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[PMID]:29329091
[Au] Autor:Jiang J; Zhang Z; Zou X; Wang R; Bai J; Zhao S; Fan X; Sheng L; Li Y
[Ad] Endereço:Department of Drug Metabolism, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Xiannongtan Street, Beijing 100050, China; Beijing Key Laboratory of Non-Clinical Drug Metabolism and PK/PD Study, Institute of Materia Medica, Chinese Academy of Me
[Ti] Título:Determination of IMM-H004 and its active glucuronide metabolite in rat plasma and Ringer's solution by ultra-performance liquid chromatography-tandem mass spectrometry.
[So] Source:J Chromatogr B Analyt Technol Biomed Life Sci;1074-1075:16-24, 2018 Feb 01.
[Is] ISSN:1873-376X
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:IMM-H004 is a novel neuroprotective agent and its glucuronide metabolite IMM-H004G has similar protective effects against cerebral ischemic injury in vivo and in vitro. A specific and sensitive ultra-performance liquid chromatography-tandem mass spectrometry method was established and validated for determination of IMM-H004 and IMM-H004G simultaneously in rat plasma and Ringer's solution. Plasma samples containing IMM-H004, IMM-H004G and internal standard propranolol were prepared by direct protein precipitation in a sample-to-solvent ratio of 1:2:6 (plasma: water: acetonitrile), whereas no protein precipitation was required for Ringer's solution samples. Separation was performed with a gradient mobile phase of methanol/water with 0.5% formic acid (v/v) on Eclipse Plus C18 column (2.1×50mm, 3.5µm) at a flow rate of 0.3mL/min. The detection was operated on a triple quadrupole mass spectrometer in positive ion multiple reaction monitoring (MRM) mode. The monitored transitions were 305.1→248.1 for IMM-H004, 481.3→305.1 for IMM-H004G and 260.1→183.1 for propranolol. The linear ranges of IMM-H004 and IMM-H004G were 5 to 3000ng/mL and 10 to 3000ng/mL for plasma method and 0.5 to 500ng/mL for Ringer's solution method. All the intra-day and inter-day precision and accuracy for the two analytes in rat plasma were below 7.5% and the intra-day precision and accuracy for analytes in Ringer's solution were within ±14.7%. There was no obvious matrix effect and the recoveries of the analytes were higher than 94.2%. IMM-H004 and IMM-H004G were stable during one analytic process. The established method was applied successfully to plasma pharmacokinetic and brain microdialysis studies of IMM-H004 and IMM-H004G in rats after a single intravenous administration of IMM-H004.
[Mh] Termos MeSH primário: Cromatografia Líquida/métodos
Cumarínicos
Soluções Isotônicas/química
Espectrometria de Massas em Tandem/métodos
[Mh] Termos MeSH secundário: Animais
Química Encefálica
Cumarínicos/análise
Cumarínicos/sangue
Cumarínicos/química
Cumarínicos/farmacocinética
Estabilidade de Medicamentos
Glucuronídeos
Limite de Detecção
Modelos Lineares
Masculino
Ratos
Ratos Sprague-Dawley
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Coumarins); 0 (Glucuronides); 0 (IMM-H004); 0 (Isotonic Solutions); 8026-10-6 (Ringer's solution)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE


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[PMID]:29465593
[Au] Autor:Lou X; Lu G; Zhao M; Jin P
[Ad] Endereço:Emergency Department.
[Ti] Título:Preoperative fluid management in traumatic shock: A retrospective study for identifying optimal therapy of fluid resuscitation for aged patients.
