Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations

Oddo, Mauro; Poole, Daniele; Helbok, Raimund; Meyfroidt, Geert; Stocchetti, Nino; Bouzat, Pierre; Cecconi, Maurizio; Geeraerts, Thomas; Martín‐Loeches, Ignacio; Quintard, Hervé; Taccone, Fabio Silvio; Geocadin, Romergryko G.; Hemphill, Claude; Ichai, Carole; Menon, David; Payen, Jean François; Perner, Anders; Smith, Martin; Suárez, José I.; Videtta, Walter; Zanier, Elisa R.; Citerio, Giuseppe

doi:10.1007/s00134-018-5086-z

Cited by 120 publications

(75 citation statements)

References 94 publications

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“…На сьогодні основною складовою інтенсивної терапії при ЧМТ є терапія, яка включає в себе ряд заходів, що направлені на спроможність попереджати розвиток та корегувати прояви порушення гомеостазу, що ідуть поряд з травматичним пошкодженням головного мозку. Згідно сучасних уявлень відповідний захист головного мозку на фоні травматичного пошкодження можуть здійснювати церебропротектори [6,8]. Одним із ускладнень, що супроводжують ЧМТ є гостра церебральна ішемія [6].…”

Section: вступunclassified

The possibilities of pharmacological correction of the disturbance of carbohydrate metabolism in brain rates with traumatic brain injury

Семененко

2019

Rep. of Vinnytsia Nation. Med. Univ.

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The development and introduction into practice of emergency neurology of new drugs capable of influencing the secondary damage of neurons in patients with traumatic brain injury (TBI) has significantly affected the recovery of such patients. The aim of the study was to evaluate the magnitude of the cerebroprotective effect of amantadine sulfate on the index of impaired carbohydrate metabolism of the brain against the background of experimental TBI. The experimental TBI model of severe severity was caused by the action of a carbon dioxide flow under pressure created using a gas balloon pneumatic gun. The therapeutic effect of amantadine sulfate on model TBI was evaluated using a dose of 10 mg/kg. The pseudoperated animals and control group received 0.9% NaCl solution at a dose of 2 ml/kg i/v. The obtained results were processed by the method of variational statistics using Student's t-test, changes of indicators were considered probable at p≤0.05. In the course of the experiment, it was found that the treatment of rats with model TBI with 0.9% NaCl solution did not significantly contribute to the restoration of impaired energy metabolism (p<0.05) and did not reduce the manifestation of metabolic acidosis in the damaged brain (p<0.05). The use of amantadine sulfate in TBI rats significantly better corrects carbohydrate metabolism disorders than 0.9% NaCl solution and contributes to the reduction of metabolic acidosis in the damaged brain (p<0.05).

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Section: вступunclassified

The possibilities of pharmacological correction of the disturbance of carbohydrate metabolism in brain rates with traumatic brain injury

Семененко

2019

Rep. of Vinnytsia Nation. Med. Univ.

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“…For children with traumatic brain injury, the hypertonicity of 0.9% saline may mitigate the risk of cerebral edema more effectively than balanced isotonic fluids; however, there is currently no evidence to support either approach in adults or children [ 67 ].…”

Section: The Case For Keeping 09% Salinementioning

confidence: 99%

Ab-normal saline in abnormal kidney function: risks and alternatives

Hayes

2018

Pediatr Nephrol

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Intravenous 0.9% saline has saved countless lives since it was introduced over a century ago. It remains the most widespread crystalloid in both adult and pediatric practice. However, in recent years, evidence of deleterious effects is accruing. These include increased mortality, acute kidney injury (AKI), metabolic acidosis, and coagulopathy. The predominant cause for these sequelae appears to be the excess chloride concentration of 0.9% saline relative to plasma. This has led to development of balanced isotonic solutions such as PlasmaLyte. This review summarizes current evidence for adverse effects of chloride-rich intravenous fluid and considers whether 0.9% saline should still be used in 2018 or abandoned as a historical treatment in favor of balanced crystalloid solutions.

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Section: Introductionmentioning

confidence: 99%

“…Several strategies are recommended for the treatment of elevated ICP in adult patients with acute brain injury 7–9. Currently, hyperosmolar therapy with mannitol or hypertonic saline solution is the main therapeutic strategy for the management of intracranial hypertension and cerebral oedema 9. Although hyperosmolar therapy has been used extensively in routine clinical practice,10–12 significant controversy regarding the choice of hyperosmolar agent and dosing exists.…”

Section: Introductionmentioning

confidence: 99%

Hyperosmolar therapy for acute brain injury: study protocol for an umbrella review of meta-analyses and an evidence mapping

et al. 2020

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IntroductionAcute brain injury is a challenging public health problem worldwide. Elevated intracranial pressure is a common complication after acute brain injury. Hyperosmolar therapy is one of the main therapeutic strategies for the management of intracranial hypertension. This study protocol outlines an umbrella review of meta-analyses which will investigate the benefits and harms of hyperosmolar therapy routinely used for the management of acute brain injury in the intensive care.Methods and analysisWe will search PubMed/MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews. We will include meta-analyses of primary research studies (eg, randomised controlled trials, observational studies or both) that evaluate one or more hyperosmolar solutions (including hypertonic saline and/or mannitol) for the treatment of adult patients with acute brain injury of any severity. Two researchers will independently screen all citations, full-text articles and abstract data. Potential conflicts will be resolved through discussion with a third researcher. Primary outcomes will be mortality and neurological outcomes at discharge. Secondary outcomes will include control of intracranial pressure, cerebral perfusion pressure, length of stay (in hospital an intensive care unit) and any adverse event. Quality of the included meta-analyses will be assessed using the AMSTAR-2 tool. An overall summary of methods and results will be performed using tabular and graphical approaches and will be supplemented by narrative description. We will analyse whether published meta-analyses present an outline of available evidence (eg, cited, described and discussed any previous meta-analysis). Where objectives from two or more meta-analyses overlap, we will assess the causes of any noted discrepancies between meta-analyses.Ethics and disseminationNo ethical approval will be required. Findings from this study will be published in a peer-reviewed journal. All data will be deposited in a cross-disciplinary public repository.PROSPERO registration numberCRD42019148152.

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Fluid therapy in neurointensive care patients: ESICM consensus and clinical practice recommendations

Abstract: We present a consensus statement and clinical practice recommendations on fluid therapy for neurointensive care patients.

Cited by 120 publications

References 94 publications

The possibilities of pharmacological correction of the disturbance of carbohydrate metabolism in brain rates with traumatic brain injury

The possibilities of pharmacological correction of the disturbance of carbohydrate metabolism in brain rates with traumatic brain injury

Ab-normal saline in abnormal kidney function: risks and alternatives

Hyperosmolar therapy for acute brain injury: study protocol for an umbrella review of meta-analyses and an evidence mapping

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