Abstract:
BACKGROUND:Fluid resuscitation is a core stone of hemorrhagic shock therapy, and crystalloid fluids seem to be associated with lower mortality compared to colloids. However, as redistribution starts within minutes, it has been suggested to replace blood loss with a minimum of a three-fold amount of crystalloids. The hypothesis was that in comparison to high volume (HV), a lower crystalloid volume (LV) achieves a favorable coagulation profile and exerts sufficient haemodynamics in the acute phase of resuscitation. METHODS:In 24 anaesthetized pigs, controlled arterial blood loss of 50 % of the estimated blood volume was either (n = 12) replaced with a LV (one-fold) or a HV (three-fold) volume of a balanced, acetated crystalloid solution at room temperature. Hemodynamic parameters, dilution effects and coagulation profile by standard coagulation tests and thromboelastometry at baseline and after resuscitation were determined in both groups. RESULTS:LV resuscitation increased MAP significantly less compared to the HV, 61 ± 7 vs. 82 ± 14 mmHg (p < 0.001) respectively, with no difference between lactate and base excess between groups. Haematocrit after fluid replacement was 0.20 vs. 0.16 (LV vs. HV, p < 0.001), suggesting a grade of blood dilution of 32 vs. 42 % (p < 0.001) compared to baseline values. Compared to LV, HV resulted in decreased core temperature (37.5 ± 0.2 vs. 36.0 ± 0.6 °C, p < 0.001), lower platelet count (318 ± 77 vs. 231 ± 53 K/μL, p < 0.01) and lower plasma fibrinogen levels (205 ± 19 vs. 168 ± 24 mg/dL, p < 0.001). Thromboelastometric measurements showed a significant impairment on viscoelastic clot properties following HV group. While prothrombin time index decreased significantly more in the HV group, activated partial thromboplastin time did not differ between both groups. HV did not result in hyperchloraemic acidosis. DISCUSSION:Coagulation parameters represented by plasma fibrinogen and ROTEM parameters were also less impaired with LV. With regrad to hematocrit, 60 % of LV remained intracascular , while in HV only 30 % remained in circulation within the first hour of administration. In the acute setting of 50 % controlled blood loss, a one fold LV crystalloid replacement strategy is sufficient to adequately raise blood pressure up to a mean arterial pressure >50 mm Hg. The concept of damage control resuscitation (DCR) with permissive hypotension may be better met by using LV as compared to a three fold HV resuscitation strategy. CONCLUSION:High volume administration of an acetated balanced crystalloid does not lead to hyperchloraemic acidosis, but may negatively influence clinical parameters, such as higher blood pressure, lower body temperature and impaired coagulation parameters, which could potentially increase bleeding after trauma. Replacement of acute blood loss with just an equal amount of an acetated balanced crystalloid appears to be the preferential treatment strategy in the acute phase after controlled bleeding.
journal_name
BMC Anesthesioljournal_title
BMC anesthesiologyauthors
Ponschab M,Schöchl H,Keibl C,Fischer H,Redl H,Schlimp CJdoi
10.1186/s12871-015-0114-9subject
Has Abstractpub_date
2015-10-06 00:00:00pages
133issn
1471-2253pii
10.1186/s12871-015-0114-9journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Post-operative delirium (POD) is a common post-operative complication in elderly individuals and imposes a significant health and financial burden. Identifying predictive biomarkers may help understand the pathophysiology of POD. Our objective is to summarize the evidence of pre-operative biomarkers and imag...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0693-y
更新日期:2019-02-23 00:00:00
abstract:BACKGROUND:The quality of patients' recovery following surgery and anesthesia has been a matter of focus and concern over the past decade. The Quality of Recovery-40 (QoR-40) questionnaire was developed and validated for post-anesthesia patient evaluation. The QoR-40, however, is English-based and was tested and valida...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0229-7
更新日期:2016-08-18 00:00:00
abstract:BACKGROUND:Persistently variable success has been experienced in locally translating even well-grounded national clinical practice guidelines, including in the perioperative setting. We have sought greater applicability and acceptance of clinical practice guidelines and protocols with our novel Perioperative Risk Optim...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0187-0
更新日期:2016-03-22 00:00:00
abstract:BACKGROUND:Preoperative intravenous rehydration for patients with pheochromocytomas and paragangliomas (PPGLs) is widely used in many medical centers, but its usefulness has not been well evaluated. The objective of this study was to compare the perioperative hemodynamics and early outcome between patients who received...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01212-6
更新日期:2020-11-30 00:00:00
abstract:BACKGROUND:To investigate the optimal dose of pretreated-dexmedetomidine in fentanyl-induced cough (FIC) suppression. METHODS:Patients of 180 undergoing elective surgery with general anesthesia, aged 18-65 years, BMI 18.5-30 kg/m2, ASA I or II, were equally randomized into four groups (n = 45) to receive intravenous p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-019-0765-z
