scholarly journals Hemodynamic efficacy and safety of using modified gelatin solution and polyhydric alcohol solution for fluid resuscitation of patients with septic shock

2020 ◽  
Vol 34 (4) ◽  
pp. 45-59
Author(s):  
Tinglan Zuo ◽  
F.S. Glumcher ◽  
S.O. Dubrov

Objective ‒ to compare the hemodynamic effects and safety of the infusion of succinylated gelatin solution, sorbitol-containing solution, and 0.9 % normal saline (0.9 % sodium chloride), analyze their effect on the treatment of septic shock and mortality.Materials and methods. A prospective randomized clinical trial that included 94 adult patients with an active surgical infection and septic shock was conducted. There were 34 (36.2 %) male and 60 (63.8 %) female patients aged between 19 and 96 years, mean age was (66.51 ± 17.06) years. An appropriate solution in a volume of 500 ml was used for resuscitation, then hemodynamic and other clinical and laboratory parameters were monitored.Results. There was no significant difference in mean arterial pressure (MAP) between the 3 groups until the 40th minute (p>0.05). At the 45th minute MAP in the NS group differed only from MAP in the Gel group (p=0.007). At the 50th minute MAP in the NS group did not differ from the baseline (p=0.139). From the 50th minute to 2 hours, MAP in the Gel and Sorb groups was higher than in the NS group in all measurements (p<0.05). There was no statistically significant difference in heart rate (HR) in any measurement (p>0.05). Cardiac output (CO) did not differ up to the 30th minute (p>0.05), at the 35th minute, CO differed only between Gel and NS groups (p=0.019), from the 40th minute to 2 hour CO in Gel and Sorb groups were significantly higher than in NS group in all measurements (p<0.05). Oxygen delivery (DO2) also did not differ up to the 30th minute (p>0.05), from the 35th minute to the 45th minute a significant difference was found only between Gel and NS groups (p<0.05), from the 50th minute to 2 hour DO2 in Gel and Sorb group was significantly higher than in NS group in all measurements (p<0.05). After infusion of the gelatin-containing solution and sorbitol-containing solution, the acid-base balance of the blood improved significantly. The dose of gelatin-containing and sorbitol-containing solutions applied in this study was safe for the renal function of the patients with septic shock. However, it is possible that a decrease in blood fibrinogen concentrations may be associated with the use of a gelatin-containing solution. Significant improvement in the Glasgow Coma Scale scores was observed only in patients in the group receiving the sorbitol-containing solution. The difference in 28-day mortality between the groups was not statistically significant (p=0.993).Conclusions. In our observations, when using these three types of solution in patients with septic shock, hemodynamic effects up to the 40th minute did not differ between groups. From the 40th minute to 2 hour, the volemic effect of 4 % succinylated gelatin solution and balanced polyionic solution with 6 % sorbitol was significantly better, compared to the 0.9 % sodium chloride solution. The volume of solutions used in these three groups did not affect renal function in patients with septic shock. The amount of balanced polyionic solution used with 6 % sorbitol and 0.9 % sodium chloride solution did not affect blood coagulation function. But the use of 4 % succinyl gelatin solution reduced the concentration of fibrinogen in the blood. After infusion of the gelatin-containing solution with buffer formulations and sorbitol-containing solution with buffer formulations, the acid-base status of the blood was significantly improved compared to 0.9 % sodium chloride solution. Infusion of the gelatin-containing solution and 0.9 % sodium chloride solution did not affect the Glasgow coma score in patients. After infusion of the sorbitol-containing solution, patients’ consciousness was improved by this scale. The 28-day mortality did not differ significantly between groups.

Author(s):  
Cem Koray Çataroğlu ◽  
Alp Alptekin ◽  
Aysel Gezer ◽  
Murat Sayın ◽  
Aslı Dönmez

Objective: It was aimed to evaluate the effect of intravenous (IV) granisetron used for nausea and vomiting prophylaxis on hypotension and bradycardia caused by spinal anesthesia. Methods: 120 ASA 1-2 patients undergoing elective surgery under spinal anesthesia were randomly divided into Group G (Ganisetron; n=60) and Group P (Placebo; n=60) groups. Five minutes before spinal anesthesia, Group G received 1 mg intravenous granisetron diluted in 10 mL of isotonic sodium chloride solution and Group P received 10 mL of isotonic sodium chloride solution. Spinal anesthesia with hyperbaric bupivacaine 0.5%, 15 mg at the level of L4-5 was applied for both groups. Hemodynamic data, sensory and motor block parameters were recorded before and after spinal anaesthesia every 5 minutes during 20 minutes of surgery. Results: There was no difference in the demographic data of both groups. Although hemodynamic data showed a decrease in both groups according to initial values, blood pressure measurements in group G were significantly higher than the first measure values. There was no significant difference in heart rate values between the groups. Conclusion: Intravenous granisetron reduces hypotension after spinal anesthesia, but it has no significant effect on heart rate.