[So] Source:Medicine (Baltimore);97(8):e9966, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Fluid resuscitation was used on aged patients with traumatic shock in their early postoperative recovery. The present study aimed to assess whether different fluid resuscitation strategies had an influence on aged patients with traumatic shock.A total of 219 patients with traumatic shock were recruited retrospectively. Lactated Ringer and hydroxyethyl starch solution were transfused for fluid resuscitation before definite hemorrhagic surgery. Subjects were divided into 3 groups: group A: 72 patients were given aggressive fluid infusion at 20 to 30 mL/min to restore normal mean arterial pressure (MAP) of 65 to 75 mm Hg. Group B: 72 patients were slowly given restrictive hypotensive fluid infusion at 4 to 5 mL/min to maintain MAP of 50 to 65 mm Hg. Group C: 75 patients were given personalized infusion to achieve MAP of 75 to 85 mm Hg. Preoperative infusion volume, preoperative MAP, optimal initial points for surgery, postoperative shock time and mortality rates at 6 and 24 hours after surgery were determined.No significant difference in clinical characteristics was found among the 3 groups. Amount of preoperative infusion was considerably lower in the restrictive group (P < .01, compared with group A). A significant difference in preoperative infusion volume was found between the personalized and other 2 groups (P < .01, compared with groups A and B). Patients in the personalized resuscitation group achieved a higher preoperative MAP (P < .01 compared with Group B; P < .05, compared with group A) and required less prepared time for surgery (P < .01 compared with groups A and B). In addition, a lower mortality rate at 6 and 24 hours after operation was observed in the subjects with personalized therapy (P < .05, compared with group B).Personalized management of fluid resuscitation in traumatized aged patients with appropriate volume and speed of fluid transfusion, suggesting increased survival rate and less prepared time for surgery.
[Mh] Termos MeSH primário: Hidratação/métodos
Cuidados Pré-Operatórios/métodos
Ressuscitação/métodos
Choque Traumático/terapia
[Mh] Termos MeSH secundário: Idoso
Pressão Arterial
Feminino
Seres Humanos
Derivados de Hidroxietil Amido/administração & dosagem
Soluções Isotônicas/administração & dosagem
Masculino
Período Pré-Operatório
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydroxyethyl Starch Derivatives); 0 (Isotonic Solutions); 8022-63-7 (Ringer's lactate)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009966


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[PMID]:29219627
[Au] Autor:Ferrer R; Mateu X; Maseda E; Yébenes JC; Aldecoa C; De Haro C; Ruiz-Rodriguez JC; Garnacho-Montero J
[Ad] Endereço:a Intensive Care Department , Vall d'Hebron University Hospital; Shock, Organ Dysfunction and Resuscitation Research Group (SODIR), Vall d'Hebron Institut de Recerca , Barcelona , Spain.
[Ti] Título:Non-oncotic properties of albumin. A multidisciplinary vision about the implications for critically ill patients.
[So] Source:Expert Rev Clin Pharmacol;11(2):125-137, 2018 Feb.
[Is] ISSN:1751-2441
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Effective resuscitation with human albumin solutions is achieved with less fluid than with crystalloid solutions. However, the role of albumin in today's critical care unit is also linked to its multiple pharmacological effects. Areas covered: The potential clinical benefits of albumin in select populations of critically ill patients like sepsis seem related to immunomodulatory and anti-inflammatory effects, antibiotic transportation and endothelial stabilization. Albumin transports many drugs used in critically ill patients. Such binding to albumin is frequently lessened in critically ill patients with hypoalbuminemia. These changes could result in sub-optimal treatment. Albumin has immunomodulatory capacity by binding several bacterial products. Albumin also influences vascular integrity, contributing to the maintenance of the normal capillary permeability. Moreover, the albumin molecule encompasses several antioxidant properties, thereby significantly reducing re-oxygenation injury, which is especially important in sepsis. In fact, most studies of albumin administration are a combination of a degree of resuscitation with a degree of maintenance or supplementation of albumin. Expert commentary: The potential clinical benefits of the use of albumin in selected critically ill patients such as sepsis seem related to its immunomodulatory and anti-inflammatory effects, antioxidant properties, antibiotic transportation and endothelial stabilization. Additional studies are warranted to further elucidate the underlying physiologic and molecular rationale.
