LIMITATIONS OF CONVENTIONAL FLUID REPLACEMENT WITH CRYSTALLOIDS IN HYPOVOLEMIC SHOCK.

Shock ◽  
1999 ◽  
Vol 12 (Supplement) ◽  
pp. 9
Author(s):  
Rocha M. e Silva
2020 ◽  
Vol 48 ◽  
Author(s):  
Maria Sette Camara Benarrós ◽  
Louysse Helene Monteiro ◽  
Dandi Kelly Souza Marques da Silva ◽  
Cinthia Távora De Albuquerque Lopes ◽  
Sheyla Farhayldes Souza Domingues

Background: The brown-throated sloth (Bradypus variegatus) occurs from the Nicaragua to Brazil. In brazilian amazonian, these animals are rescued with illnesses caused by anthropic actions. Emergencial treatment of sloths is complex because is a lack of specie-specific information allied to a particularly physiology. They have low metabolism and physiological parameters during resting time is 4-7 breaths/min, 40-100 heartbeats/min and temperature between 32-35ºC. They are also folivores, predisposing cases of dehydration and even hypovolemic shock. This study aimed to report the emergency treatment performed on a specimen of Bradypus variegatus affected by hypovolemic shock due to dehydration.Case: A male sloth weighing 2.7 kg was attended at the Veterinary Hospital-Wild Animals Sector of the Federal University of Pará (HVSAS-UFPA), victim of untreated hypovolemic shock due three days of forced eating with inadequate food, which resulted in dehydration, non-hemorrhagic hypovolemic shock, and severe apathy. Physiological parameters were 8 breaths/min, heart rate 90/min and rectal temperature of 33°C. Treatment begun with fluid therapy taking account of 10% of body dehydration (270 mL Ringer lactate, 8 mL vitamin complex and 2 mL glucose), for respiratory decompensation nebulization was conducted with epinephrine (0.5 mL/kg), and intramuscular administration of vitamin B complex (1 mg/kg), metoclopramide (0.2 mg/kg), ranitidine (0.5 mg/kg), and dexamethasone (0.3 mg/kg) to metabolic stimulation improvement. Physiological parameters were monitored every 10 min for the first 12 h of hospitalization. The management were gradually established as the clinical conditions were improved, including forced feeding, daily walks, and enclosure adapted for the minimal behavioral and biological requirements. After 14 days of intensive treatment, the animal was considered ready for release.Discussion: Treatment of critically ill and unnourishment patients requires prompt interventions. Animals with low metabolism potentially have reduced chances of success, therefore, a prompt establishment of viable airways and body temperature maintenance would allow the efficient drugs metabolization. Severe dehydration can lead to animal death by hypovolemic shock, as a consequence of low blood volume, diminish in blood pressure and in the amount of oxygen in body supply, so fluid replacement is essential, as well as stimulating respiratory compensation through bronchodilator drugs. Furthermore, metabolic stimulation is important in cases to prevent numbness, which is common in very weak sloths. The constant monitoring of physiological parameters since at first moment of hospitalization provided parameter to decide about particular needs adaptations during the animal recovery time. Such protocols described for the brown-throated sloth was absent in the literature. In conclusion, the therapeutic and management protocol implemented and adapted to a particular patience, as brown-throated sloth, resulted in a gradual clinical improvement and allowed to its return for the natural environment.


2007 ◽  
Vol 12 (2) ◽  
pp. 024001 ◽  
Author(s):  
Jangwoen Lee ◽  
Albert E. Cerussi ◽  
Darin Saltzman ◽  
Tom Waddington ◽  
Bruce J. Tromberg ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Manon Durand Bechu ◽  
Antoine Rouget ◽  
Christian Recher ◽  
Elie Azoulay ◽  
Vincent Bounes

Systemic Capillary Leak Syndrome (SCLS) is a rare disease with poor prognosis, characterized by the occurrence of mucocutaneous and visceral edema with hypotension, hemoconcentration, and unexpected hypoalbuminemia. The disease can be idiopathic (Clarkson syndrome) or secondary to other diseases and treatments. We describe this syndrome in a prehospitalized, 63-year-old patient with chronic lymphocytic leukemia and an idiopathic form of SCLS manifesting as hypovolemic shock. Initial care is hospitalization in intensive care. In addition to etiological treatment if fluid replacement is necessary, treatment must be closely monitored for secondary overload complications. Catecholamine rather than arrhythmogenic support may be associated.


2019 ◽  
Vol 98 (6) ◽  
pp. 256-259

Introduction: This case report describes bleeding from an iatrogenic thoracic aortic injury in minimally invasive thoracoscopic esophagectomy. Case report: A 53-year-old man underwent neoadjuvant radiochemotherapy for adenocarcinoma of the esophagus with positive lymph nodes. PET/CT showed only a partial response after neoadjuvant therapy. Minimally invasive thoracoscopic esophagectomy in the semi-prone position with selective intuba- tion of the left lung was performed. However, massive bleeding from the thoracic aorta during separation of the tumor resulted in conversion from minimally invasive to conventional right thoracotomy. The bleeding was caused by a five millimeter rupture of the thoracic aorta. The thoracic aortic rupture was treated by suture with a gore prosthesis in collaboration with a vascular surgeon. Esophagestomy was not completed due to hypovolemic shock. Hybrid transhiatal esophagectomy was performed on the seventh day after the primary operation. Definitive histological examination showed T3N3M0 adenocarcinoma. Conclusion: Esophagectomy for cancer of the esophagus is one of the most difficult operations in general surgery in which surgical bleeding from the surrounding structures cannot be excluded. Aortic hemorrhage is hemodynamically significant in all cases and requires urgent surgical treatment.


1998 ◽  
Vol 39 (4) ◽  
pp. 400-404
Author(s):  
A. Rotondo ◽  
Orlando Catalano ◽  
R. Grassi ◽  
M. Scialpi ◽  
G. Angelelli

Author(s):  
Tvrtko Tupek ◽  
Analena Gregorić ◽  
Dino Pavoković ◽  
Anis Cerovac ◽  
Dubravko Habek

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