macrouse amino acids, primarily methionine. The aim of this work was to study the influence of composition of DAFS-25+Polizon on morpho-biochemical parameters of blood and functional state of the liver in fattening bulls of black-motley breed in the conditions of the Republic of Bashkortostan. Experiments using were conducted on bull-calves of black-motley breed of the properties in the properties age from 6 to 15 months. The first experimental group during the experiment was additionally given the composition of DAFS-25+Polizon at a dose of 2 mg/kg, the animals of the control group received a standard diet. To assess the impact of the composition DAFS-25+Polizon on metabolism cattle studied morphological and biochemical indicators of blood and conducted histological examination of the liver. It is established that the use of the composition of DAFS-25+Polizon at a dose of 2 mg/kg increases the number of erythrocytes and hemoglobin in the experimental group and reduces the amount of white blood cells. The serum content of total protein, phosphorus and calcium increases in the group of experimental animals. Microscopic examination of the liver revealed no changes in the structure of the organ and hepatocytes in the experimental group, whereas in the control group hemodynamic disorders and dystrophic changes in liver cells were observed. Thus, the use of the composition DAFS-25+Polizon at a dose of 2 mg/kg of live weight in fattening bulls black-and-white breed contributes to the increase of redox processes in the body, stimulation of metabolism, prevent the development of liver disorders of cellular mechanisms of metabolism, optimizes the structure of the liver, which generally provides higher productivity.

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