[Mh] Termos MeSH primário: Estado Terminal
Sepse/tratamento farmacológico
Albumina Sérica Humana/administração & dosagem
[Mh] Termos MeSH secundário: Animais
Seres Humanos
Hipoalbuminemia/tratamento farmacológico
Unidades de Terapia Intensiva
Soluções Isotônicas/administração & dosagem
Soluções Isotônicas/farmacologia
Ressuscitação/métodos
Sepse/fisiopatologia
Albumina Sérica Humana/farmacologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Isotonic Solutions); 0 (crystalloid solutions); ZIF514RVZR (Serum Albumin, Human)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171209
[St] Status:MEDLINE
[do] DOI:10.1080/17512433.2018.1412827


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[PMID]:29381975
[Au] Autor:Han JW; Oh AY; Seo KS; Na HS; Koo BW; Lee YJ
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do.
[Ti] Título:Comparison of intraoperative basal fluid requirements in distal pancreatectomy: Laparotomy vs. laparoscopy: A retrospective cohort study.
[So] Source:Medicine (Baltimore);96(47):e8763, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There has been recent progress in intraoperative fluid therapy. However, little is known about intraoperative fluid therapy in laparoscopic surgery. The purpose of this study is to determine whether there are differences in the basal fluid requirements during surgery between laparotomy and laparoscopic distal pancreatectomy.This retrospective cohort study analyzed the electronic medical records of 253 patients who underwent distal pancreatectomy via either laparotomy (73 patients) or laparoscopy (180 patients) between June 2006 and March 2016. The volume of intraoperative fluid administered, postoperative complications, length of hospital stay, and readmission rate were evaluated. The total volume of fluids was calculated as the sum of the volume of crystalloid plus the volume of colloid multiplied by 1.5 or 2.0.Patients who had laparotomy were older and had higher American Society of Anesthesiologists classes. Anesthesia time was longer and estimated blood loss was larger in laparotomy. More colloid (1.8 mL/kg per h vs. 1.2 mL/kg per h, P < .001) and more total calculated fluid (1.5 times: 11.7 mL/kg per h vs. 10.6 mL/kg per h, P = .002; 2.0 times: 12.6 mL/kg per h vs. 11.2 mL/kg per h, P = .001) were infused in laparotomy. Crystalloid (9.0 mL/kg per h vs. 8.9 mL/kg per h, P = .203) did not show significant difference. Postoperative complications were more frequent (63% vs. 45%, P = .008), the hospital stay was longer (18 days vs. 13.4 days, P < .001), and readmission rate was higher (15% vs. 5.6%, P = .02) in laparotomy. By logistic regression analysis, we could find that operation type (laparotomy vs. laparoscopy, odds ratio 1.900, 95% confidence interval 1.072-3.368) and operation time (P = .004) had effect on complications.In patients undergoing distal pancreatectomy, basal fluid requirements were larger in laparotomy compared with laparoscopy. Operation time and estimated blood loss had effects on fluid administration. Postoperative complications were more frequent in laparotomy but we could not find relationships with infused colloid or total calculated fluid volumes. Operation type (laparotomy vs. laparoscopy) and operation time were the only related factors to postoperative complications.
[Mh] Termos MeSH primário: Hidratação/estatística & dados numéricos
Cuidados Intraoperatórios/métodos
Laparoscopia/métodos
Laparotomia/métodos
Pancreatectomia/métodos
[Mh] Termos MeSH secundário: Idoso
Coloides/uso terapêutico
Feminino
Hidratação/métodos
Seres Humanos
Soluções Isotônicas/uso terapêutico
Tempo de Internação
Masculino
Meia-Idade
Duração da Cirurgia
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Colloids); 0 (Isotonic Solutions); 0 (crystalloid solutions)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008763


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[PMID]:28470550
[Au] Autor:Garmi G; Zuarez-Easton S; Zafran N; Ohel I; Berkovich I; Salim R
[Ad] Endereço:Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.
[Ti] Título:The effect of type and volume of fluid hydration on labor duration of nulliparous women: a randomized controlled trial.
