248 August 2013 I N this issue of ANesthesiology, Konrad et al.1 present a study in pigs in which they compare the renal microvascular oxygenation effects by using either a balanced crystalloid solution or a balanced hydroxyethyl starch 6% 130/0.4 solution (hes) for acute normovolemic hemodilution to a fixed hematocrit of 15%. They have chosen this method to assess the impact of crystalloids an...

BACKGROUND Multi-frequency bioelectrical impedance analysis (MF-BIA) has been used to evaluate extracellular fluid volume (ECFV), but not fluid fluxes associated with fluid or furosemide administration in horses. If able to detect acute changes in ECFV, MF-BIA would be useful in monitoring fluid therapy in horses. HYPOTHESIS The purpose of this study was to evaluate the ability of MF-BIA to d...

Abstract Pre-analytical error may occur when collecting blood samples from intravenous (IV) lines. Blood can be inadvertently diluted by exogenous solutions if an insufficient amount of is discarded prior to collection. Rules built in the laboratory information system or middleware used alert staff specimens that require co-investigation with clinical team determine sample dilution possible lik...

BACKGROUND Comparative clinical effects of balanced crystalloids and saline are uncertain, particularly in noncritically ill patients cared for outside an intensive care unit (ICU). METHODS We conducted a single-center, pragmatic, multiple-crossover trial comparing balanced crystalloids (lactated Ringer's solution or Plasma-Lyte A) with saline among adults who were treated with intravenous cr...

The crystalloid – colloid debate regarding the most effective intravenous fluid for resuscitation from haemorrhagic shock has been raging over the past 60 years, and still continues without a satisfactory resolution (1). Crystalloid solutions are essentially isotonic salt solutions (270-310 mOsm/L) and have been in use since the 1800s but their use became widespread during World War I. Normal s...

BACKGROUND Excessive or inadequate intravenous fluid given in the perioperative period can affect outcomes. A number of guidelines exist but these can conflict with the entrenched practice, evidence base and prescriber knowledge. We conducted a multi-centre audit of intraoperative and postoperative intravenous fluid therapy to investigate fluid administration practice and frequency of postopera...

There is increasing evidence that intraoperative fluid therapy decisions may influence postoperative outcomes. In the past, patients undergoing major surgery were often administered large volumes of crystalloid, based on a presumption of preoperative dehydration and nebulous intraoperative 'third space' fluid loss. However, positive perioperative fluid balance, with postoperative fluid-based we...

While early plasma transfusion for the treatment of patients with ongoing major hemorrhage is widely accepted as part of the standard of care in the hospital setting, logistic constraints have limited its use in the out-of-hospital setting. Freeze-dried plasma (FDP), which can be stored at ambient temperatures, enables early treatment in the out-of-hospital setting. Point-of-injury plasma trans...

AIMS To examine the level of microbial colonisation in intravenous fluids after 24 hours of use in an acute care setting to determine the necessity of changing infusate bags on a time-related basis. BACKGROUND Catheter-related bloodstream infections are a serious and life-threatening complication of intravascular devices. Colonised intravenous fluids are one potential source of infection; how...

The crystalloid – colloid debate regarding the most effective intravenous fluid for resuscitation from haemorrhagic shock has been raging over the past 60 years, and still continues without a satisfactory resolution (1). Crystalloid solutions are essentially isotonic salt solutions (270-310 mOsm/L) and have been in use since the 1800s but their use became widespread during World War I. Normal s...