A Pilot Comparison of Limited Versus Large Fluid Volume Resuscitation in Canine Spontaneous Hemoperitoneum

2014 ◽  
Vol 50 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Tara N. Hammond ◽  
Jennifer L. Holm ◽  
Claire R. Sharp
Keyword(s):  
Hemorrhagic Shock ◽  
Vital Signs ◽  
Fluid Volume ◽  
Volume Resuscitation ◽  
Hemodynamic Parameters ◽  
Future Studies ◽  
Time Points ◽  
Spontaneous Hemoperitoneum ◽  
Time To Stabilization ◽  
Potential Benefits

Treatment for hemorrhagic shock secondary to a spontaneous hemoperitoneum includes restoration of IV volume and surgical control of hemorrhage. This study was designed to determine if limited fluid volume resuscitation (LFVR) with hypertonic saline (HS) and hyperoncotic fluids (hydroxyethylstarch [HES]) results in more rapid cardiovascular stabilization in dogs with spontaneous hemoperitoneum versus conventional resuscitation (CR) with large volume resuscitation. Eighteen client-owned dogs presenting in hemorrhagic shock with a spontaneous hemoperitoneum were enrolled. Dogs were randomized to be fluid resuscitated with up to 90 mL/kg of an isotonic crystalloid (CR group) or up to 8 mL/kg of 7.2% Na chloride (i.e., HS) combined with up to 10 mL/kg of 6% HES. Measurements of vital signs, lactate, packed cell volume (PCV), total solids (TS), and blood pressure were made at standard time points. The primary end point was time to stabilization of hemodynamic parameters (measured in min). Dogs in the LFVR group achieved hemodynamic stabilization significantly faster (20 min; range, 10–25 min) than those in the CR group (35 min; range, 15–50 min; P = .027). Future studies are warranted to further investigate potential benefits associated with LFVR in dogs with spontaneous hemoperitoneum.

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

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.

A Comparison of the Hemoglobin-Based Oxygen Carrier HBOC-201 to Other Low-Volume Resuscitation Fluids in a Model of Controlled Hemorrhagic Shock

2003 ◽  
Vol 55 (4) ◽  
pp. 747-754 ◽  
Author(s):  
CPT James B. Sampson ◽  
CPT Michael R. Davis ◽  
MAJ Deborah L. Mueller ◽  
LT Vikram S. Kashyap ◽  
LT Donald H. Jenkins ◽  
...  
Keyword(s):  
Hemorrhagic Shock ◽  
Oxygen Carrier ◽  
Volume Resuscitation ◽  
Low Volume

Abstract P14: Estradiol Does Not Improve Survival and Hemodynamic Parameters in Male Piglets after Hemorrhage and Ventricular Fibrillation

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Egidijus Semenas ◽  
Lars Wiklund
Keyword(s):  
Gender Differences ◽  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Hemorrhagic Shock ◽  
Repeated Measures ◽  
Troponin I ◽  
Control Group ◽  
Hemodynamic Parameters ◽  
Start Time ◽  
Arterial Blood

Introduction: Gender differences in organ functions and survival have been described in animal models of trauma and hemorrhagic shock. The female gender is associated with better cardiac, hepatic and immune functions compared to males after hemorrhagic shock. However, data about gender differences in hypovolemic normothermic cardiac arrest is lacking. Hypothesis: We hypothesized that the estradiol given during cardiopulmonary resuscitation (CPR) will improve survival and hemodynamic response in hypovolemic cardiac arrest and subsequent CPR. Methods: Twenty anesthetized male piglets (with a weight of 25.7 ± 1.7 kg [mean ± SD]) were bled 30% via the right femoral artery to a mean arterial blood pressure of 35 mm during 15 minutes. In the end of bleeding period estradiol group (n=10) received 17â-estradiol 50 ìg/kg intravenously, while the control group received no estradiol (n=10). Later all piglets were subjected to 4 min of untreated ventricular fibrillation followed by up to 15 min of open chest CPR. At 5 min of cardiac arrest piglets received vasopressin 0.4 U/kg, amiodarone 0.5 mg/kg, and hypertonic-hyperoncotic solution 3 ml/kg infusion for 20 minutes. Internal defibrillation was attempted from 8 min of cardiac arrest to achieve restoration of spontaneous circulation (ROSC). The experiment was terminated at 3 hours after initial resuscitation. Data were analyzed using Fisher’s exact test, Kaplan-Meier and repeated measures ANOVA methods. Results: All piglets were successfully resuscitated. No significant differences were observed in survival between the groups (p=0.24). All piglets needed dobutamine infusion and no differences were observed in either total dobutamin dose, or infusion start time (p=0.05). No significant changes were observed in any hemodynamic parameters (p>0.05). Troponin I levels did not differ between groups (p>0.75). Conclusions: Intravenous 17â-estradiol does not improve survival and hemodynamic parameters in male piglets after experimental hypovolemic cardiac arrest.