[So] Source:Arch Gynecol Obstet;295(6):1407-1412, 2017 Jun.
[Is] ISSN:1432-0711
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Type and volume of fluid administered for intrapartum maintenance had been reported to differently affect labor length, delivery mode, and cord artery pH and glucose level. We aimed to compare the effect of three different fluid regimens on labor duration. METHODS: In a randomized trial, healthy nulliparous in labor were randomized into one of three intravenous fluid regimens: group 1, the reference group, lactated Ringer's solution infused at a rate of 125 mL/h; group 2, lactated Ringer's solution infused at a rate of 250 mL/h; group 3, 0.9% saline solution boosted with 5% glucose, infused at a rate of 125 mL/h. The primary outcome was labor length from enrollment until delivery. RESULTS: Between December 2010 and July 2015, 300 women were randomized to one of the three groups. Demographic and baseline obstetric characteristics were comparable between the groups. There was no significant difference in the time from enrollment to delivery (p = 0.62). Furthermore, there were no significant differences in second stage duration (p = 0.73), mode of delivery (p = 0.21), cord artery pH and glucose level between the groups. CONCLUSIONS: Increasing the intravenous volume of lactated Ringer's solution or substituting to fluid containing 5% glucose solution does not affect labor length. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, http://www.clinicaltrials.gov , NCT01242293.
[Mh] Termos MeSH primário: Parto Obstétrico
Soluções Isotônicas/administração & dosagem
Trabalho de Parto/fisiologia
[Mh] Termos MeSH secundário: Administração Intravenosa
Adulto
Glicemia
Feminino
Hidratação/métodos
Glucose/administração & dosagem
Glucose/uso terapêutico
Seres Humanos
Soluções Isotônicas/química
Soluções Isotônicas/uso terapêutico
Gravidez
Resultado da Gravidez
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Isotonic Solutions); 8022-63-7 (Ringer's lactate); IY9XDZ35W2 (Glucose)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180121
[Lr] Data última revisão:
180121
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1007/s00404-017-4381-1


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[PMID]:29202257
[Au] Autor:Bihari S; Gelbart B; Seppelt I; Thompson K; Watts N; Prakash S; Festa M; Bersten A; The George Institute for Global Health ; The Australian and New Zealand Intensive Care Society Clinical Trials Group
[Ad] Endereço:Department of ICCU, Flinders Medical Centre, Adelaide, SA, Australia. biharishailesh@gmail.com.
[Ti] Título:Maintenance fluid practices in paediatric intensive care units in Australia and New Zealand.
[So] Source:Crit Care Resusc;19(4):310-317, 2017 Dec.
[Is] ISSN:1441-2772
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Maintenance fluid administration is a common practice in paediatric intensive care units (PICUs), contributing to daily fluid intake and fluid balance, but little is known about this practice. OBJECTIVES: To determine the volume and type of maintenance fluid delivered to PICU patients, and to assess changes in practice compared with a previous time point. METHODS: A prospective, observational, single-day, point prevalence study of paediatric patients from 11 Australian and New Zealand PICUs, conducted in 2014. RESULTS: Seventy-two patients were enrolled. The median age and weight of infants aged < 1 year (n = 34) were 2 months (interquartile range [IQR],1-4) and 5 kg (IQR, 4-6), respectively; while in children ≥ 1 year of age (n = 38), these were 4 years (IQR, 2-8) and 17 kg (IQR, 12-23), respectively. On the study day, 19 infants (56%) and 19 children aged ≥ 1 year (50%) received maintenance fluids. Infants received a median of 23 mL/kg (IQR, 12-45) of maintenance fluid in addition to 51 mL/kg (IQR, 40-72) of fluid and nutrition from other sources; maintenance fluids contributed 29% (IQR, 13%-60%) of the total daily fluid intake. Children ≥ 1 year of age received a median of 18 mL/kg (IQR, 9-37) of maintenance fluid in addition to 39 mL/kg (IQR, 25-53) of fluid and nutrition from other sources; maintenance fluids contributed 33% (IQR, 17%-69%) of the total daily fluid intake. When compared with similar data from 2011, there was no change in the amount of maintenance fluid given, which was administered mostly as isotonic fluids. CONCLUSION: Maintenance fluid contributes about a third of total fluid administration in children in Australian and New Zealand PICUs and is mostly administered as isotonic solutions.
