The effect of acetate Ringer’s solution versus lactate Ringer’s solution on acid base physiology in infants with biliary atresia

Abstract Background The choice of the perioperative crystalloid is a key component of the fluid management and must take into account the liver function and the appearing metabolic disorders to avoid increase the liver extra metabolism. The aim of this study is to analyze the effect of acetate Ringer’s solution or lactate Ringer’s solution in biliary atresia patients. Methods We included 68 infant patients aged between 21 ~ 65 d, ASA physical status II or III, who underwent elective Kasai hepatoportoenterostomy, received either AR and LR for intravenous fluid resuscitation according to their group allocation. Lactate concentration, serum electrolytes and pH were noteded before skin incision (T1), end of surgery (T2) and postoperative 12 h. We also recorded the time of operation, stay of hospital, loss of blood and urinary, total volume of infusion of crystalloid. Results Lactate level was significantly higher in Group LR than in Group AR patients at T2 (0.76 ± 0.13 versus 0.57 ± 0.22, P = 0.03). Compared with T3, sodium and chlorine were significantly higher in two groups at T2 (145.2 ± 3.1 versus 143.4 ± 3.4 and 104.6 ± 3.7 versus 105.2 ± 2.1). No significant differences were noted in potassium, HCO3− and calcium. There was no statistically significant difference in pH. No glycopenia was recorded in two groups. No significant difference was noted in administration of vasoactive drug (0.7% versus 1%). Conclusions Resuscitation with AR and LR was associated with similar clinical improvement in infants with biliary atresia. Use of AR reduced the level of lactate comparison with LR.

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The Effect of Acetate Ringer's Solution Versus lactate Ringer's Solution on Acid Base Physiology in Infants with Biliary Atresia

10.21203/rs.3.rs-745650/v1 ◽

2021 ◽

Author(s):

Xiang Liu ◽

Hongyan Cao ◽

Xiaona Tan ◽

Jing Shi ◽

Li Qiao ◽

...

Keyword(s):

Biliary Atresia ◽

Metabolic Disorders ◽

Fluid Management ◽

Lactate Concentration ◽

Skin Incision ◽

Physical Status ◽

Solution Versus ◽

Ringer’S Solution ◽

Significant Difference ◽

Time Of Operation

Abstract Backgroud: The choice of the perioperative crystalloid is a key component of the fluid management and must take into account the liver function and the appearing metabolic disorders to avoid increase the liver extra metabolism. The aim of this study is to analyze the effect of acetate Ringer's solution or lactate Ringer's solution in biliary atresia patients.Methods: We included 68 infant patients aged between 21~65 d, ASA physical status II or Ⅲ, who underwent elective Kasai hepatoportoenterostomy, received either AR and LR for intravenous fluid resuscitation according to their group allocation. Lactate concentration, serum electrolytes and pH were noteded before skin incision (T1), end of surgery (T2) and postoperative 12 h. We also recorded the time of operation, stay of hospital, loss of blood and urinary, total volume of infusion of crystalloid.Results: Lactate level was significantly higher in Group LR than in Group AR patients at T2 ( 0.76 ± 0.13 versus 0.57 ± 0.22, P=0.03 ). Compared with T3, sodium and chlorine were significantly higher in two groups at T2 ( 145.2 ± 3.1 versus 143.4 ± 3.4 and 104.6 ± 3.7 versus 105.2 ± 2.1 ). No significant differences were noted in potassium, HCO3- and calcium. There was no statistically significant difference in pH. No glycopenia was recorded in two groups. No significant difference was noted in administration of vasoactive drug (0.7% versus 1% ).Conclusions: Resuscitation with AR and LR is associated with similar clinical improvement in infants with biliary atresia. Use of AR reduced the level of lactate in comparison with LR.

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Differences in triglyceride levels before and after whey protein intervention in field workers exposed and unexposed to arsenic

JURNAL GIZI INDONESIA ◽

10.14710/jgi.9.2.166-171 ◽

2021 ◽

Vol 9 (2) ◽

pp. 166-171

Author(s):

Eka Putri Rahmadhani ◽

Ani Margawati ◽

Apoina Kartini

Keyword(s):

