Resuscitation fluids for the treatment of hemorrhagic shock in dogs

Tait, Alan R.; Larson, Lawrence O.

doi:10.1097/00003246-199112000-00020

Cited by 23 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The possibility that fluid resuscitation lead to hemodilution [20,21] in already anemic children, reducing oxygen delivery to the myocardium [22] and leading to ischemia and cardiac dysfunction, is largely ruled out by the lack of heterogeneity in the TCEs by hemoglobin level, and by the analysis showing excess harm with fluids across the whole range of hemoglobin values. These findings challenge the presumption that early and rapid reversal of shock by fluid resuscitation translates into longer-term survival benefits [8,23,24] in settings where intensive care facilities are not available.…”

Section: Discussionmentioning

confidence: 99%

Exploring mechanisms of excess mortality with early fluid resuscitation: insightsfrom the FEAST trial

Maitland

George

Evans

et al. 2013

BMC Med

225

173

View full text Add to dashboard Cite

BackgroundEarly rapid fluid resuscitation (boluses) in African children with severe febrile illnesses increases the 48-hour mortality by 3.3% compared with controls (no bolus). We explored the effect of boluses on 48-hour all-cause mortality by clinical presentation at enrolment, hemodynamic changes over the first hour, and on different modes of death, according to terminal clinical events. We hypothesize that boluses may cause excess deaths from neurological or respiratory events relating to fluid overload.MethodsPre-defined presentation syndromes (PS; severe acidosis or severe shock, respiratory, neurological) and predominant terminal clinical events (cardiovascular collapse, respiratory, neurological) were described by randomized arm (bolus versus control) in 3,141 severely ill febrile children with shock enrolled in the Fluid Expansion as Supportive Therapy (FEAST) trial. Landmark analyses were used to compare early mortality in treatment groups, conditional on changes in shock and hypoxia parameters. Competing risks methods were used to estimate cumulative incidence curves and sub-hazard ratios to compare treatment groups in terms of terminal clinical events.ResultsOf 2,396 out of 3,141 (76%) classifiable participants, 1,647 (69%) had a severe metabolic acidosis or severe shock PS, 625 (26%) had a respiratory PS and 976 (41%) had a neurological PS, either alone or in combination. Mortality was greatest among children fulfilling criteria for all three PS (28% bolus, 21% control) and lowest for lone respiratory (2% bolus, 5% control) or neurological (3% bolus, 0% control) presentations. Excess mortality in bolus arms versus control was apparent for all three PS, including all their component features. By one hour, shock had resolved (responders) more frequently in bolus versus control groups (43% versus 32%, P <0.001), but excess mortality with boluses was evident in responders (relative risk 1.98, 95% confidence interval 0.94 to 4.17, P = 0.06) and 'non-responders' (relative risk 1.67, 95% confidence interval 1.23 to 2.28, P = 0.001), with no evidence of heterogeneity (P = 0.68). The major difference between bolus and control arms was the higher proportion of cardiogenic or shock terminal clinical events in bolus arms (n = 123; 4.6% versus 2.6%, P = 0.008) rather than respiratory (n = 61; 2.2% versus 1.3%, P = 0.09) or neurological (n = 63, 2.1% versus 1.8%, P = 0.6) terminal clinical events.ConclusionsExcess mortality from boluses occurred in all subgroups of children. Contrary to expectation, cardiovascular collapse rather than fluid overload appeared to contribute most to excess deaths with rapid fluid resuscitation. These results should prompt a re-evaluation of evidence on fluid resuscitation for shock and a re-appraisal of the rate, composition and volume of resuscitation fluids.Trial registrationISRCTN69856593

show abstract

Section: Discussionmentioning

confidence: 99%

Exploring mechanisms of excess mortality with early fluid resuscitation: insightsfrom the FEAST trial

Maitland

George

Evans

et al. 2013

BMC Med

225

173

View full text Add to dashboard Cite

show abstract

“…Hyperemia scores were higher in the pigs from Group 2 when compared to those in Group 1, but no differences were observed in these two groups when compared to the control group. Tait et al similarly reported a compensatory hyperemia following 6% hetastarch resuscitation that increased myocardial blood flow and maintained oxygen transport in a canine, severe hemorrhage, and resuscitation model that was not observed following RL resuscitation. By increasing the intestinal microcirculation, HES 130/0.4 may have caused a more pronounced hyperemia in Group 2 when compared to Group 1 in our study.…”

Section: Discussionmentioning

confidence: 96%

The influence of Ringer's lactate or HES 130/0.4 administration on the integrity of the small intestinal mucosa in a pig hemorrhagic shock model under general anesthesia

Ortiz

Vala

Venâncio

et al. 2016

J Vet Emergen Crit Care

View full text Add to dashboard Cite

show abstract

“…Resuscitation with succinylated gelatin, urea‐linked gelatin and hetastarch resulted in significant haemodilution 20 . Saline solution can also be used in acute anaemia.…”

Section: Discussionmentioning

confidence: 99%

The effect of replacement fluids and normovolaemic haemodilution on the survival of dorsal skin flaps in rats

Tüz

Eroğlu²,

Doğru

et al. 2004

Clin Otolaryngol

View full text Add to dashboard Cite

The objective of this study is to investigate the effect of normovolaemic haemodilution (anaemia), haemoglobin level and replacement fluids on the survival of local flaps in rats. Fifty male Wistar rats were divided into four study groups and one control group (10 rats for each). In the study groups, 20% or 30% of blood was withdrawn and replaced by either Gelofusine or saline (0.9%). Single 1.5 cm x 3 cm cranially based dorsal random skin flaps consisting of skin and panniculus carnosus were elevated in all rats. No difference was determined between the control and 20% exsanguinated groups regarding flap survival area. There was a statistically significant difference between the flap survival areas of 20% exsanguinated groups and 30% exsanguinated groups. If the blood loss exceeds 30% of total volume and/or haemoglobin (Hb) level is lower than 10.72 g/dL, the risk of flap necrosis increases significantly.

show abstract

Resuscitation fluids for the treatment of hemorrhagic shock in dogs

Cited by 23 publications

References 0 publications

Exploring mechanisms of excess mortality with early fluid resuscitation: insightsfrom the FEAST trial

Exploring mechanisms of excess mortality with early fluid resuscitation: insightsfrom the FEAST trial

The influence of Ringer's lactate or HES 130/0.4 administration on the integrity of the small intestinal mucosa in a pig hemorrhagic shock model under general anesthesia

The effect of replacement fluids and normovolaemic haemodilution on the survival of dorsal skin flaps in rats

Contact Info

Product

Resources

About