Therapeutic Small-Volume Resuscitation Preserves Pancreatic Microcirculation in Acute Experimental Pancreatitis of Graded Severity in Rats

Mann, Oliver; Kaifi, Jussuf T.; Bloechle, C.; Schneider, Claus; Yekebas, Emre F.; Kluth, Dietrich; Izbicki, Jakob R.; Strate, Tim

doi:10.1159/000212100

Cited by 17 publications

(5 citation statements)

References 41 publications

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“…It was demonstrated that the pulmonary edema that usually occurred in normal saline resuscitation was completely avoided when using the low-volume hypertonic saline and hydroxyethyl starch resuscitation 13. The efficiency of small-volume resuscitation was also validated by using other animal models such as rats with pancreatitis-caused microcirculatory disorders or endotoxemia-induced kidney injuries 14,15. In addition, a study has confirmed that hypertonic saline infusion has a far less influence on the coagulation function than that of hemodilution 16.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Zhao

Feng

et al. 2017

TCRM

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ObjectiveThe objective of the present study was to explore the resuscitative effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency.MethodsIn this study, the resuscitative effects in 200 trauma patients with uncontrolled hemorrhagic shock in emergency were studied. Half of these patients were infused with hypertonic/hyperoncotic fluid (small-volume resuscitation group, n=100), whereas the rest were infused with Hespan and lactated Ringer’s solution (conventional fluid resuscitation group, n=100). The changes in hemodynamics, coagulation function, blood biochemistry, blood hematology, and the average infusion volume in both the groups were comparatively studied.ResultsIt was found that the hemodynamics were improved in both the groups after resuscitation. Interestingly, compared with trauma patients infused with Hespan and lactated Ringer’s solution, the growth rate, range, and time duration of the mean arterial pressure of the patients in small-volume resuscitation group increased significantly, and the shock index decreased progressively; in the 60th min after the resuscitation, blood index including hemoglobin, hematocrit, red blood cells, white blood cells, and platelet declined, whereas prothrombin time and activated partial thromboplastin time were prolonged in both the groups, but these changes were less obvious in the small-volume group. In addition, the average infusion volume of patients in the small-volume group was less than that of patients in conventional fluid resuscitation group.ConclusionFeatured with small infusion volume and less influence to coagulation function and homeostasis of human body, small-volume resuscitation possesses a significantly higher resuscitative effect. Therefore, trauma patients may have a better chance to maintain the hemodynamic stability and the survival rate, or recovery speed will be increased when traditional aggressive fluid resuscitation is replaced by small-volume resuscitation.

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Section: Introductionmentioning

confidence: 99%

Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Zhao

Feng

et al. 2017

TCRM

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“…The introduction of novel concepts of advanced hemodynamic monitoring and the development of differentiated treatment algorithms for improving macrocirculation have intensified the debate regarding the most favorable fluid management (9,10). Several studies revealed that improved microcirculation results in less histopathologic organ destruction and improved survival (7,(11)(12)(13)(14). However, for maintenance of adequate microcirculatory perfusion, maintaining macrocirculation is indispensable.…”

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confidence: 99%

Individualized Early Goal-Directed Therapy in Systemic Inflammation

Wodack

Poppe

Tomkoetter

et al. 2014

Critical Care Medicine

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“…The treatment by hypertonic saline attenuated this inflammatory response, in line with the above. Other mechanisms of action may include microcirculatory improvements (28), and the clinical value of this relatively simple treatment should be evaluated, although potentially limited by development of harmful hypernatremia for prolonged periods of time. One of the end points to be studied then is the prevention of intra-abdominal hypertension and compartment syndrome with small-volume hypertonic saline resuscitation (25).…”

Section: Hypertonic Saline and Prevention Of Abdominal Compartment Symentioning

confidence: 99%

What's New in Shock, November 2010?

Groeneveld¹

2010

Shock

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Therapeutic Small-Volume Resuscitation Preserves Pancreatic Microcirculation in Acute Experimental Pancreatitis of Graded Severity in Rats

Cited by 17 publications

References 41 publications

Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Evaluation of the clinical effect of small-volume resuscitation on uncontrolled hemorrhagic shock in emergency

Individualized Early Goal-Directed Therapy in Systemic Inflammation

What's New in Shock, November 2010?

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