Whey Protein ◽

Dairy Products ◽

Metabolic Disorders ◽

Fat Metabolism ◽

Exposed Group ◽

The Body ◽

Unexposed Group ◽

Significant Difference ◽

Before And After ◽

Field Workers

Background: A work environment that is exposed to heavy metals, such as a coal mining environment, can change fat metabolism in the body. Changes in fat metabolism will lead to cardiovascular disease. Consumption of dairy products, e.g. whey protein, can reduce the risk of metabolic disorders and cardiovascular disease.Objectives: To test and analyze the differences in triglyceride levels before and after whey protein intervention to field workers with different working conditions.Materials and Methods: This experimental research with pretest and posttest was conducted on field workers at PT Bukit Asam Tbk. Tarahan Port Unit, Lampung as an Arsenic exposed group and PTPN VII Way Berulu Business Unit as an Arsenic unexposed group. Both groups received 24 grams of whey protein daily for 28 days. The triglyceride levels before and after the intervention were measured by laboratory analysis using the enzymatic calorimetry method. The data were analyzed using independent t-test, Mann Whitney test, and Wilcoxon test.Results: The average triglyceride levels increased by 50.48 ± 98.09 mg/dL in the exposed group and 16.78 ± 67.67 mg/dL in the unexposed group. There was a significant difference in triglyceride levels before and after the whey protein intervention in the two groups.Conclusions: The whey protein intervention increased the triglyceride level in the exposed group and decreased it in the unexposed group.

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Lactate, Heart Rate and Rating of Perceived Exertion Responses to Shorter and Longer Duration CrossFit® Training Sessions

Journal of Functional Morphology and Kinesiology ◽

10.3390/jfmk3040060 ◽

2018 ◽

Vol 3 (4) ◽

pp. 60 ◽

Cited By ~ 2

Author(s):

Ramires Tibana ◽

Nuno de Sousa ◽

Jonato Prestes ◽

Fabrício Voltarelli

Keyword(s):

Heart Rate ◽

Perceived Exertion ◽

Recovery Period ◽

Lactate Concentration ◽

Blood Lactate Concentration ◽

Cardiovascular Responses ◽

Cardiovascular Fitness ◽

Rating Of Perceived Exertion ◽

Training Experience ◽

Significant Difference

The aim of this study was to analyze blood lactate concentration (LAC), heart rate (HR), and rating perceived exertion (RPE) during and after shorter and longer duration CrossFit® sessions. Nine men (27.7 ± 3.2 years; 11.3 ± 4.6% body fat percentage and training experience: 41.1 ± 19.6 months) randomly performed two CrossFit® sessions (shorter: ~4 min and longer: 17 min) with a 7-day interval between them. The response of LAC and HR were measured pre, during, immediately after, and 10, 20, and 30 min after the sessions. RPE was measured pre and immediately after sessions. Lactate levels were higher during the recovery of the shorter session as compared with the longer session (shorter: 15.9 ± 2.2 mmol/L/min, longer: 12.6 ± 2.6 mmol/L/min; p = 0.019). There were no significant differences between protocols on HR during (shorter: 176 ± 6 bpm or 91 ± 4% HRmax, longer: 174 ± 3 bpm or 90 ± 3% HRmax, p = 0.387). The LAC was significantly higher throughout the recovery period for both training sessions as compared to pre-exercise. The RPE was increased immediately after both sessions as compared to pre-exercise, while there was no significant difference between them (shorter: 8.7 ± 0.9, longer: 9.6 ± 0.5; p = 0.360). These results demonstrated that both shorter and longer sessions induced elevated cardiovascular responses which met the recommendations for gains in cardiovascular fitness. In addition, both training sessions had a high metabolic and perceptual response, which may not be suitable if performed on consecutive days.

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Characteristics of Gut Microbiota in Children With Biliary Atresia After Liver Transplantation

Frontiers in Physiology ◽

10.3389/fphys.2021.704313 ◽

2021 ◽

Vol 12 ◽

Author(s):

Wei Song ◽

Li-Ying Sun ◽

Zhi-Jun Zhu ◽

Lin Wei ◽

Wei Qu ◽

...

Keyword(s):