[Mh] Termos MeSH primário: Hidratação/estatística & dados numéricos
Unidades de Terapia Intensiva Pediátrica
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Austrália
Cateteres de Demora/estatística & dados numéricos
Pré-Escolar
Nutrição Enteral/estatística & dados numéricos
Feminino
Seres Humanos
Lactente
Soluções Isotônicas/administração & dosagem
Masculino
Nova Zelândia
Nutrição Parenteral/estatística & dados numéricos
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Isotonic Solutions)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE


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[PMID]:28452823
[Au] Autor:Hahn RG
[Ad] Endereço:From the Research Unit, Department of Patient Safety and Quality, Södertälje Hospital, Södertälje, Sweden.
[Ti] Título:Arterial Pressure and the Rate of Elimination of Crystalloid Fluid.
[So] Source:Anesth Analg;124(6):1824-1833, 2017 06.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Excretion of crystalloid fluid is slow during general anesthesia. The distribution and elimination of buffered Ringer's solution were analyzed to determine whether the rate of elimination correlates with a hemodynamic factor, consciousness, patient posture, or the type of general anesthesia. Data were derived from 4 separately published studies in which 30 volunteers and 48 anesthetized patients had received 0.833 (1 series 0.667) mL/kg/min of lactated or acetated Ringer's solution over 30 minutes. Frequent measurements of the blood hemoglobin and mean urinary excretion were used as input in a kinetic analysis according to a 2-volume model and covariates, using microconstants and mixed-effects modeling software.The results show that rate of elimination of crystalloid fluid decreased with the mean arterial pressure (MAP) and patient age, but was unaffected by consciousness and inhalational or intravenous anesthesia. The elimination rate constant was 6.5 (95% confidence interval, 5.2-7.9) × 10 × (MAP/mean MAP) × (Age/mean Age). The mean MAP for the 2108 data points was 81.3 mm Hg and the mean age was 40 years. The central fluid space that was expanded by infused fluid (Vc, plasma volume) increased with body weight but decreased with general anesthesia and with reductions of MAP.Simulations revealed a more than 10-fold difference in the excreted fluid volume after a theoretical 30-minute infusion, depending on whether the MAP was 50 or 100 mm Hg.In conclusion, the rate of elimination of crystalloid fluid decreased in proportion to MAP but was independent of general anesthesia and moderate-sized surgery.
[Mh] Termos MeSH primário: Anestesia Geral
Pressão Arterial
Hidratação/métodos
Soluções Isotônicas/farmacocinética
Soluções para Reidratação/farmacocinética
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Idoso
Simulação por Computador
Feminino
Seres Humanos
Infusões Intravenosas
Soluções Isotônicas/administração & dosagem
Masculino
Taxa de Depuração Metabólica
Meia-Idade
Modelos Biológicos
Soluções para Reidratação/administração & dosagem
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Isotonic Solutions); 0 (Rehydration Solutions); 0 (Ringer's acetate); 0 (crystalloid solutions); 8022-63-7 (Ringer's lactate)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002075


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[PMID]:29193918
[Au] Autor:López-Díaz T; Lugo F; Rodríguez JM; Sabao E; Sierra K; Valdés Y; Vera J
[Ti] Título:Compliance with management guidelines in patients with suspected dengue.
[So] Source:Bol Asoc Med P R;108(1):51-4, 2016.