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:To assess the effect of rostral anterior cingulate cortex (rACC) administration with ifenprodil (NR2B receptor blocker) on bone cancer pain (BCP)-related aversion sentiment using the conditioned place avoidance experiments in rats. METHODS:A total of 30 male Wistar rats without place preference were randoml...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0283-1
更新日期:2016-11-21 00:00:00
abstract:BACKGROUND:McGrath MAC video laryngoscope offers excellent laryngosopic views and increases the success rate of orotracheal intubation in some cases. The aim of this study was to determine the usefulness of McGrath MAC for routine nasotracheal intubation by comparing McGrath MAC with Airway scope and Macintosh laryngos...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0451-y
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Tenascin-C is a pro-inflammatory glycoprotein with various biological functions. High expression of tenascin-C is found in inflammation, tissue remodeling, and autoimmune diseases. However, its expression and clinical significance in sepsis remain unclear. This study was designed to investigate the relations...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0634-1
更新日期:2018-11-15 00:00:00
abstract::An amendment to this paper has been published and can be accessed via the original article. ...
journal_title:BMC anesthesiology
pub_type: 已发布勘误
doi:10.1186/s12871-020-01196-3
更新日期:2020-11-09 00:00:00
abstract:BACKGROUND:The primary goal of this study was to determine whether administration of intrathecal morphine reduces postoperative pain. The secondary goal was to determine the effect of intrathecal morphine upon circulating levels of the weakly analgesic endocannabinoids, anandamide (AEA) and 2-arachidonoylglycerol (2-AG...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0489-5
更新日期:2018-02-27 00:00:00
abstract:BACKGROUND:Laryngeal mask airway is a supraglottic airway device which has led to a fundamental change in the management of modern general anesthesia. In the present study; we evaluated the laryngeal mask airway insertion conditions and hemodynamic changes comparing ketamine-propofol mixture (ketofol) with propofol. Th...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0711-0
更新日期:2019-03-20 00:00:00
abstract:BACKGROUND:Local anesthetic Bupivacaine commonly used in gastric cancer resection operation has been reported to suppress the progression of gastric cancer. However, the specific mechanism by which Bupivacaine functions is largely unexplored. METHODS:The viability and metastasis of gastric cancer cells were assessed b...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01179-4
更新日期:2020-10-30 00:00:00
abstract:BACKGROUND:Rotational elastometry (ROTEM) has been shown useful to monitor coagulation in trauma patients and in major elective surgery. In this study, we aimed to evaluate the utility of ROTEM to identify hemostatic disturbances and to predict the need for transfusion, compared with standard coagulation tests (SCTs) i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-017-0440-1
更新日期:2017-10-24 00:00:00
abstract:BACKGROUND:Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients. METHODS:A randomized, double blind, p...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2253-14-93
更新日期:2014-10-17 00:00:00
abstract:BACKGROUND:Volume replacement therapy with colloid is still worth studying in major pediatric surgery with potential risk of bleeding. This study assessed the effects of 6% hydroxyethyl starch (HES) 130/0.4 and 5% Human Albumin (HA) on coagulation tested by thromboelastography (TEG) during elective intracranial tumor s...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-017-0353-z
更新日期:2017-04-27 00:00:00
abstract:BACKGROUND:In the immediate postoperative period, obese patients are more likely to exhibit hypoxaemia due to atelectasis and impaired respiratory mechanics, changes which can be attenuated by non-invasive ventilation (NIV). The aim of the study was to evaluate the duration of any effects of early initiation of short t...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-11-10
更新日期:2011-05-23 00:00:00
abstract:BACKGROUND:Intracranial-pressure (ICP) monitoring is useful for patients with increased ICP following hemorrhagic stroke. In this study, the changes in pressure gradients between the two cerebral hemispheres were investigated after hemorrhagic stroke of one side, and after a craniotomy. METHODS:Twenty-four patients wi...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-14-112
更新日期:2014-12-03 00:00:00
abstract:BACKGROUND:In infants, securing the airway is time-critical because of anatomical and physiological differences related to airway management in children less than 1 year old. The aim of this study was to compare the time to ventilation using two different hyperangulated video laryngoscope blades with the time to ventil...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0580-y
