Hydroxyethyl Starch 6% (130/0.4) Ameliorates Acute Lung Injury in Swine Hemorrhagic Shock

Abstract

Our study indicates that resuscitation after hemorrhagic shock with hydroxyethyl starch 130/0.4 led to less lung edema and less microvascular permeability in this swine model.

Derivation and Diagnostic Accuracy of the Surgical Lung Injury Prediction Model

“…Factors such as infection, 52 ventilator management, 43,53 fluid 21,54 and transfusion strategies 55 , and choice of volatile anesthetic, 56 may potentially impact the development and/or progression of ALI in the postoperative period. While the addition of such variables would be expected to improve the overall performance of our prediction model, their inclusion would preclude the use of this model as intended (preoperative risk assessment), prohibiting the identification of patients at high-risk of ALI prior to the surgical procedure.…”

Precision real-time evaluation of bowel perfusion: accuracy of confocal endomicroscopy assessment of stoma in a controlled hemorrhagic shock model

“…Hemorrhagic shock was induced by retrieving units of blood from the central venous catheter targeting a mean arterial pressure (MAP) of 40 mmHg and/or a systemic lactatemia of C4 mmol/L. The shock phase (T1) was continued for 90 min after reaching the targets [8].…”

Controversies in the use of hydroxyethyl starch solutions in small animal emergency and critical care

“…With little exception, results of these studies point consistently toward an anti‐inflammatory effect of HES. In a similar set of studies, the influence of HES on leukocyte function (activation, migration, and adhesion) assessed directly through histology, flow cytometry, and intravital fluorescence microscopy, or indirectly using different markers, demonstrated an overall decrease in activity of inflammatory cells in the presence of HES . In light of their experimental nature, and because of the controversial effects of suppression of inflammation in critically ill patients, the implication of these results for clinical practice must be assessed cautiously.…”

“…The effect of HES on pulmonary permeability has been the subject of numerous experimental and clinical investigations, using clinical, laboratory, and histological methods to assess pulmonary vascular leakage and edema formation, including pulmonary leak index, extravascular lung water, lung injury scores, arterial blood gas analyses, and wet‐to‐dry lung ratios . Most of these studies reported a positive effect of HES in decreasing pulmonary permeability .…”