[Is] ISSN:0004-4849
[Cp] País de publicação:Puerto Rico
[La] Idioma:eng
[Ab] Resumo:Dengue is an endemic disease in Puerto Rico, with three to nine thousand suspected dengue cases reported yearly. In PR, physicians are required to maintain medical education courses about dengue in order to recertify their medical licenses. The purpose of this study was to describe characteristics of patients admitted to Bella Vista Hospital with suspected dengue and estimate the compliance with guidelines established by the CDC documented in medical records. A total of 197 medical records of patients admitted with diagnosis of suspected dengue during January 1, 2013 through December 31, 2013 were reviewed. The annual distribution of admitted cases showed a higher incidence during the months of June through September, with August having the higher incidence of all. Combined aches and pains were most commonly reported at admission with a prevalence of 82%. In general there was a low prevalence of severe disease as per definition at presentation (DM, clinical fluid accumulation, hepatomegaly, pregnancy and/or renal insufficiency). Overall, compliance with CDC established guidelines were only partially followed. The guideline that was followed more frequently was a daily CBC, with 95% of patients having this as part of their management. Prevalence of administration of isotonic intravenous fluids was 63%, monitoring of vital signs was 48%), and administration of bolus of intravenous fluid was11%. No fatalities were reported during the period.
[Mh] Termos MeSH primário: Dengue/terapia
Fidelidade a Diretrizes
Guias de Prática Clínica como Assunto
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Contagem de Células Sanguíneas
Centers for Disease Control and Prevention (U.S.)
Criança
Pré-Escolar
Estudos Transversais
Dengue/epidemiologia
Feminino
Hidratação/métodos
Seres Humanos
Incidência
Lactente
Recém-Nascido
Soluções Isotônicas/administração & dosagem
Masculino
Meia-Idade
Porto Rico/epidemiologia
Estados Unidos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Isotonic Solutions)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171214
[Lr] Data última revisão:
171214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE


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[PMID]:28745705
[Au] Autor:Karyakin NN; Klemenova IA; Luzan AS
[Ad] Endereço:Volga Federal Medical Research Center, Health Ministry of Russia, Nizhny Novgorod, Russia.
[Ti] Título:[The outcomes of lower extremities burn wounds management by using of controlled moist environment].
[Ti] Título:Rezul'taty lecheniia ozhogovykh ran konechnostei v usloviiakh vlazhnoi sredy..
[So] Source:Khirurgiia (Mosk);(7):40-43, 2017.
[Is] ISSN:0023-1207
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To the outcomes of lower extremities burn wounds management by using of controlled moist environment. MATERIAL AND METHODS: Burn wounds management by using of controlled moist environment in 23 patients is presented in the article. Physiological moist conditions on the surface of wounds were created with isotonic sodium chloride solution and sterile polyethylene diaphanous containers. Сontrol group included 12 patients who were treated with hydrocolloid patch. RESULTS: It was shown that burn wounds management with moist environment allows to use and improve this method further. This technique gives good analgesic effect within the first days after burn trauma, allows to implement permanent clinical monitoring of the wound and preserve functional activity of the limbs.
[Mh] Termos MeSH primário: Curativos Hidrocoloides
Queimaduras
Traumatismos da Perna
Administração dos Cuidados ao Paciente/métodos
Cloreto de Sódio/uso terapêutico
Cicatrização
[Mh] Termos MeSH secundário: Adulto
Queimaduras/diagnóstico
Queimaduras/etiologia
Queimaduras/fisiopatologia
Queimaduras/cirurgia
Feminino
Seres Humanos
Soluções Isotônicas/uso terapêutico
Traumatismos da Perna/diagnóstico
Traumatismos da Perna/etiologia
Traumatismos da Perna/cirurgia
Masculino
Manejo da Dor/métodos
Federação Russa
Índices de Gravidade do Trauma
Resultado do Tratamento
Cicatrização/efeitos dos fármacos
Cicatrização/fisiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Isotonic Solutions); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171130
[Lr] Data última revisão:
171130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.17116/hirurgia2017740-43


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[PMID]:28973227
[Au] Autor:Andrews B; Semler MW; Muchemwa L; Kelly P; Lakhi S; Heimburger DC; Mabula C; Bwalya M; Bernard GR
[Ad] Endereço:Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee.
