scholarly journals Fluid administration rate for uncontrolled intraabdominal hemorrhage in pigs

2017 ◽  
Author(s):  
Ujwal R. Yanala ◽  
Jason M. Johanning ◽  
Iraklis I. Pipinos ◽  
Robin R. High ◽  
Gustavo Larsen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hemoglobin Concentration ◽  
Rapid Infusion ◽  
Slow Group ◽  
Group Limit ◽  
Intraabdominal Hemorrhage ◽  
Domestic Swine ◽  
Uncontrolled Hemorrhage ◽  
Serum Testing ◽  
Administration Rate

ABSTRACTBackgroundWe hypothesized that slow crystalloid resuscitation would improve blood loss and hemoglobin compared to a rapid resuscitation during uncontrolled hemorrhage.MethodsAnesthetized, splenectomized domestic swine underwent hepatic lobar hemitransection. Lactated Ringers was given at 150 or 20 mL/min IV (rapid vs. slow, respectively, N = 12 per group; limit of 100 mL/kg). Vital sign monitoring and serum testing was done for up to 180 min, followed by necropsy.ResultsSurvival was 7 vs. 8 out of 12 subjects, rapid vs. slow respectively (p>0.05). The slow group had a less blood loss (1.6 vs. 2.7 L, respectively) and a higher final hemoglobin concentration (6.0 vs. 3.4 g/dL).ConclusionsUsing a fixed volume of crystalloid resuscitation in this porcine model of uncontrolled intraabdominal hemorrhage, a slow IV infusion rate produced less blood loss and a higher hemoglobin level compared to rapid infusion.

Chitosan based hemostatic dressing is associated with decreased blood loss in a swine uncontrolled hemorrhage model

2012 ◽  
Vol 215 (3) ◽  
pp. S54-S55
Author(s):  
Nicholas R. Kunio ◽  
Gordon M. Riha ◽  
Katherine M. Watson ◽  
Igor V. Kremenevskiy ◽  
Jerome A. Differding ◽  
...  
Keyword(s):  
Blood Loss ◽  
Hemostatic Dressing ◽  
Uncontrolled Hemorrhage

Erythropoietin and Desmopressin Obviated Transfusion in a Thromboasthenic Jehovah's Witness Undergoing Scoliosis Surgery

1996 ◽  
Vol 2 (1) ◽  
pp. 11-13
Author(s):  
Stefan Lethagen ◽  
Magnus K. Karlsson
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Bleeding Time ◽  
Hemoglobin Concentration ◽  
Scoliosis Surgery ◽  
Scoliosis Patient ◽  
Platelet Dysfunction ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Erythropoietin Treatment

A 13-year-old female Jehovah's Witness with thromboasthenia was scheduled for scoliosis surgery. To reduce the risk of heterologous transfusion, she was given erythropoietin for 2 weeks preoperatively. Bleeding time and platelet dysfunction normalized during erythropoietin treatment, but the hemoglobin concentration increased only marginally. Desmopressin and tranexamic acid were given as cover for surgery. Blood loss was less than that in the average scoliosis patient, 1,490 ml as compared to 2,740 ml, and no heterologous transfusion was given. Erythropoietin may thus be given preoperatively, not only to increase the hemoglobin concentration, but also to improve the platelet function in thromboasthenic pa tients.

Population Volume Kinetics Predicts Retention of 0.9% Saline Infused in Awake and Isoflurane-anesthetized Volunteers

2007 ◽  
Vol 107 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Åke Norberg ◽  
Robert G. Hahn ◽  
Husong Li ◽  
Joel Olsson ◽  
Donald S. Prough ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Hemoglobin Concentration ◽  
Compartment Model ◽  
Population Pharmacokinetic Analysis ◽  
The Body ◽  
Pharmacokinetic Analysis ◽  
Peripheral Compartment ◽  
Population Pharmacokinetic ◽  
Rapid Infusion ◽  
Isoflurane Anesthesia

