Hypotensive Resuscitation

Smith, Jeremy; Pittet, Jean–François; Pierce, Albert

doi:10.1007/s40140-014-0064-7

Cited by 19 publications

(16 citation statements)

References 45 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Permissive hypotension may have a survival benefit. [ 13 ] In our study, the volume of polygeline was administered based on the patient's condition and was well tolerated by all patients without increased bleeding.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of polygeline in patients with hypovolemia due to trauma

Singh

Ali

Shetty

2017

J Emerg Trauma Shock

View full text Add to dashboard Cite

Background:This retrospective study examined the effectiveness and safety of polygeline in adult patients with hypovolemia due to traumatic injury.Materials and Methods:Polygeline was administered after evaluating the amount of blood loss and estimating hematological and biochemical parameters. Changes in vital signs, serum electrolytes, arterial pH, and serum lactate were evaluated. The safety was evaluated by recording the adverse events if any.Results:Sixty patients with the mean age 37.5 ± 11.26 years were included in the study. All patients had blood loss < 20%. The mean total polygeline administered was 1025.0 ± 464.18 ml. Blood transfusion was required in 3.33% of patients. Diastolic, systolic, and mean arterial blood pressure and pulse rate significantly increased after 1 h of polygeline administration (P < 0.0001). There was a trend toward increase in urine output (P = 0.0715) after 1 h. The improvement in vital parameters was consistent at 6, 14, and 18 h after administration of polygeline. Arterial pH significantly increased from 7.2 ± 0.12 to 7.3 ± 0.11 after 1 h of administration (P < 0.0001) and was consistent till 24 h (P = 0.035). Blood lactate decreased after 1 h (P < 0.0001). Changes in laboratory parameters were not clinically significant. After mean duration hospital stay of 10.5 ± 4.63 days all patients were discharged without any clinically significant abnormality or adverse event.Conclusion:Polygeline improved hemodynamic stability in patients with hypovolemia due to traumatic injury. The improvement was seen within 1 h (golden hour) of polygeline administration and maintained consistently. Polygeline can be safely administered to patients with traumatic injury to improve hemodynamic parameters and achieve stability.

show abstract

Section: Discussionmentioning

confidence: 99%

Effectiveness and safety of polygeline in patients with hypovolemia due to trauma

Singh

Ali

Shetty

2017

J Emerg Trauma Shock

View full text Add to dashboard Cite

show abstract

“…Hemorrhagic shock is the major cause of potentially preventable death after accidental injuries and accounts for over 40% of deaths within the first 24 h in trauma patients [2]. Adequate fluid resuscitation to compensate for intravascular volume deficits and to support organ perfusion is an essential cornerstone in the treatment of patients with traumatic-hemorrhagic shock [3]. High-volume fluid resuscitation, however, carries the well-recognized risk of fluid overload, which can lead to third-spacing of fluids into tissues, edema formation, coagulopathy, abdominal compartment syndrome, or acute lung injury, and significantly contributes to mortality and morbidity in critically ill patients [4–6].…”

Section: Introductionmentioning

confidence: 99%

Kv7 voltage-activated potassium channel inhibitors reduce fluid resuscitation requirements after hemorrhagic shock in rats

