Renal tolerance to delayed volume resuscitation following traumatic shock

Traumatic shock is considered to be the most common clinical form of a severe patient’s condition (63%). Timely and adequate blood volume resuscitation is one of the most important procedures in providing medical care to critically injured casualties and patients at the forward medical evacuation stage. The key to this problem, especially when the infusion therapy is needed at the pre-hospital stage, is the development of alternative (extravascular) techniques of plasma volume expander administration. The article presents the results of testing of the first domestic medical devices for intraosseous infusion in critically injured casualties and patients. At present, on commission of the Russian Ministry of Defense and with the scientific support of Kirov Military Medical Academy, domestic enterprises developed test samples of medical devices to provide intraosseous infusions: a «Disposable device for intraosseous infusion of solutions if there is no intravenous access, which was designed on the basis of a spring drive» - the index «VKI-P», developed by limited liability company «Novoplast-М» and a set for intraosseous infusion using an electric drive - the index « VKI-E», developed by limited liability company «Research engineering company «Spetsproekt». Assessment of performance of test samples of the medical devices for intraosseous infusions «VKI-P» and «VKI-E» was carried out using pathophysiologic model of traumatic shock in 14 experimental animals (pigs) by creating artificial blood loss of medium severity, 25% of circulating blood volume (in average 440 ml), followed by its resuscitation with intraosseous infusion of 0,9% solution of NaCl. As a result of the performed tests it was found that the device «VKI-P» and the set «VKI-E» provide for NaCl infusion in major vessels (with an intraosseous infusion), 750 ml of volume during 45-50 min, and can be used as an alternative access to provide infusion as a part of anti-shock therapy, which solves the problem of volume resuscitation when giving care to severely injured casualties and patients at the forward medical evacuation stages. These samples may be recommended for inclusion into the medical service list of complete supplies and the Medical Corps supply support, the Armed Forces of the Russian Federation.

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244 Desmopressin Can Be Given with Normal Saline in Severe Hypovolemic Hyponatremia Requiring Large Volume Resuscitation

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2019.03.246 ◽

2019 ◽

Vol 73 (5) ◽

pp. 706

Keyword(s):

Large Volume ◽

Normal Saline ◽

Volume Resuscitation

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Faculty Opinions recommendation of Abdominal compartment syndrome is common in medical intensive care unit patients receiving large-volume resuscitation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1092024.545385 ◽

2007 ◽

Author(s):

Manu Malbrain

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Compartment Syndrome ◽

Abdominal Compartment Syndrome ◽

Large Volume ◽

Medical Intensive Care Unit ◽

Volume Resuscitation ◽

Medical Intensive Care ◽

Abdominal Compartment

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Faculty Opinions recommendation of Chloride Content of Fluids Used for Large-Volume Resuscitation Is Associated With Reduced Survival.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726743335.793523342 ◽

2016 ◽

Author(s):

Tom Woodcock

Keyword(s):

Large Volume ◽

Chloride Content ◽

Volume Resuscitation

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A Preoperative Volume Resuscitation Window Between 1.0 and 2.5 L Is Associated with Decreased Mortality in Hypotensive Patients with a Ruptured Abdominal Aortic Aneurysm

Journal of Vascular Surgery ◽

10.1016/j.jvs.2020.12.020 ◽

2021 ◽

Vol 73 (3) ◽

pp. 37

Author(s):

Amanda R. Phillips ◽

Nancy Mikati ◽

Neal Corbelli ◽

Joshua B. Brown ◽

Michel S. Makaroun ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Volume Resuscitation ◽

Ruptured Abdominal Aortic Aneurysm ◽

Abdominal Aortic

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Shenfu injection improves cerebral microcirculation and reduces brain injury in a porcine model of hemorrhagic shock; SFI reduces brain injury after hemorrhagic shock

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-211100 ◽

2021 ◽

pp. 1-11

Author(s):

Junyuan Wu ◽

Zhiwei Li ◽

Wei Yuan ◽

Qiang Zhang ◽

Yong Liang ◽

...

Keyword(s):

Brain Injury ◽

Hemorrhagic Shock ◽

Interleukin 6 ◽

Aquaporin 4 ◽

Flow Index ◽

Sham Operation ◽

Volume Resuscitation ◽

Cerebral Microcirculation ◽

Shenfu Injection ◽

Tnf Α

BACKGROUND: Shenfu injection (SFI) is a traditional Chinese herbal medicine which has been clinically used for treatment of septic shock and cardiac shock. The aim of this study was to clarify effects of SFI on cerebral microcirculation and brain injury after hemorrhagic shock (HS). METHODS: Twenty-one domestic male Beijing Landrace pigs were randomly divided into three groups: SFI group (SFI, n = 8), saline group (SA, n = 8) or sham operation group (SO, n = 5). In the SFI group, animals were induced to HS by rapid bleeding to a mean arterial pressure of 40 mmHg within 10 minutes and maintained at 40±3 mmHg for 60 minutes. Volume resuscitation (shed blood and crystalloid) and SFI were given after 1 hour of HS. In the SA group, animals received the same dose of saline instead of SFI. In the SO group, the same surgical procedure was performed but without inducing HS and volume resuscitation. The cerebral microvascular flow index (MFI), nitric oxide synthase (NOS) expression, aquaporin-4 expression, interleukin-6, tumor necrosis factor-α (TNF-α) and ultrastructural of microvascular endothelia were measured. RESULTS: Compared with the SA group, SFI significantly improved cerebral MFI after HS. SFI up regulated cerebral endothelial NOS expression, but down regulated interleukin-6, TNF-α, inducible NOS and aquaporin-4 expression compared with the SA group. The cerebral microvascular endothelial injury and interstitial edema in the SFI group were lighter than those in the SA group. CONCLUSIONS: Combined application of SFI with volume resuscitation after HS can improve cerebral microcirculation and reduce brain injury.

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Intra-abdominal Inferior Vena Cava Injuries: Operative Strategies and Outcomes

The American Surgeon ◽

10.1177/0003134820973395 ◽

2020 ◽

pp. 000313482097339

Author(s):

Christine A. Castater ◽

Margo Carlin ◽

Virginia D. Parker ◽

Chris Sciarretta ◽

Deepika Koganti ◽

...

Keyword(s):

Inferior Vena Cava ◽

Inferior Vena ◽

Vena Cava ◽

Mortality Rates ◽

Volume Resuscitation ◽

Vascular Injuries ◽

Trauma Centers ◽

Review Of The Literature ◽

Hemorrhage Control ◽

Operative Strategies

Visceral vascular injuries are relatively uncommon even in busy urban trauma centers. The inferior vena cava (IVC) is the most frequently injured visceral vein and can be a complex operative challenge. Despite advances in early volume resuscitation, improved transport times, prompt operative intervention, and hemorrhage control, mortality rates have remained largely unchanged. This article conducts an in-depth review of the literature surrounding IVC injuries and a detailed discussion of operative strategies and management as survivability is ultimately dependent on the grade of injury, location, and the presence of hemorrhagic shock.

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