Liver Transplantation ◽

Gut Microbiota ◽

Biliary Atresia ◽

Control Level ◽

Control Group ◽

Metagenomic Sequencing ◽

Polyamine Biosynthesis ◽

Fecal Samples ◽

Linear Discriminant ◽

Significant Difference

Background and AimsBiliary atresia (BA) is an idiopathic neonatal cholestasis and is the most common indication in pediatric liver transplantation (LT). Previous studies have suggested that the gut microbiota (GM) in BA is disordered. However, the effect of LT on gut dysbiosis in patients with BA has not yet been elucidated.MethodsPatients with BA (n = 16) and healthy controls (n = 10) were recruited. In the early life of children with BA, Kasai surgery is a typical procedure for restoring bile flow. According to whether BA patients had previously undergone Kasai surgery, we divided the post-LT patients into the with-Kasai group (n = 8) and non-Kasai group (n = 8). Fecal samples were collected in both the BA and the control group; among BA patients, samples were obtained again 6 months after LT. A total of 40 fecal samples were collected, of which 16 were pre-LT, 14 were post-LT (8 were with-Kasai, 6 were non-Kasai), and 10 were from the control group. Metagenomic sequencing was performed to evaluate the GM.ResultsThe Kruskal-Wallis test showed a statistically significant difference in the number of genes between the pre-LT and the control group, the pre-LT and the post-LT group (P < 0.05), but no statistical difference between the post-LT and the control group. Principal coordinate analysis also showed that the microbiome structure was similar between the post-LT and control group (P > 0.05). Analysis of the GM composition showed a significant decrease in Serratia, Enterobacter, Morganella, Skunalikevirus, and Phifllikevirus while short chain fatty acid (SCFA)-producing bacteria such as Roseburia, Blautia, Clostridium, Akkermansia, and Ruminococcus were increased after LT (linear discriminant analysis > 2, P < 0.05). However, they still did not reach the normal control level. Concerning functional profiles, lipopolysaccharide metabolism, multidrug resistance, polyamine biosynthesis, GABA biosynthesis, and EHEC/EPEC pathogenicity signature were more enriched in the post-LT group compared with the control group. Prior Kasai surgery had a specific influence on the postoperative GM.ConclusionLT partly improved the GM in patients with BA, which provided new insight into understanding the role of LT in BA.

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The Effect of Pedal Pump Lymphatic Technique Versus Passive Recovery Following Maximal Exercise: A Randomized Cross-Over Trial

Sports Medicine - Open ◽

10.1186/s40798-021-00402-x ◽

2022 ◽

Vol 8 (1) ◽

Author(s):

Joanne DiFrancisco-Donoghue ◽

Thomas Chan ◽

Alexandra S. Jensen ◽

James E. B. Docherty ◽

Rebecca Grohman ◽

...

Keyword(s):

Blood Lactate ◽

Outcome Measures ◽

Repeated Measures ◽

Maximal Exercise ◽

Lactate Concentration ◽

The Body ◽

Intense Exercise ◽

Passive Recovery ◽

Significant Difference ◽

Recovery Protocols

Abstract Context Muscle damage and delayed onset muscle soreness (DOMS) can occur following intense exercise. Various modalities have been studied to improve blood lactate accumulation, which is a primary reason for DOMS. It has been well established that active recovery facilitates blood lactate removal more rapidly that passive recovery due to the pumping action of the muscle. The pedal pump is a manual lymphatic technique used in osteopathic manipulative medicine to increase lymphatic drainage throughout the body. Pedal pump has been shown to increase lymphatic flow and improve immunity. This may improve circulation and improve clearance of metabolites post-exercise. Objective This study compared the use of pedal pump lymphatic technique to passive supine recovery following maximal exercise. Methods 17 subjects (male n = 10, age 23 ± 3.01; female n = 7, age 24 ± 1.8), performed a maximal volume O2 test (VO2 max) using a Bruce protocol, followed by a recovery protocol using either pedal pump technique or supine passive rest for 10 min, followed by sitting for 10 min. Outcome measures included blood lactate concentration (BL), heart rate (HR), systolic blood pressure (SBP) and VO2. Subjects returned on another day to repeat the VO2 max test to perform the other recovery protocol. All outcomes were measured at rest, within 1- minute post-peak exercise, and at minutes 4, 7, 10 and 20 of the recovery protocols. A 2 × 6 repeated measures ANOVA was used to compare outcome measures (p ≤ 0.05). Results No significant differences were found in VO2, HR, or SBP between any of the recovery protocols. There was no significant difference in BL concentrations for recovery at minutes 4, 7, or 10 (p > 0.05). However, the pedal pump recovery displayed significantly lower BL concentrations at minute 20 of recovery (p = 0.04). Conclusion The pedal pump significantly decreased blood lactate concentrations following intense exercise at recovery minute 20. The use of manual lymphatic techniques in exercise recovery should be investigated further.