更新日期:2018-08-31 00:00:00
abstract:BACKGROUND:As defined by evidence-based medicine randomized controlled trials rank higher than observational studies in the hierarchy of clinical research. Accordingly, when assessing the effects of treatments on patient outcomes, there is a tendency to focus on the study method rather than also appraising the key elem...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-016-0264-4
更新日期:2016-10-14 00:00:00
abstract:OBJECTIVE:To compare the analgesic effects of patient-controlled intravenous analgesia (PCA) with hydromorphone and sufentanil after thoracic surgery on postoperative pulmonary complications (PPCs). METHODS:A total of 142 patients who were scheduled for thoracic surgery were randomly allocated to receive PCA with hydr...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0657-7
更新日期:2018-12-19 00:00:00
abstract:BACKGROUND:Low-flow sevoflurane anesthesia has been shown to influence renal function in rats, but not in adult humans. Presently, no study has assessed the effects of sevoflurane on renal function in low birth weight infants. Our aim was to study the renal function in low birth weight infants undergoing surgery with l...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-15-6
更新日期:2015-01-21 00:00:00
abstract:BACKGROUND:Bone cement implantation syndrome is a known complication causing mortality during perioperative period particularly in patients with malignancy. With rise in aging population with malignancy in low income country, the syndrome is more likely to be encountered. CASE PRESENTATION:We present a case of 66 year...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-018-0492-x
更新日期:2018-03-02 00:00:00
abstract:BACKGROUND:The effect of local infiltration after breast surgery is controversial. This prospective double blind randomized study sought to document the analgesic effect of local anaesthetic infiltration after breast cancer surgery. METHODS:Patients scheduled for mastectomy or tumorectomy and axillary nodes dissection...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-11-23
更新日期:2011-11-24 00:00:00
abstract:BACKGROUND:Post-dural puncture headache (PDPH) due to excessive cerebrospinal fluid (CSF) leakage is a well-known complication of lumbar puncture. Although various factors, especially the type of spinal needle, have been demonstrated to be associated with PDPH, the clinical implications of CSF leakage detected on magne...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/1471-2253-13-35
更新日期:2013-10-27 00:00:00
abstract:BACKGROUND:A mouth gag is usually used during tonsillectomy and adenotonsillectomy surgeries, cleft palate repair, obstructive sleep apnea surgery, and intraoral tumor excision. The placement of the gag causes hemodynamic changes similar to laryngoscopy. The aim of this study was to evaluate the effect of mouth gag pla...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01079-7
更新日期:2020-07-03 00:00:00
abstract:BACKGROUND:Renal dysfunction following intraoperative arterial hypotension is mainly caused by an insufficient renal blood flow. It is associated with higher mortality and morbidity rates. We hypothesised that the intraoperative haemodynamics are more stable during xenon anaesthesia than during isoflurane anaesthesia i...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-019-0799-2
更新日期:2019-07-09 00:00:00
abstract:BACKGROUND:The role of N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) as a prognostic factor in patients admitted to the intensive care unit (ICU) is not yet fully established. We aimed to determine whether NT-pro-BNP is predictive of ICU mortality in a multicenter cohort of critically ill patients. METHODS:A ...
journal_title:BMC anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1186/1471-2253-14-16
更新日期:2014-03-10 00:00:00
abstract:BACKGROUND:The present study aimed to compare the intravenous bolus effect of oxycodone and fentanyl on hemodynamic response after endotracheal intubation and postoperative pain in patients undergoing closed reduction of nasal bone fracture. METHODS:In this prospective randomized double-blinded study, 64 patients unde...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-016-0279-x
更新日期:2016-11-17 00:00:00
abstract:BACKGROUND:Since blood pressure tends to be unstable during induction of anesthesia in patients undergoing cardiovascular surgery, an artery catheter is often inserted before induction to continuously monitor arterial pressure during induction of anesthesia. ClearSight System™ enables noninvasive continuous measurement...
journal_title:BMC anesthesiology
pub_type: 杂志文章
doi:10.1186/s12871-020-01091-x
更新日期:2020-07-20 00:00:00
abstract:BACKGROUND:Endotracheal intubation of patients with massive regurgitation represents a challenge in emergency airway management. Gastric contents tend to block suction catheters, and few treatment alternatives exist. Based on a technique that was successfully applied in our district, we wanted to examine if endotrachea...
journal_title:BMC anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12871-018-0474-z
更新日期:2018-01-18 00:00:00