Fluid resuscitation with colloids is an established second line therapy for septic patients. Evidence of relative efficacy outcomes is tempered by considerations of the relative costs of the individual fluids. An assessment of recent large clinical trials was performed, resulting in a ranking in the efficacy of these therapies. Probabilities for mortality and the need for renal replacement ther...

Glycosaminoglycan hyaluronan (HA), a major constituent of the endothelial glycocalyx, helps to maintain vascular integrity. Preconditioning the heart with volatile anesthetic agents protects against ischemia/reperfusion injury. We investigated a possible protective effect of sevoflurane on the glycocalyx, especially on HA. The effect of pre-ischemic treatment with sevoflurane (15 minutes at 2% ...

BACKGROUND Hypotension is one of the most common complications after spinal anesthesia for cesarean delivery. Normally, preloading with fluids, especially crystalloids, is used to prevention of hypotension. METHODS In the present randomized clinical trial study, 120 parturients presenting for elective cesarean section with the American Society of Anesthesiologists Class I and II received eith...

OBJECTIVE To examine the effects of hypertonic/hyperoncotic treatment on physiologic variables and regional cerebral blood flow and to test its neuroprotective efficiency in a model of permanent venous ischemia. DESIGN Randomized prospective study. SETTING University research institute. SUBJECTS Adult male Wistar rats, weighing 359 +/- 54 g (n = 38). INTERVENTIONS Rats were subjected to...

Acute kidney injury associated with renal hypoperfusion is a frequent and severe complication during sepsis. Fluid resuscitation is the main therapy. However, heart failure is usually lethal for those patients receiving large volumes of fluids. We compared the effects of small-volume resuscitation using four different treatment regimens, involving saline, hypertonic saline (HTS), hydroxyethyl s...

PURPOSE Vogt´s antioxidant solution (red blood cells, Ringer's solution, sodium bicarbonate, mannitol, allopurinol and 50% glucose) or its modification including hydroxyethyl starch (HES) were tested for the prevention of splanchnic artery occlusion shock. METHODS Seventy rats were distributed in treatment (3), control (1), and sham (3) groups. Ischemia and reperfusion were induced by celiac,...

Editors,—I read with interest the article by Ruttmann, James and Aronson1 concerning haemodilution with hydroxethyl starch and normal saline. However, I disagree with their conclusion that they have shown that haemodilution per se exerted a procoagulant effect in both groups. Instead, I propose that their conclusion should be that they demonstrated that haemodilution with normal saline resulted...

Background: Hypotension is commonly occurred with Spinal anesthesia. Colloids and Crystalloids are used preoperatively to prevent hypotension. Objective: To examine the effect of fluid (crystalloid vs. colloid) preloading on hemodynamic stability in old patients planned for lower limb orthopedic operations spinal Patients methods: Eighty undergoing surgery under anesthesia were included this wo...

The objective of the study was to determine the early effects of hypertonic/hyperoncotic starch resuscitation after 2 h occlusion of the superior mesenteric artery (SMA) in comparison to animals reperfused without treatment and isotonic resuscitation. SMA was clamped (18 pigs, 19-23 kg) for 2 h followed by a 2-h reperfusion period, which was initiated with isotonic (ISO) (35 mL/kg 0.9% NaCl and...