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Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

International Surgery Journal ◽

10.18203/2349-2902.isj20211817 ◽

2021 ◽

Vol 8 (5) ◽

pp. 1507

Author(s):

Amit Yadav ◽

Lakshman Agarwal ◽

Sumit A. Jain ◽

Sanjay Kumawat ◽

Sandeep Sharma

Keyword(s):

Postoperative Pain ◽

Blood Loss ◽

Abdominal Surgery ◽

Wound Infection ◽

Skin Incision ◽

P Value ◽

Wound Area ◽

Significant Difference ◽

Group A ◽

Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

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Physiological and Competitive Characteristics of Professional Female Futsal Players

Teorìâ ta Metodika Fìzičnogo Vihovannâ ◽

10.17309/tmfv.2021.1.03 ◽

2021 ◽

Vol 21 (1) ◽

pp. 19-25

Author(s):

Tommy Apriantono ◽

Samsul Bahri ◽

Sri Ihsani Indah ◽

Bagus Winata

Keyword(s):

Perceived Exertion ◽

Lactate Concentration ◽

Anaerobic Capacity ◽

Blood Lactate Concentration ◽

Aerobic Performance ◽

Anaerobic Performance ◽

Mean Power ◽

Significant Difference ◽

Post Test ◽

Training Team

The study purpose was to examine the anaerobic and aerobic performance and also determine the influence of the anaerobic performance on specific movements during a match-play. Materials and methods. A total of 12 Indonesian professional female players from Bandung district female futsal club were recruited and enrolled to participate in this study. They were required to complete one familiarization and two experimental sessions. During the first session (laboratory test), all players performed a treadmill test to ascertain their maximum rate of oxygen consumption (VO2max) and a running-based anaerobic sprint test (RAST) to measure their anaerobic performance. For the second session (on-court test), the participants played a simulated match on the court. A training team of 5 experts carried out an investigation regarding each player’s competitive performance per match. Furthermore, the blood lactate concentration and Rate of Perceived Exertion (RPE) were assessed in the pre- and post-test for both sessions, which were separated by a week to enable the players to recover. Results. The results showed that there was no significant difference between the mean power (MP) and fatigue index (FI) (p = 0.425, p = 0.938, respectively) for anaerobic performance using Analysis of Variance (ANOVA), although, the MP and FI of team C was lower compared to A and B. Furthermore, the total number of failed passes and shot off target of team C was larger compared to B and A (for failed passes = 30 vs 20 vs 25, for shot off target 14 vs 13 vs 8). Conclusions. The results obtained indicate that there are strong associations between anaerobic capacity and explosive movements (shooting, tackling, heading and passing) among female futsal players.

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Aggressive intravenous hydration with lactated Ringer’s solution for prevention of post-ERCP pancreatitis: a prospective randomized multicenter clinical trial

Endoscopy ◽

10.1055/s-0043-122386 ◽

2017 ◽

Vol 50 (04) ◽

pp. 378-385 ◽

Cited By ~ 11

Author(s):

Chang-Hwan Park ◽

Woo Paik ◽

Eun Park ◽

Chan Shim ◽

Tae Lee ◽

...

Keyword(s):

High Risk ◽

Multicenter Trial ◽

High Risk Patients ◽

Intention To Treat ◽

Ringer’S Solution ◽

Significant Difference ◽

Risk Patients ◽

Intravenous Hydration ◽

Lactated Ringer's Solution ◽

First Time

Abstract Background and study aims The present study aimed to determine the type of intravenous hydration that is best suited to reducing the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis. Patients and methods In a prospective randomized multicenter trial, average-to-high risk patients who underwent first-time ERCP were randomly assigned to three groups (1:1:1) who received: aggressive intravenous hydration (3 mL/kg/h during ERCP, a 20-mL/kg bolus and 3 mL/kg/h for 8 hours after ERCP) with either lactated Ringer’s solution (LRS) or normal saline solution (NSS), or standard intravenous hydration with LRS (1.5 mL/kg/h during and for 8 hours after ERCP). The primary end point was post-ERCP pancreatitis (PEP). Results 395 patients were enrolled, and 385 completed the protocols. The three groups showed no significant differences in demographic characteristics. There was a significant difference in the intention-to-treat (ITT) PEP rate between the aggressive LRS group (3.0 %, 95 % confidence interval [CI] 0.1 % – 5.9 %; 4 /132), the aggressive NSS group (6.7 %, 95 %CI 2.5 % – 10.9 %; 9 /134) and the standard LRS group (11.6 %, 95 %CI 6.1 % – 17.2 %; 15 /129; P = 0.03). In the two-group comparisons, the ITT PEP rate was significantly lower for the aggressive LRS group than for the standard LRS group (relative risk [RR] 0.26, 95 %CI 0.08 – 0.76; P = 0.008). There was no significant difference in the ITT PEP rate between the aggressive NSS group and the standard LRS group (RR 0.57, 95 %CI 0.26 – 1.27; P = 0.17). Conclusion Aggressive hydration with LRS is the best approach to intravenous hydration for the prevention of PEP in average-to-high risk patients.