Discontinuation of Somatic Medication During Psychiatric Hospitalization

2014 ◽  
Vol 48 (11) ◽  
pp. 1415-1424 ◽  
Author(s):  
Heshu Abdullah-Koolmees ◽  
Helga Gardarsdottir ◽  
Lennart J. Stoker ◽  
Judith Vuyk ◽  
Toine C. G. Egberts ◽  
...  
Keyword(s):  
Crossover Study ◽  
Confidence Intervals ◽  
Index Date ◽  
Cox Regression ◽  
Psychiatric Hospitalization ◽  
The Other ◽  
Future Studies ◽  
Time Points ◽  
Relative Risks ◽  
Health Objective

Background: Psychiatric hospitalization can increase the risk of discontinuation of pharmacotherapy, which may negatively influence patients’ health. Objective: To investigate the association between psychiatric hospitalization and discontinuation of somatic medication. Methods: A retrospective crossover study was performed in patients admitted to a psychiatric hospital (index date), who had got somatic medication dispensed during the 3 months prior to hospitalization. Discontinuation of somatic medication was investigated at the following time points: index date and 3, 6, and 9 months before the index date. Relative risks (RR) with 95% confidence intervals (95% CIs) of discontinuing somatic medication at the index date versus the time points before the index date were estimated using Cox regression. Results: In all, 471 hospitalized patients were included in the study; 38.9% of the patients were discontinuers on the index date. RR for discontinuation of ≥1 somatic medication was 1.88 (95% CI = 1.55-2.27) at the index date compared with the other time points and highest for patients <45 years (RR = 2.83; 95% CI = 1.92-4.18). Conclusions: Psychiatric hospitalization was associated with an almost doubled risk of discontinuation of somatic medication. Future studies should address the influence of discontinuation of care on patients’ health.

Limited fluid volume resuscitation (LFVR) in severe shock unresponsive to initial fluid challenge: A pilot study in 10 cats

2018 ◽  
Vol 45 (6) ◽  
pp. 782-787 ◽  
Author(s):  
Elisabetta Giudice ◽  
Chiara Crinò ◽  
Francesco Macrì ◽  
Simona Di Pietro
Keyword(s):  
Pilot Study ◽  
Fluid Challenge ◽  
Fluid Volume ◽  
Volume Resuscitation ◽  
Severe Shock

Shenfu Injection Improves Cerebral Microcirculation and Reduces Brain Injury in a Porcine Model of Hemorrhagic Shock

2020 ◽  
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 ◽  
Sham Operation Group ◽  
Tnf Α

Abstract Background: The aim of this study was to clarify effects of Shenfu infusion (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.

Consider Four Types of Online Identities for Teaching and Modeling Online Behavior

2016 ◽  
pp. 48-71 ◽  
Author(s):  
L. Koh-Herlong ◽  
Abbie Brown
Keyword(s):  
Social Interaction ◽  
Web 2.0 ◽  
Online Behavior ◽  
Online Identity ◽  
Self Presentation ◽  
Teaching Online ◽  
Future Studies ◽  
Potential Benefits ◽  
Theoretical Foundations ◽  
Online Identities

The purpose of this chapter is to provide data and suggestions to educators for teaching and modeling concepts and practices related to online identity. The capabilities introduced by Web 2.0 have changed the potential benefits and liabilities of using online identities. Because online identities can be different from a person's real, offline self, approaches for teaching online self-presentation will differ from the traditional methods of teaching about social interaction. The authors present two theoretical foundations to frame the concept of online self. After a discussion of issues and problems associated with online identities, the authors apply the findings from a recent study to help educators model and teach about online identities. The primary findings are the identification of four types of online identities that include real, desired, enhanced, and deceptive. The chapter concludes with recommendations for future studies to further this topic and extend the current research.

Hypertonic hydroxyethyl starch restores hepatic microvascular perfusion in hemorrhagic shock

1994 ◽  
Vol 266 (5) ◽  
pp. H1927-H1934 ◽  
Author(s):  
B. Vollmar ◽  
G. Lang ◽  
M. D. Menger ◽  
K. Messmer
Keyword(s):  
Hemorrhagic Shock ◽  
Hydroxyethyl Starch ◽  
Small Volume ◽  
Microvascular Perfusion ◽  
Volume Resuscitation ◽  
Shock Model ◽  
Intravital Fluorescence Microscopy ◽  
Ringer Lactate ◽  
Endothelial Lining ◽  
Perfusion Failure

The influence of small-volume resuscitation (hypertonic saline-10% hydroxyethyl starch, HS/HES) on liver microcirculation (intravital fluorescence microscopy) was studied in a nonheparinized hemorrhagic shock model [mean arterial pressure (MAP) 40 mmHg for 1 h] in rats. Resuscitation was performed with Ringer lactate (RL, 4-fold shed volume/20 min; n = 7), 10% hydroxyethyl starch 200/0.6 (HES, shed volume/5 min; n = 6), or 7.2% NaCl-10% hydroxyethyl starch 200/0.6 (HS/HES, 10% shed volume/2 min; n = 7). One hour after resuscitation, MAP increased in all groups, but it did not return to preshock values (P < 0.05). HES (16 +/- 2% nonperfused sinusoids) and HS/HES (14 +/- 2% nonperfused sinusoids), but not RL (24 +/- 2% nonperfused sinusoids), reduced (P < 0.05) shock-induced sinusoidal perfusion failure (28 +/- 3%) with restoration of leukocyte velocity in sinusoids (S) and postsinusoidal venules (V). Shock-induced stasis/adherence of leukocytes was further increased (P < 0.05) after resuscitation with RL (S, 38 +/- 6%; V, 55 +/- 20%) and HES (S, 31 +/- 8%; V, 23 +/- 14%). In contrast, resuscitation with HS/HES prevented increased leukocyte stasis in sinusoids (-4 +/- 4%) as well as adherence to endothelial lining of postsinusoidal venules (-5 +/- 10%). We conclude that replacement of only 10% of actual blood loss by means of small-volume resuscitation (HS/HES) can restore hepatic microvascular perfusion and prevent reperfusion-induced leukocyte stasis/adherence.

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