Does the type of fluid affect rapidity of shock reversal in an anaesthetized-piglet model of near-fatal controlled haemorrhage? A randomized study

Roger, Claire; Muller, Laurent; Deras, Pauline; Louart, Guillaume; Nouvellon, Emmanuel; Molinari, Nicolas; Goret, Lucie; Gris, Jean‐Christophe; Ripart, Jacques; Coussaye, J.-E. de La; Lefrant, Jean‐Yves

doi:10.1093/bja/aet375

Cited by 28 publications

(22 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In an animal model of hemorrhagic shock, restoration of blood pressure was four times faster with hydroxyethyl starch (HES) than with LR (P \ 0.001) and required fourfold less volume (P = 0.04). 65 Avoidance of excess crystalloid is also the most important independent predictor of outcomes within an enhanced recovery protocol. 66 Although it is possible that a crystalloid could be used effectively for fluid challenges, this remains uncertain; therefore, in our opinion, a colloid is still the rational choice, especially if fluid challenges are given only in the context of blood loss and objective hypovolemia.…”

Section: Which Fluid Should I Use?mentioning

confidence: 99%

Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS)

Miller

Roche

Mythen

2014

Can J Anesth/J Can Anesth

225

137

View full text Add to dashboard Cite

Optimal perioperative fluid management is an important component of Enhanced Recovery After Surgery (ERAS) pathways. Fluid management within ERAS should be viewed as a continuum through the preoperative, intraoperative, and postoperative phases. Each phase is important for improving patient outcomes, and suboptimal care in one phase can undermine best practice within the rest of the ERAS pathway. The goal of preoperative fluid management is for the patient to arrive in the operating room in a hydrated and euvolemic state. To achieve this, prolonged fasting is not recommended, and routine mechanical bowel preparation should be avoided. Patients should be encouraged to ingest a clear carbohydrate drink two to three hours before surgery. The goals of intraoperative fluid management are to maintain central euvolemia and to avoid excess salt and water. To achieve this, patients undergoing surgery within an enhanced recovery protocol should have an individualized fluid management plan. As part of this plan, excess crystalloid should be avoided in all patients. For low-risk patients undergoing low-risk surgery, a ''zero-balance'' approach might be sufficient. In addition, for most patients undergoing major surgery, individualized goal-directed fluid therapy (GDFT) is recommended. Ultimately, however, the additional benefit of GDFT should be determined based on surgical and patient risk factors. Postoperatively, once fluid intake is established, intravenous fluid administration can be discontinued and restarted only if clinically indicated. In the absence of other concerns, detrimental postoperative fluid overload is not justified and ''permissive oliguria'' could be tolerated.Résumé La gestion périopératoire optimale des liquides est un élément important des programmes de récupération rapide après la chirurgie (RRAC). La gestion des liquides dans le cadre de la RRAC doit être vue comme un continuum au travers des phases pré-, per-et postopératoires. Chaque phase est importante pour améliorer la condition du patient et des soins sous-optimaux au cours d'une de ces phases peuvent miner les meilleures pratiques déployées tout au long de la RRAC. L'objectif de la gestion préopératoire des liquides est de faire en sorte que le patient entre en salle d'opération correctement hydraté et dans un état euvolémique. Pour y parvenir, un jeûne prolongé n'est pas recommandé et le nettoyage mécanique de l'intestin est à éviter. Les patients doivent être encouragés à absorber une boisson claire riche en hydrates de carbone, deux à trois heures avant la chirurgie. Les buts de la gestion peropératoire des liquides sont de maintenir une euvolémie centrale et d'éviter un excès de sel et d'eau. Pour y parvenir, les patients subissant une intervention chirurgicale dans le cadre d'un protocole de récupération rapide devraient avoir un programme personnalisé de gestion des liquides. Dans le cadre de ce plan, l'excès de cristalloïdes doit être évité chez tous les patients. Pour des patients à faible risque subissant une intervention c...

show abstract

Section: Which Fluid Should I Use?mentioning

confidence: 99%

Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS)

Miller

Roche

Mythen

2014

Can J Anesth/J Can Anesth

225

137

View full text Add to dashboard Cite

show abstract

“…Ganter et al reported that VEGFs were not increased and their levels did not correlate with severity of injury and tissue hypoperfusion in the early stages after trauma [17]. In another animal study, fluid resuscitation with HES did not increase VEGF levels and hence, did not lead to capillary leakage [7]. Although prolonged hypoperfusion and hypoxia caused by hemorrhagic shock can induce inflammatory responses leading to enhanced vascular permeability and capillary leaks [18], earlier hemodynamic stability by fluid resuscitation with HES can attenuate the inflammatory responses [19,20].…”

Section: Fluid Resuscitation In Septic Shock or Hemorrhagic Shockmentioning

confidence: 94%

“…Colloids have been shown to maintain intravascular volume and hemodynamics better than crystalloids through preservation of colloid osmotic pressure [4,5]. Several studies have demonstrated that fluid resuscitation with colloids compared to crystalloids might improve the outcomes of acute hemorrhagic shock [6,7]. Moreover, recent studies have elucidated the detailed effects of fluid resuscitation with hydroxyethyl starch (HES) on microcirculation and micro-vessels in subjects with acute hemorrhagic shock [8,9].…”

Section: Introductionmentioning

confidence: 99%

Fluid resuscitation with hydroxyethyl starch in perioperative acute hemorrhagic shock

Hirata

2020

J Anesth

View full text Add to dashboard Cite

“…30 A recent, carefully controlled study of hemorrhagic resuscitation in piglets clearly demonstrated that in acute hypovolemia, HES is four to five times more effective than crystalloids in terms of both volume and rapidity of resuscitation. 31 It should be noted that not all HES restores blood volume equally after hemorrhage. In normal volunteers, a tetrastarch restored blood volume better than did a hetastarch.…”

Section: Trauma and Acute Hypovolemiamentioning

confidence: 99%

Update of use of hydroxyethyl starches in surgery and trauma

Weiskopf

James

2015

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

Does the type of fluid affect rapidity of shock reversal in an anaesthetized-piglet model of near-fatal controlled haemorrhage? A randomized study

Abstract: Restoration of MAP was four times faster with HES than with LR in the early phase of controlled haemorrhagic shock. However, there was no evidence of increased vascular permeability.

Cited by 28 publications

References 43 publications

Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS)

Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS)

Fluid resuscitation with hydroxyethyl starch in perioperative acute hemorrhagic shock

Update of use of hydroxyethyl starches in surgery and trauma

Contact Info

Product

Resources

About