Colloid versus crystalloid resuscitation in experimental bowel obstruction

Rowe, Marc I.; Arango, Abelardo

doi:10.1016/0022-3468(76)90085-3

Cited by 6 publications

(2 citation statements)

References 4 publications

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“…It has been postulated that as ALB extravasates into the interstitium, it might increase the interstitial oncotic pressure, leading to further fluid movement out of the capillary (17), thus paradoxically increasing pulmonary edema. Paradoxical increased edema was found in several vascular beds in a trial comparing ALB to NS in a piglet model of bowel obstruction (18).…”

Section: Discussionmentioning

confidence: 99%

Randomized Trial of Volume Infusion During Resuscitation of Asphyxiated Neonatal Piglets

et al. 2007

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Despite its use, there is little evidence to support volume infusion (VI) during neonatal cardiopulmonary resuscitation (CPR). This study compares 5% albumin (ALB), normal saline (NS), and no VI (SHAM) on development of pulmonary edema and restoration of mean arterial pressure (MAP) during resuscitation of asphyxiated piglets. Mechanically ventilated swine (n ϭ 37, age: 8 Ϯ 4 d, weight: 2.2 Ϯ 0.7 kg) were progressively asphyxiated until pH Ͻ7.0, PaCO 2 Ͼ100 mm Hg, heart rate (HR) Ͻ100 bpm, and MAP Ͻ20 mm Hg. After 5 min of ventilatory resuscitation, piglets were randomized blindly to ALB, NS, or SHAM infusion. Animals were recovered for 2 h before euthanasia and lung tissue sampled for wet-to-dry weight ratio (W/D) as a marker of pulmonary edema. SHAM MAP was similar to VI during resuscitation. The American Academy of Pediatrics/American Heart Association Neonatal Resuscitation Program (NRP) recommends consideration of volume infusion using crystalloid or Onegative blood for neonates with obvious hypovolemic shock and for those not responding to ventilation, cardiac compressions, and epinephrine (1). 5% Albumin (ALB) was removed from the recommendations in 2000, in part due to concerns that ALB may worsen pulmonary edema and increase mortality (2,3). Although guidelines for ALB use in the delivery room were changed, there are no randomized studies assessing the efficacy of any type of volume infusion during delivery room resuscitation of newborns. A recent retrospective study of near-term and term infants reported lower admission blood pressures and higher base deficits that persisted over the first 2 h of life for infants who received volume infusions compared with those that did not during delivery room cardiopulmonary resuscitation (CPR) (4). Due to the retrospective nature of the study, it was unclear whether volume infusion exacerbated the hypotension or whether its use was simply a marker for a more severe injury due to asphyxia. The infrequent and unexpected need coupled with the difficulty of obtaining informed consent for such studies has impeded the design and completion of rigorous randomized delivery room resuscitation trials. Thus, we designed a blinded, randomized, controlled trial to examine the risks and benefits of volume infusion during resuscitation of asphyxiated, hypotensive neonatal piglets whose cardiopulmonary compromise closely parallels that of infants who receive volume resuscitation in the delivery room.Our primary hypothesis was that ALB administration would increase pulmonary edema (as evidenced by lung tissue wetto-dry weight ratio (W/D)) by 20% compared with normal saline (NS) or no volume infusion (SHAM). Additional hypotheses were that administration of ALB would adversely affect respiratory mechanics such as pulmonary dynamic compliance (Cd) but that volume infusion (NS and ALB) would be beneficial compared with SHAM in restoring MAP during resuscitation. METHODS This investigation was approved by the Institutional Review Board for Animal Research at The University of...

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Section: Discussionmentioning

confidence: 99%

Randomized Trial of Volume Infusion During Resuscitation of Asphyxiated Neonatal Piglets

et al. 2007

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“…The most common clinical manifestations of upper gastrointestinal obstruction are abdominal pain, poor appetite, nausea and vomiting, and it predisposes patients to ischemia and perforation with a high mortality if left untreated (4). Such obstruction, when persistent, results in a huge loss of body fluid and chronic undernutrition that may induce changes in physiological function (5).…”

Section: Introductionmentioning

confidence: 99%

Wernicke's encephalopathy after acute pancreatitis with upper gastrointestinal obstruction: A case report and literature review

Wang

Zhang²,

Deng³

et al. 2023

Front. Neurol.

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A 42-year-old female was admitted with upper abdominal pain. Imaging studies and laboratory tests were performed to consider acute lipogenic pancreatitis. After symptomatic treatment, her abdominal pain was significantly relieved. However, the patient was accompanied by upper gastrointestinal obstruction, which was gradually relieved after long-term fasting, gastrointestinal decompression, and fluid rehydration. The patient developed dizziness and ataxia, which worsened. Cranial magnetic resonance imaging (MRI) indicated patchy abnormal signal shadows in the bilateral thalami and dorsal brainstem and suggested metabolic encephalopathy. Wernicke's encephalopathy (WE) was the initial diagnosis of suspicion, adequate vitamin B1 was immediately replenished until the complete resolution of symptoms, and the patient made a rapid and dramatic recovery.

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Perioperative Fluid and Blood Volume Management in Infants and Children

Cook¹

1995

Pediatric and Obstetrical Anesthesia

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Colloid versus crystalloid resuscitation in experimental bowel obstruction

Cited by 6 publications

References 4 publications

Randomized Trial of Volume Infusion During Resuscitation of Asphyxiated Neonatal Piglets

Randomized Trial of Volume Infusion During Resuscitation of Asphyxiated Neonatal Piglets

Wernicke's encephalopathy after acute pancreatitis with upper gastrointestinal obstruction: A case report and literature review

Perioperative Fluid and Blood Volume Management in Infants and Children

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