ringer’s lactate
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О. V. Tkachuk ◽  
A. B. Kebkalo

The purpose of the work is to improve the results of treatment of severe acute pancreatitis in obese patients and to develop an algorithm for comprehensive treatment. Materials and methods. Patients with severe acute pancreatitis and obesity (mean BMI 37.48 ± 2.19 kg/m2) were randomized into two groups. In the experimental group (n = 18; step-up approach),early resuscitation with Ringer's lactate solution and ulinastatin in the first 5 days of the disease was used. Unilastatin was administered at a dose of 200,000IU by 1-hourintra­venous infusion TID for 5 days. The first stage of surgery was a drainage under ultrasound control, the second stage (if necessary) was laparos­copic retroperitoneal necrectomy (video-assisted­retroperitoneal debri­de­ment — VARD). Open surgery was performed in case of development of abdominal compartment syndrome. In the control group (n = 18; standard approach), resuscita­tion was performed with 0.9 % sodium chlo­ride solution without ulinastatin. The first stage of surgery was draina­ge under ultrasound control, the second stage was traditional median laparotomy with laparostomy. Results. The use of resuscitation with Ringer’s lactate solution in combination with ulinastatin for 5 days contributed to a decrease of procalcitoninlevels by 1.8 times (2.89 ± 0.88 compared with 1.8 ± 0.23 ng/mg; p = 0.001; α = 0.05). The level of CRP during the period of ulinastatin decreased by 41.68 mg/l (267.28 ± 114.11 compared with 225.6 ± 84.9 mg/l; p = 0.01; α = 0.05). There was a statistically significant difference in procalcitonin levels between groups on the 10th day (1.83 compared with 3.32 ng/mg; p = 0.001; α = 0.05), on the 15th day (1.15 compared with 1 .83 ng/mg; p = 0.001; α = 0.05) and on the 45th day (0.35 compared with 0.55 ng/mg; p = 0.001; α = 0.05). These results confirm the effect of the proposed method of treatment by reducing the risk of infection. Conclusions. The effectiveness of the proposed treatment algorithm is evidenced by a statistically significant difference in the level of CRP between groups on the 10th day (p = 0.035; α = 0.05). The use of VARD in the experimental group as a second stage of surgery is a less traumatic but effective method (p = 0.001; α = 0.05), which reduces the total number of complications (χ² = 4.012; p = 0.046). Evaluation of data «before—after» revealed the effectiveness of treatment by step-up approach (χ² = 5.4; p = 0.021). 

Metals ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1597
Junaidi Syarif ◽  
Yudha Pratesa ◽  
Yudi Prasetyo ◽  
Sri Harjanto

Carbon-containing Fe-Mn alloys have been developed for the materials for stent application. The alloys fabricated by the powder metallurgy route retain a significant amount of porosity and require a longer sintering time. In this study, the corrosion behavior and cytotoxicity of FeMnC alloy fabricated by powder metallurgy were investigated. The ball-milling process was applied to increase the sample density. Mn content was set to 25 or 35 wt.%, while 1 wt.% carbon was added to all samples. The austenite stability was independent of porosity and the ball-milling process, whereas hardness had a strong dependence on porosity and the ball-milling process. The corrosion resistance of FeMnC alloy depends mainly on the porosity rather than Mn content. The concentration of Fe ions was higher than that of Mn ions in all immersion times in the Ringer’s lactate solution. The released metallic ion concentration rate is also dependent on the porosity of the sample rather than Mn content. However, the ion concentration was lower than the upper intake limit. The extract of FeMnC alloy in Ringer’s lactate solution reduced cell viability. The ball-milled (BM) FeMnC alloys showed higher cell viability than the non-BM sample. However, the FeMnC alloy shows the same level of biocompatibility as SS316L. This result indicates that the FeMnC alloy has a suitable corrosion behavior and proven biocompatibility for biodegradable materials.

2021 ◽  
Vol 7 (1) ◽  
Yoko Midorikawa ◽  
Junichi Saito ◽  
Masato Kitayama ◽  
Kentaro Toyooka ◽  
Kazuyoshi Hirota