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Safety and Efficacy of Nonanesthesiologist-Administrated Propofol during Endoscopic Submucosal Dissection of Gastric Epithelial Tumors

Gastroenterology Research and Practice ◽

10.1155/2019/5937426 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Keiichiro Abe ◽

Keiichi Tominaga ◽

Akira Kanamori ◽

Tsunehiro Suzuki ◽

Hitoshi Kino ◽

...

Keyword(s):

Adverse Events ◽

Endoscopic Submucosal Dissection ◽

University Hospital ◽

Physical Status ◽

Safety And Efficacy ◽

Submucosal Dissection ◽

Epithelial Tumors ◽

Physical Status Classification ◽

Significant Difference ◽

Status Classification

Objective. There is no consensus regarding administration of propofol for performing endoscopic submucosal dissection (ESD) in patients with comorbidities. The aim of this study was to evaluate the safety and efficacy of propofol-induced sedation administered by nonanesthesiologists during ESD of gastric cancer in patients with comorbidities classified according to the American Society of Anesthesiologists (ASA) physical status. Methods. Five hundred and twenty-two patients who underwent ESD for gastric epithelial tumors under sedation by nonanesthesiologist-administrated propofol between April 2011 and October 2017 at Dokkyo Medical University Hospital were enrolled in this study. The patients were divided into 3 groups according to the ASA physical status classification. Hypotension, desaturation, and bradycardia were evaluated as the adverse events associated with propofol. The safety of sedation by nonanesthesiologist-administrated propofol was measured as the primary outcome. Results. The patients were classified according to the ASA physical status classification: 182 with no comorbidity (ASA 1), 273 with mild comorbidity (ASA 2), and 67 with severe comorbidity (ASA 3). The median age of the patients with ASA physical status of 2/3 was higher than the median age of those with ASA physical status of 1. There was no significant difference in tumor characteristics, total amount of propofol used, or ESD procedure time, among the 3 groups. Adverse events related to propofol in the 522 patients were as follows: hypotension (systolic blood pressure<90 mmHg) in 113 patients (21.6%), respiratory depression (SpO2<90%) in 265 patients (50.8%), and bradycardia (pulse rate<50 bpm) in 39 patients (7.47%). There was no significant difference in the incidences of adverse events among the 3 groups during induction, maintenance, or recovery. No severe adverse event was reported. ASA 3 patients had a significantly longer mean length of hospital stay (8 days for ASA 1, 9 days for ASA 2, and 9 days for ASA 3, P=0.003). However, the difference did not appear to be clinically significant. Conclusions. Sedation by nonanesthesiologist-administrated propofol during ESD is safe and effective, even for at-risk patients according to the ASA physical status classification.

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Surgical fat removal exacerbates metabolic disorders but not atherogenesis in LDLR−/− mice fed on high-fat diet

Scientific Reports ◽

10.1038/s41598-019-54392-8 ◽

2019 ◽

Vol 9 (1) ◽

Author(s):

Lin Liu ◽

Chenxi Liang ◽

Xiaowei Wang ◽

Xiayu Ding ◽

Yingjing Lu ◽

...

Keyword(s):

High Fat Diet ◽

Metabolic Disorders ◽

Subcutaneous Fat ◽

Surgical Removal ◽

High Fat ◽

Fat Depots ◽

Systemic Insulin Resistance ◽

Significant Difference ◽

Fat Removal ◽

Adipose Dysfunction

AbstractLipodystrophy is a severe adipose dysfunction that can be classified as congenital or acquired lipodystrophy, in term of the etiology. Previous knowledge about the metabolic disorders and cardiovascular consequences were mostly obtained from lipodystrophic mice with genetic defects. To completely rule out the genetic influence, we established a mouse model of acquired generalized lipodystrophy by surgical removal of multiple fat depots, including subcutaneous fat in the inguinal, visceral fat in the epididymis and brown fat in the scapula, in atherosclerosis-prone LDLR−/− mice which were fed with a high-fat diet (HFD). It was observed that fat removal increased diet-induced hyperlipidemia, especially hypercholesteremia, as early as 2 weeks after HFD and till the end of HFD feeding. After 12 weeks on the HFD, the residual fats of fat-removed mice were found expanded. Although fat removal aggravated diet-induced lipid deposition in the liver and systemic insulin resistance, there was no significant difference in atherogenesis in fat-removed mice compared with sham-operated control mice. Acquired generalized lipodystrophy by surgical fat removal promoted metabolic disorders but not atherogenesis in LDLR−/− mice fed on HFD.

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