2017

View full text Add to dashboard Cite

BackgroundRecent evidence suggests that drugs targeting Kv7 channels could be used to modulate vascular function and blood pressure. Here, we studied whether Kv7 channel inhibitors can be utilized to stabilize hemodynamics and reduce resuscitation fluid requirements after hemorrhagic shock.MethodsAnesthetized male Sprague-Dawley rats were instrumented with arterial and venous catheters for blood pressure monitoring, hemorrhage and fluid resuscitation. Series 1: Linopirdine (Kv7 channel blocker, 0.1–6 mg/kg) or retigabine (Kv7 channel activator, 0.1–12 mg/kg) were administered to normal animals. Series 2: Animals were hemorrhaged to a MAP of 25 mmHg for 30 min, followed by fluid resuscitation with normal saline (NS) to a MAP of 70 mmHg until t = 75 min. Animals were treated with single bolus injections of vehicle, linopirdine (1–6 mg/kg), XE-991 (structural analogue of linopirdine with higher potency for channel blockade, 1 mg/kg) prior to fluid resuscitation. Series 3: Animals were resuscitated with NS alone or NS supplemented with linopirdine (1.25–200 μg/mL). Data were analyzed with 2-way ANOVA/Bonferroni post-hoc testing.ResultsSeries 1: Linopirdine transiently (10–15 min) and dose-dependently increased MAP by up to 15%. Retigabine dose-dependently reduced MAP by up to 60%, which could be reverted with linopirdine. Series 2: Fluid requirements to maintain MAP at 70 mmHg were 65 ± 34 mL/kg with vehicle, and 57 ± 13 mL/kg, 22 ± 8 mL/kg and 22 ± 11 mL/kg with intravenous bolus injection of 1, 3 and 6 mg/kg linopirdine, respectively. XE-991 (1 mg/kg), reduced resuscitation requirements comparable to 3 mg/kg linopirdine.Series 3: When resuscitation was performed with linopirdine-supplemented normal saline (NS), fluid requirements to stabilize MAP were 73 ± 12 mL/kg with NS alone and 72 ± 24, 61 ± 20, 36 ± 9 and 31 ± 9 mL/kg with NS supplemented with 1.25, 6.25, 12.5 and 200 μg/mL linopirdine, respectively.ConclusionsOur data suggest that Kv7 channel blockers could be used to stabilize blood pressure and reduce fluid resuscitation requirements after hemorrhagic shock.

show abstract

“…In line with this, rabbit mean arterial pressure decreased to 40 to 50 mm Hg in the current study, suggesting the rabbits were subjected to severe shock conditions. Notably, transfusion of allogeneic RBCs or HbVs increased the pressure to 50 to 55 mm Hg, which is generally recommended in hypotensive management . Shrestha et al demonstrated that damage control resuscitation increases successful nonoperative management rates and survival after severe blunt liver injury.…”

Section: Discussionmentioning

confidence: 99%

Combination therapy using fibrinogen γ‐chain peptide‐coated, ADP‐encapsulated liposomes and hemoglobin vesicles for trauma‐induced massive hemorrhage in thrombocytopenic rabbits

et al. 2019

View full text Add to dashboard Cite

BACKGROUND: We previously developed substitutes for red blood cells (RBCs) and platelets (PLTs) for transfusion. These substitutes included hemoglobin vesicles (HbVs) and fibrinogen γ-chain (dodecapeptide HHLGGAKQAGDV, H12)-coated, adenosine diphosphate (ADP)-encapsulated liposomes [H12-(ADP)liposomes]. Here, we examined the efficacy of combination therapy using these substitutes instead of RBC and PLT transfusion in a rabbit model with traumainduced massive hemorrhage with coagulopathy. ABBREVIATIONS: ADP = adenosine diphosphate; APTT = activated partial thromboplastin time; AT = antithrombin; CR = clot rate; CT = clotting time; HbVs = hemoglobin vesicles; HSA = human serum albumin; MAP = mannitol adenine phosphate; NO = nitric oxide; NOx = NO 2 − /NO 3 ; PPP = plateletpoor plasma; PRP = platelet-rich plasma; PT = prothrombin time.From the

show abstract

Hypotensive Resuscitation

Cited by 19 publications

References 45 publications

Effectiveness and safety of polygeline in patients with hypovolemia due to trauma

Effectiveness and safety of polygeline in patients with hypovolemia due to trauma

Kv7 voltage-activated potassium channel inhibitors reduce fluid resuscitation requirements after hemorrhagic shock in rats

Combination therapy using fibrinogen γ‐chain peptide‐coated, ADP‐encapsulated liposomes and hemoglobin vesicles for trauma‐induced massive hemorrhage in thrombocytopenic rabbits

Contact Info

Product

Resources

About