Abstract Background: In previous work, extravascular expansion was observed to be enhanced by isoflurane anesthesia in sheep when a crystalloid bolus was administered. The aim of the current study was to further elaborate these investigations to humans and to explore the use of population kinetics in the analysis of fluid shifts. Methods: Eleven healthy volunteers participated in two experiments each, either awake or isoflurane anesthetized, during which they received 25 ml/kg saline, 0.9%, intravenously over 20 min. Plasma dilution data were derived from repeated sampling of hemoglobin concentration, and population pharmacokinetic analysis was conducted using the WinNonMix 2.0.1 software (Pharsight Corporation, Mountain View, CA). Plasma hormones were measured, and hemodynamic values were monitored. Results: Fluid infusion during isoflurane anesthesia was followed by a higher cardiac output, lower arterial pressure, and lower urinary excretion as compared with the awake protocol (P < 0.05). Albumin dilution was greater than hemoglobin concentration–derived plasma dilution, which indicates a transcapillary leak of albumin. A two-compartment model with an isoflurane-depressed, intercompartmental distribution parameter predicted that more than 50% of the infused volume was retained in the peripheral compartment at 180 min in both protocols. Isoflurane markedly increased the plasma levels of renin and aldosterone, whereas vasopressin was mostly unchanged. Conclusion: Fluid retention after rapid infusion of 0.9% saline was prominent in both awake and isoflurane-anesthetized subjects. Altered kinetics of infused 0.9% saline during isoflurane anesthesia was expressed as reduced clearance and a slower distribution, resulting in a small but significant increase in fluid accumulation in the body fluid compartments. These changes may be due to the associated decreasing of mean arterial pressure and increased release of renin and aldosterone.

scholarly journals Reduced Intraoperative Blood Loss and Hypothermia in Burn Surgery using Cardiopulmonary Bypass Pumps

2021 ◽  
pp. 229255032110247
Author(s):  
Amit Persad ◽  
Kevin Mowbrey ◽  
Edward Tredget
Keyword(s):  
Blood Loss ◽  
Transfusion Requirement ◽  
Temperature Drop ◽  
Total Body Surface Area ◽  
Retrospective Chart Review ◽  
Inhalation Injury ◽  
Rapid Infusion ◽  
Pneumatic Tourniquet ◽  
Roller Pump ◽  
Estimated Blood Loss

Objective: Patients presenting with total body surface area (TBSA) >40% burns require significant surgical treatment. Two substantial challenges during these surgeries are limiting blood loss and maintaining core temperatures. To overcome these challenges, several techniques have been developed, ranging from the Pitkin syringe method to the pneumatic tourniquet strategy for large-volume hyperthermic insufflation. Here, we compare the pneumatic tourniquet method to a roller pump method for maintenance of intraoperative normothermia and control of bleeding. Methods: We conducted a retrospective chart review of 20 patients presenting with TBSA >40% burns, 10 of whom were treated with the rapid infusion roller pump and 10 of whom were treated with the pneumatic tourniquet technique. Patients from each group were controlled for % TBSA, presence of inhalation injury, age, and date of admission. We reviewed transfusion requirement and the intraoperative temperatures, as well as the average intraoperative drop in temperature. Results: We observed improvement in the infusion volume, operative time, intraoperative temperature drop, minimum intraoperative temperature, estimated blood loss, and amount of required transfusion. Conclusions: Our study suggests that the rapid infusion roller pump technique is capable of achieving superior intraoperative bleeding control and temperature maintenance compared to the pneumatic tourniquet technique, resulting in decreased transfusion requirement.

scholarly journals A Prospective Comparison of Three Strategies for Evaluating Blood Loss in Transurethral Resection of the Prostate

