Effect of fluid resuscitation with balanced solutions on platelets: In vitro simulation of 20% volume substitution

Krzych, Łukasz J.; Czempik, Piotr F.

doi:10.5603/cj.a2017.0054

Cited by 5 publications

(8 citation statements)

References 18 publications

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“…However, in the case of 24-survival rate treatment with hypertonic fluid solutions was related to a significantly higher survival rate, as well as significantly lower overall mortality. 0.9% sodium chloride solution is a basic crystalline fluid used in both pre-hospital and hospital care [29]. Due to high chlorine levels in the isotonic salt, there is a potential risk of metabolic hyperchloremic acidosis [30].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of hypertonic saline solutions fluid resuscitation on hypovolemic shock: A systematic review and meta-analysis of randomized controlled trials

Safiejko

Smereka

Pruc³

et al. 2022

Cardiol J

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Background: Fluid resuscitation is a fundamental intervention in patients with hypovolemic shock resulting from trauma. Appropriate fluid resuscitation in trauma patients could reduce organ failure, until blood components are available, and hemorrhage is controlled. We conducted a systematic review and meta-analysis assessing the effect of hypertonic saline/dextran or hypertonic saline for fluid resuscitation on patient outcomes restricted to adults with hypovolemic shock. Methods: We conducted a search of electronic information sources, including PubMed, Embase, Web of Science, Cochrane library and bibliographic reference lists to identify all randomized controlled trials (RCTs) investigating outcomes of crystalloids versus colloids in patients with hypovolemic shock. We calculated the risk ratio (RR) or mean difference (MD) of groups using fixed or random-effect models. Results: Fifteen studies including 3264 patients met our inclusion criteria. Survival to hospital discharge rate between research groups varied and amounted to 71.2% in hypertonic saline/dextran group vs. 68.4% for isotonic/normotonic fluid (normal saline) solutions (odds ratio [OR] = 1.19; 95% confidence interval [CI] 0.97-1.45; I 2 = 48%; p = 0.09). 28-to 30-days survival rate for hypertonic fluid solutions was 72.8% survivable, while in the case of isotonic fluid (normal saline) -71.4% (OR = 1.13; 95% CI 0.75-1.70; I 2 = 43%; p = 0.56). Conclusions: This systematic review and meta-analysis, which included only evidence from RCTs hypertonic saline/dextran or hypertonic saline compared with isotonic fluid did not result in superior 28-to 30-day survival as well as in survival to hospital discharge. However, patients with hypotension who received resuscitation with hypertonic saline/dextran had less overall mortality as patients who received conventional fluid.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of hypertonic saline solutions fluid resuscitation on hypovolemic shock: A systematic review and meta-analysis of randomized controlled trials

Safiejko

Smereka

Pruc³

et al. 2022

Cardiol J

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“…Forty individuals were screened for eligibility between February 2021 and May 2021, and 25 healthy Caucasian males were included. The median age of the participants was 25 (23)(24)(25)(26)(27)(28)(29) years, and the median BMI was 23.9 (22.5-26.7) kg/m 2 . The most frequent blood type was A Rh-positive (n = 13, 52%), followed by B Rh-positive (n = 8, 32%), A Rh-negative (n = 2, 8%), and B Rh-negative (n = 2, 8%).…”

Section: Resultsmentioning

confidence: 99%

“…On the contrary, whole-blood viscoelastic tests are affected by the platelet component, and insufficient platelet inactivation can cause falsely elevated readings of fibrinogen contribution to clot formation [ 22 ]. This shortcoming can, to some extent, be limited by calculating the ROTEM parameter of the MCE and assessing the platelet contribution to the clot by the equation of ΔMCE = MCE EXTEM − MCE FIBTEM [ 23 ]. However, the better method of verifying the platelets’ functionality is to perform separate additional testing through dedicated equipment, such as multiple electrode aggregometry and light transmission aggregometry (for instance, Multiplate or PFA200) [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Functional Parameters of Coagulation and Conventional Coagulation Tests in the Setting of Fluid Resuscitation with Balanced Crystalloid or Gelatine: A Secondary Analysis of an In Vivo Prospective Randomized Crossover Study