Abstract Background Acute normovolemic hemodilution (ANH) is used to reduce the risk of peri-operative allogeneic blood transfusion. Although crystalloid and/or colloid solutions have been used for volume replacement during ANH, no studies have examined the differences among solutions on the volume status, electrolytes, acid-base balance, and hemodynamic status during surgery with ANH. Methods We retrospectively compared the effect of Ringer’s lactate with 3% dextran-40 (Saviosol®, DEX group) and 6% hydroxyethyl starch 130/0.4 in 0.9% sodium chloride (Voluven®, HES group) on blood hemoglobin serum electrolytes and estimated blood volume before induction of anesthesia (baseline), after ANH and after blood transfusion following surgery in patients undergoing open gynecological surgery (n = 111 and 67, respectively). The primary outcomes were the changes in hemoglobin and electrolytes after ANH. Results There were no differences in hemoglobin or electrolytes between the two groups at baseline. Postoperative hemoglobin was significantly higher (11.0 ± 1.5 g/dL vs 9.9 ± 1.3 g/dL) (mean ± SD) in the DEX group than in the HES group (p = 0.03). Postoperative potassium was significantly decreased from the baseline both in the DEX group (137.9 ± 2.5 mmol/L vs 136.3 ± 2.7 mmol/L) and in the HES group (138.3 ± 2.0 mmol/L vs 137.8 ± 2.5 mmol/L) (p < 0.001 for both); however, it was significantly higher than in the DEX group after surgery (p < 0.001). Estimated blood volume after surgery was significantly increased after ANH in both groups; however, it was larger in the HES group than in the DEX group. Conclusions Postoperative hemoglobin and potassium were significantly higher, and estimated blood volume was significantly smaller in the DEX than in the HES group.

2021 ◽  
Vol 1867 (1) ◽  
pp. 360-360

Hiromasa Tanaka ◽  
Shogo Maeda ◽  
Kae Nakamura ◽  
Hiroshi Hashizume ◽  
Kenji Ishikawa ◽  

2021 ◽  
Vol 11 (3) ◽  
Mohamed Elsonbaty ◽  
Sherif Abdullah ◽  
Ahmed Elsonbaty

Background: Effective perioperative fluid therapy is a great consideration. Objectives: Using lung ultrasound (LUS), this study evaluated the preference of the conventional and restrictive fluid replacement regimens for their volume impact in pediatric patients undergoing a relatively long procedure with limited volume loss (hypospadias repair). Methods: Eighty pediatric patients scheduled for hypospadias repair surgery were enrolled for conventional (CG) or restrictive fluid management groups (RG). The CG obtained Ringer's lactate at the conventional calculated doses, while the RG obtained infusion of Ringer's lactate at a rate of 3 mL/kg/h. B-line numbers in the LUS, recovery score, urine output, blood pressure (BP), heart rate HR, and oxygen saturation (SpO2) were recorded. Results: As evidenced by the LUS, RG showed a higher incidence of normal lung morphology with a mean and SD of 1.3 ± 2.2 for B-line numbers, whereas, in CG, they were 3.1 ± 2.2 with a P-value < 0.001. Urine output was 3.2 ± 0.8 and 2.9 ± 0.7 for CG and RG, respectively, with a P-value equal to 0.07. HR, BP, and SpO2 differences between groups were statistically insignificant. The recovery score was higher in RG (5.8 ± 0.4) than in CG (5.1 ± 0.8) at the first postoperative 20 minutes, with a P-value < 0.001. Conclusions: In lengthy procedures with limited volume loss, using a moderately restrictive regimen is preferred over the conventional intraoperative fluid regimen considering both respiratory dysfunctions and recovery score.

Redox Biology ◽  
2021 ◽  
Vol 43 ◽  
pp. 101989
Li Jiang ◽  
Hao Zheng ◽  
Qinying Lyu ◽  
Shotaro Hayashi ◽  
Kotaro Sato ◽  

Samartha Ram Hemmanur ◽  
Illa Sai Samyuktha ◽  
Nagashree Vasudeva

Background: Utero-placental insufficiency is one of the major causes of oligoamnios and diminished fetal movements (FM). Rapid intravenous isotonic fluid infusion within the cardiovascular reserve improves tissue perfusion in all systems. We tested the hypothesis that isotonic fluid challenge may improve uteroplacental perfusion, which may, in turn improve fetal oxygenation, liquor formation, and FM.Methods: In this descriptive study, twenty-three antenatal mothers with gestational age >26 weeks, and with amniotic fluid index (AFI) <8 cm were included. Intravenous isotonic fluid challenge with 2 or 3 pints of ringer’s lactate, at the rate of 180-200 drops/minute, twice daily for 2-3days and, L-arginine infusion, 300 ml/day alternate days for 2-3 doses were given. Women were advised to take more than 3 litres of water a day. AFI was recorded once daily for 5 days, and then biweekly. The fluid challenge was repeated whenever AFI diminished <8.00 cm. AFI and perceived FM were graded. Pregnancies were terminated when there was no response to fluid challenge. The trend of changes in AFI and FM grades, number of days pregnancies continued, and perinatal outcomes were recorded.Results: We noted recurrent fall in AFI after an initial arise in 20 women, which required recurrent fluid challenges. Pregnancies could be continued for 18±8.5 days (median±SD). Three women, with case of absent FM, reported FM within 1 hour after initiation of the fluid challenge. There were no perinatal deaths.Conclusions: Intravenous isotonic fluid challenge and L-arginine infusion, improves AFI and FM, and helps to prolong pregnancies towards viability.

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