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xiaojuan Yuan ◽  
Wei Yu ◽  
Ronghua Wu ◽  
Longkun Li ◽  
Fan He
Keyword(s):  
Blood Loss ◽  
Transurethral Resection ◽  
Prostate Volume ◽  
Hemoglobin Concentration ◽  
New Method ◽  
R Software ◽  
Prospective Comparison ◽  
New Strategy ◽  
Red Blood Cell Count ◽  
Hb Concentration

Objective. The aim of the current investigation is to develop a new strategy for evaluating blood loss in the process of transurethral resection of the prostate (TURP). Methods. 318 patients diagnosed with benign prostatic hyperplasia (BPH) that need TURP were enrolled in this study. Hospitalization information including age, height, weight, surgery time, prostate volume, hemoglobin (Hb) concentration, hematocrit (HCT) percentage, and red blood cell count (RBC) was evaluated for each patient. All statistical analysis drawing were conducted using R software. Results. Three methods were employed for calculating blood loss in TURP. Results from a new method display 0 missing value and got higher confidence (0 of 318, Poisson distribution, P < 0.001 ) compared with blood loss calculated with hemoglobin concentration (20.44%) and hematocrit percentage (19.18%). Also, the new method demonstrated narrow range (0.03~270.03 ml) and approximate normal distribution compared with blood loss calculated with hemoglobin concentration and hematocrit percentage. More importantly, the new method explained positive correlation with prostate volume ( R 2 = 0.138 , P < 0.001 ) and also surgery lasting time ( R 2 = 0.193 , P < 0.001 ). Conclusion. Methods developed for calculating blood loss in TURP in the current study displayed more accurate and reasonable evaluation of bleeding, which can guide the transfusion blood for patients.

Labetalol-induced hypotension decreases blood loss during uncontrolled hemorrhage

Resuscitation ◽  
1998 ◽  
Vol 38 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Boris Gurevich ◽  
Alan A Artru ◽  
Dani Geva ◽  
Gabriel Gurman ◽  
Yoram Shapira
Keyword(s):  
Blood Loss ◽  
Induced Hypotension ◽  
Uncontrolled Hemorrhage

scholarly journals Infusion Rate Escalation Study of Rituximab in Patients with CD20+ B-Cell Lymphomas: A Single Institution Analysis in Japan

ISRN Oncology ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Masahiro Yokoyama ◽  
Yasuhito Terui ◽  
Kengo Takeuchi ◽  
Eriko Nara ◽  
Kenji Nakano ◽  
...  
Keyword(s):  
B Cell ◽  
Infusion Rate ◽  
B Cell Lymphoma ◽  
Indolent Lymphoma ◽  
B Cell Lymphomas ◽  
Single Institution ◽  
Rapid Infusion ◽  
Large B Cell Lymphoma ◽  
Grade 3 ◽  
Administration Rate

Background. To determine the maximum tolerable infusion rate of rituximab, and investigate the safety and feasibility of rapid infusion of rituximab for patients with CD20 positive B-cell lymphomas (CD20+NHL). Patients and Methods. 18 patients with CD20+NHL were registered. This study had six cohorts of administration rate of rituximab. The median age was 56 years (range, 38–79), and five of 18 patients were male. Two patients (11%) with diffuse large B-cell lymphoma were receiving R-CHOP therapy, two (11%) with indolent lymphoma were receiving R-CVP therapy, and 14 (78%) with indolent lymphoma were receiving rituximab as maintenance therapy. Results. A total of 88 cycles of rituximab was administered. Rapid infusion of rituximab was well tolerated, with only one grade 3 leukocytepenia and one grade 4 neutropenia. Four patients (22%) developed grade 1 infusion-related toxicities at the first administration of rituximab. No patient with severe drug-related events was observed. Conclusions. We determined that the maximum tolerable infusion rate of rituximab is 300 mL/h (under 700 mg/h), and confirmed that administration of over 60 minutes is safe and feasible. We recommend rapid administration of rituximab for practice setting in patients with CD20+NHL being treated with rituximab or rituximab-containing chemotherapy. (Clinical trial no. JFCR2009-1027).

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