2016 ◽  
Vol 97 (4) ◽  
pp. 651-656
Author(s):  
A I Musaev ◽  
K K Kenzhekulov

Aim. To evaluate the effectiveness of using ozonated solutions combined with decamethoxin solution in the treatment of purulent wounds.Methods. 101 patients with purulent wounds were under observation. In the treatment of all patients, the first stage was surgical debridement, which removes exudate and non-viable tissue. Also the conditions for wound drainage and good drainage of wound exudate were created, and then the treatment of wounds under a bandage was performed. In the main group (51 people) in addition to the basic treatment ozonated 0.9% sodium chloride solution with a concentration of ozone 8-10 μg/mL and 0.02% decamethoxin solution were used. The general condition of patients and the wound condition were evaluated over time.Results. The duration of fever and pain syndrome did not differ in the groups. A statistically significant difference between groups in the terms of symptoms disappearance and wounds healing was found, indicating the advantages of using the decamethoxin solution in combination with ozonated 0.9% sodium chloride solution in treatment of purulent wounds. The length of stay in hospital statistically significantly decreased compared to the control group. Positive dynamics was observed on the wounds cytology: starting from 3 days of treatment in the main group neutrophil count decreased, number of lymphocytes and polyblasts increased. With the increase in terms from the beginning of the treatment, there was even greater reduction in the number of neutrophils, the increase in the number of lymphocytes and the appearance of macrophages and fibroblasts.Conclusion. The study results demonstrated the benefits of using combination of ozonated solutions with decametoxine solution in the treatment of purulent wounds; method is available to any surgical wards and outpatient clinics.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Vahid Pourzarghan ◽  
Bahman Fazeli-Nasab

AbstractThe most important inhibitors used in bronze disease are BTA and AMT. While these inhibitors control corrosion, they are toxic and cancerous. In this study, the acacia fruit extract (200 ppm to 1800 ppm) was used to the prevention of corrosion inhibition of bronze alloy in corrosive sodium chloride solution 0.5 M, for 4 weeks consecutively. The Bronze alloy used in this research, was made based on the same percentage as the ancient alloys (Cu-10Sn). IE% was used to obtain the inhibitory efficiency percentage and Rp can be calculated from the resistance of polarization. SEM–EDX was used to evaluate the surfaces of alloy as well as inhibitory. The experiment was conducted in split plot design in time based on the RCD in four replications. ANOVA was performed and comparison of means square using Duncan's multiple range test at one percent probability level. The highest rate of corrosion inhibition (93.5%) was obtained at a concentration of 1800 ppm with an increase in the concentration of the extract, corrosion inhibition also increased, i.e., more bronze was prevented from burning. Also, the highest corrosion inhibitory activity of Acacia extract (79.66) was in the second week and with increasing duration, this effect has decreased. EDX analysis of the control sample matrix showed that the amount of chlorine was 8.47%wt, while in the presence of corrosive sodium chloride solution, after 4 weeks, the amount of chlorine detected was 3.20%wt. According to the morphology (needle and rhombus) of these corrosion products based on the SEM images, it can be said, they are the type of atacamite and paratacamite. They have caused bronze disease in historical bronze works. The green inhibitor of Acacia fruit aqueous extract can play an effective role in inhibiting corrosion of bronze, but at higher concentrations, it became fungal, which can reduce the role of Acacia fruit aqueous extract and even ineffective. To get better performance of green inhibitors, more tests need to be done to improve and optimize.


1960 ◽  
Vol 38 (9) ◽  
pp. 1488-1494 ◽  
Author(s):  
E. J. Bounsall ◽  
W. A. E. McBryde

An analytical method is described for the determination of microgram amounts of silver in galena ores, based on the "reversion" of silver dithizonate. Silver is separated from relatively large amounts of lead by extraction as dithizonate into chloroform from an aqueous 1:99 nitric acid solution. Separation from mercury, which is also extracted under these conditions and would, if present, interfere in the analysis, is achieved by reverting the dithizonate solution with a 5% aqueous sodium chloride solution which is also 0.015 molar in hydrochloric acid. Following dilution of this aqueous solution and adjustment of pH, silver is again extracted into chloroform as the dithizonate, and determined absorptiometrically. Analyses of a number of galena ore samples showed a precision of within 3% for a silver content ranging from 0.03 to 0.4%.Some other methods for isolating silver from these samples, which were tried but found unsatisfactory, are discussed.


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