Wiórek

Mazur

Niemiec

et al. 2022

JCM

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Functional point-of-care tests (POCTs) have evolved into useful tools for diagnosing disorders of blood coagulation and fibrinolysis. We aimed to describe the in vivo association between standard and functional parameters of coagulation and fibrinolysis in the setting of acute hemodilution induced by an infusion of balanced crystalloid or synthetic gelatine solutions. This prospective randomized crossover in vivo study included healthy male volunteers aged 18–30 years. Enrolled participants were randomly assigned to receive either the Optilyte® or Geloplasma® infusion. Laboratory analysis included conventional coagulation parameters and rotational thromboelastometry (ROTEM) assays. A total of 25 healthy Caucasian males were included. ROTEM viscoelastic assays presented moderate to strong correlations with conventional coagulation tests, regardless of the fluid type utilized. Irrespectively of the extent of hemodilution, significant correlations remained unaffected. The strongest associations were found between the ROTEM clot formation and clot strength and the fibrinogen concentration and platelet count, and between the ROTEM clotting time and the APTT and PT. This in vivo experimental study in healthy male volunteers demonstrated that ROTEM may be used as a credible alternative to standard laboratory tests to assess blood coagulation and fibrinolysis in the setting of fluid resuscitation with both crystalloid and colloid solutions. The study was registered online in the ClinicalTrials.gov database (NCT05148650).

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“…Currently, fluid resuscitation is the first step in the hemodynamic management of traumatic hemorrhagic shock [ 3 ]. The rapid vascular access and stabilization of the cardiovascular system can protect the patient from the severe consequences of hypovolemic shock.…”

Section: Introductionmentioning

confidence: 99%

“…Fluid resuscitation can be carried out based on changes in hemodynamics, diuresis, serum lactate levels or alkaline deficit. However, excessive fluid resuscitation could contribute to the development of coagulopathy of trauma [ 3 , 9 ] as well as tissue edema [ 10 ], which can lead to alterations of tissue perfusion and complications such as abdominal compartment syndrome or adult respiratory distress syndrome [ 11 , 12 ]. The optimal level of BP during resuscitation of hemorrhagic shock patients is still debated.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and safety of hypotension fluid resuscitation in traumatic hemorrhagic shock: A systematic review and meta-analysis of randomized controlled trials

Safiejko¹,

Smereka

Filipiak‬

et al. 2022

Cardiol J.

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Background Although the resuscitation of an adult trauma patient has been researched and written about for the past century, the ideal fluid strategy to infuse during the initial resuscitation period remains unresolved. This work was aimed at assessing the effect of hypotensive versus conventional resuscitation strategies in traumatic hemorrhagic shock patients on mortality, and the need for blood transfusions including adverse events. Methods This systematic review and meta-analysis were performed following the PRISMA guidelines. Electronic databases were searched for randomized controlled trials (RCT) comparing the effect of hypotension versus conventional fluid resuscitation for traumatic hemorrhagic shock patients. Two reviewers independently performed the screening, data extraction, and bias assessment. The data analysis was completed using the Cochrane Collaboration’s software RevMan 5.4. Results Data from 28 RCTs on 4503 patients were included in the final meta-analysis. Patients receiving hypotension fluid resuscitation compared with conventional fluid resuscitation experienced less mortality (12.5% vs. 21.4%; RR = 0.58; 95% CI: 0.51–0.66; p < 0.001), fewer adverse events (10.8% vs. 13.4%; RR = 0.70; 95% CI: 0.59–0.83; p < 0.001), including fever acute respiratory distress syndrome (7.8% vs. 16.8%) or multiple organ dysfunction syndrome (8.6% vs. 21.6%). Conclusions This meta-analysis showed that hypotensive fluid resuscitation significantly reduced the mortality of hypovolemic shock patients. Findings are low in certainty and should be interpreted with caution. Therefore, there is an urgent need for larger, multicenter, randomized trials to confirm these findings.

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Effect of fluid resuscitation with balanced solutions on platelets: In vitro simulation of 20% volume substitution

Abstract: (Cardiol J 2018; 25, 2: 254-259)

Cited by 5 publications

References 18 publications

Efficacy and safety of hypertonic saline solutions fluid resuscitation on hypovolemic shock: A systematic review and meta-analysis of randomized controlled trials

Efficacy and safety of hypertonic saline solutions fluid resuscitation on hypovolemic shock: A systematic review and meta-analysis of randomized controlled trials

Association between Functional Parameters of Coagulation and Conventional Coagulation Tests in the Setting of Fluid Resuscitation with Balanced Crystalloid or Gelatine: A Secondary Analysis of an In Vivo Prospective Randomized Crossover Study

Effectiveness and safety of hypotension fluid resuscitation in traumatic hemorrhagic shock: A systematic review and meta-analysis of randomized controlled trials

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