[Ti] Título:Effect of an Early Resuscitation Protocol on In-hospital Mortality Among Adults With Sepsis and Hypotension: A Randomized Clinical Trial.
[So] Source:JAMA;318(13):1233-1240, 2017 10 03.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: The effect of an early resuscitation protocol on sepsis outcomes in developing countries remains unknown. Objective: To determine whether an early resuscitation protocol with administration of intravenous fluids, vasopressors, and blood transfusion decreases mortality among Zambian adults with sepsis and hypotension compared with usual care. Design, Setting, and Participants: Randomized clinical trial of 212 adults with sepsis (suspected infection plus ≥2 systemic inflammatory response syndrome criteria) and hypotension (systolic blood pressure ≤90 mm Hg or mean arterial pressure ≤65 mm Hg) presenting to the emergency department at a 1500-bed referral hospital in Zambia between October 22, 2012, and November 11, 2013. Data collection concluded December 9, 2013. Interventions: Patients were randomized 1:1 to either (1) an early resuscitation protocol for sepsis (n = 107) that included intravenous fluid bolus administration with monitoring of jugular venous pressure, respiratory rate, and arterial oxygen saturation and treatment with vasopressors targeting mean arterial pressure (≥65 mm Hg) and blood transfusion (for patients with a hemoglobin level <7 g/dL) or (2) usual care (n = 105) in which treating clinicians determined hemodynamic management. Main Outcomes and Measures: The primary outcome was in-hospital mortality and the secondary outcomes included the volume of intravenous fluid received and receipt of vasopressors. Results: Among 212 patients randomized to receive either the sepsis protocol or usual care, 3 were ineligible and the remaining 209 completed the study and were included in the analysis (mean [SD] age, 36.7 [12.4] years; 117 men [56.0%]; 187 [89.5%] positive for the human immunodeficiency virus). The primary outcome of in-hospital mortality occurred in 51 of 106 patients (48.1%) in the sepsis protocol group compared with 34 of 103 patients (33.0%) in the usual care group (between-group difference, 15.1% [95% CI, 2.0%-28.3%]; relative risk, 1.46 [95% CI, 1.04-2.05]; P = .03). In the 6 hours after presentation to the emergency department, patients in the sepsis protocol group received a median of 3.5 L (interquartile range, 2.7-4.0 L) of intravenous fluid compared with 2.0 L (interquartile range, 1.0-2.5 L) in the usual care group (mean difference, 1.2 L [95% CI, 1.0-1.5 L]; P < .001). Fifteen patients (14.2%) in the sepsis protocol group and 2 patients (1.9%) in the usual care group received vasopressors (between-group difference, 12.3% [95% CI, 5.1%-19.4%]; P < .001). Conclusions and Relevance: Among adults with sepsis and hypotension, most of whom were positive for HIV, in a resource-limited setting, a protocol for early resuscitation with administration of intravenous fluids and vasopressors increased in-hospital mortality compared with usual care. Further studies are needed to understand the effects of administration of intravenous fluid boluses and vasopressors in patients with sepsis across different low- and middle-income clinical settings and patient populations. Trial Registration: clinicaltrials.gov Identifier: NCT01663701.
[Mh] Termos MeSH primário: Hidratação
Mortalidade Hospitalar
Hipotensão/terapia
Ressuscitação/métodos
Sepse/terapia
Vasoconstritores/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Transfusão de Sangue
Protocolos Clínicos
Feminino
Soropositividade para HIV/complicações
Seres Humanos
Hipotensão/etiologia
Infusões Intravenosas
Soluções Isotônicas/uso terapêutico
Estimativa de Kaplan-Meier
Masculino
Sepse/complicações
Sepse/mortalidade
Tempo para o Tratamento
Zâmbia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Isotonic Solutions); 0 (Vasoconstrictor Agents); 0 (crystalloid solutions)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171004
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.10913



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