Beneficial Effect of Hypertonic Saline Resuscitation in a Porcine Model of Severe Acute Pancreatitis

Ni, Haibin; Ke, Lu; Sun, Jianfang; Tong, Zhihui; Ding, Weiwei; Li, Weiqin; Li, Ning; Li, Jieshou

doi:10.1097/mpa.0b013e3182297fec

Cited by 6 publications

(2 citation statements)

References 29 publications

(29 reference statements)

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“…Several animal studies proved that hypertonic saline (HTS) resuscitation improves hemodynamics [164][165][166][167]. HTS treatment allows smaller fluid volume resuscitation in the burn shock period and reduces the risk of low abdominal perfusion and secondary ACS 21].…”

Section: Type Of Resuscitation Fluidsmentioning

confidence: 99%

Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome: A Narrative Review

Jacobs

Wise

Myatchin

et al. 2022

Life

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Background: General pathophysiological mechanisms regarding associations between fluid administration and intra-abdominal hypertension (IAH) are evident, but specific effects of type, amount, and timing of fluids are less clear. Objectives: This review aims to summarize current knowledge on associations between fluid administration and intra-abdominal pressure (IAP) and fluid management in patients at risk of intra-abdominal hypertension and abdominal compartment syndrome (ACS). Methods: We performed a structured literature search from 1950 until May 2021 to identify evidence of associations between fluid management and intra-abdominal pressure not limited to any specific study or patient population. Findings were summarized based on the following information: general concepts of fluid management, physiology of fluid movement in patients with intra-abdominal hypertension, and data on associations between fluid administration and IAH. Results: We identified three randomized controlled trials (RCTs), 38 prospective observational studies, 29 retrospective studies, 18 case reports in adults, two observational studies and 10 case reports in children, and three animal studies that addressed associations between fluid administration and IAH. Associations between fluid resuscitation and IAH were confirmed in most studies. Fluid resuscitation contributes to the development of IAH. However, patients with IAH receive more fluids to manage the effect of IAH on other organ systems, thereby causing a vicious cycle. Timing and approach to de-resuscitation are of utmost importance, but clear indicators to guide this decision-making process are lacking. In selected cases, only surgical decompression of the abdomen can stop deterioration and prevent further morbidity and mortality. Conclusions: Current evidence confirms an association between fluid resuscitation and secondary IAH, but optimal fluid management strategies for patients with IAH remain controversial.

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Section: Type Of Resuscitation Fluidsmentioning

confidence: 99%

Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome: A Narrative Review

Jacobs

Wise

Myatchin

et al. 2022

Life

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“…Preliminary studies have suggested that early administration of hypertonic saline may reduce severity in AP. 129 One possible mechanism for this effect is to provide sodium to drive the Na-H exchange that is critical for reducing cell acidity.…”

Section: Update On Promising Treatmentsmentioning

confidence: 99%

Acute Pancreatitis—Progress and Challenges

Afghani¹,

Pandol²,

Shimosegawa³

et al. 2015

Pancreas

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An international symposium entitled “Acute pancreatitis: progress and challenges” was held on November 5, 2014 at the Hapuna Beach Hotel, Big Island, Hawaii, as part of the 45th Anniversary Meeting of the American Pancreatic Association and the Japanese Pancreas Society. The course was organized and directed by Drs. Stephen Pandol, Tooru Shimosegawa, Robert Sutton, Bechien Wu, and Santhi Swaroop Vege. The symposium objectives were to: (1) highlight current issues in management of acute pancreatitis, (2) discuss promising treatments, (3) consider development of quality indicators and improved measures of disease activity, and (4) present a framework for international collaboration for development of new therapies. This article represents a compilation and adaptation of brief summaries prepared by speakers at the symposium with the purpose of broadly disseminating information and initiatives.

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Fluid Management in Intra-abdominal Hypertension

Malbrain,

Nasa,

De laet

et al. 2023

Rational Use of Intravenous Fluids in Critically Ill Patients

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Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) have significant pathophysiological consequences that can affect multiple organ systems. Fluid resuscitation is often used to restore hemodynamic stability in patients with elevated IAP; however, excessive intravenous fluid administration can paradoxically lead to ACS. This chapter explores the impact of fluid management in patients with IAH and ACS, including the effects of fluid on IAP in different patient populations and conditions. The importance of appropriate management of patients with elevated pressures in adjacent compartments, such as the abdomen, thorax, and skull, is also highlighted. The Abdominal Compartment Society's clear definitions for IAH and ACS, as well as concepts such as abdominal perfusion pressure, are discussed. Additionally, this chapter delves into the effects of elevated pressure on different organ systems, including the cardiovascular, respiratory, central nervous, renal, and gastrointestinal systems. The authors emphasize the need for careful fluid management in these patients to avoid exacerbating the pathophysiological consequences of elevated IAP.

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Beneficial Effect of Hypertonic Saline Resuscitation in a Porcine Model of Severe Acute Pancreatitis

Abstract: Early administration of HTS generally improves hemodynamics and peripheral oxygenation. Despite these normalized parameters, organ damage could not be diminished to a significant degree during observation.

Cited by 6 publications

References 29 publications

Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome: A Narrative Review

Fluid Management, Intra-Abdominal Hypertension and the Abdominal Compartment Syndrome: A Narrative Review

Acute Pancreatitis—Progress and Challenges

Fluid Management in Intra-abdominal Hypertension

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