Objective: To explore the effect of clinically available crystalloids on lactate clearance in patients with septic shock Methods: Sixty-eight patients with septic shock who were treated in our hospital from January 20...Objective: To explore the effect of clinically available crystalloids on lactate clearance in patients with septic shock Methods: Sixty-eight patients with septic shock who were treated in our hospital from January 2017 to January 2019 were enrolled in the study. The selected patients were randomly divided into three groups: sodium lactate Ringer's solution group (LR group), saline group (NS group) and compound sodium chloride injection group (RS group), each group received the corresponding crystal liquid for fluid resuscitation, compare three groups Heart rate (HR), mean arterial pressure (MAP), cardiac output, procalcitonin (PCT), and C-reactive protein (CRP) before and after treatment, compared with the treatment of 24 hours of lactate clearance and APACHE II scores, and the overall hospitalization time and mortality rate of the three groups of patients were statistically compared;Results: (1) The difference of HR, MAP and cardiac output between the three groups before treatment was not statistically significant (P>0.05), treatment for 24h The HR of the post-Lactate Ringer's solution group was lower than that of the control group, and the MAP and cardiac output were higher than the control group (P<0.05). (2) The difference of PCT, CRP and BNP levels between the three groups before and after treatment was not statistically significant. (P>0.05);(3) Compared with the results, there was no statistically significant difference in the clearance rate of lactate clearance between the three groups (P>0.05). Three groups before and after treatment APACHE II score was not statistically significant difference comparison (P> 0.05). (4) Three groups The overall hospitalization time and mortality rate of the patients were not statistically significant (P>0.05). Conclusion: Lactate Ringer's solution can better maintain the circulation capacity and blood pressure, which can alleviate the clinical symptoms of patients with septic shock, but no obvious effect on lactic acid clearance. The effect of resuscitation with clinically available crystalloid sodium lactate Ringer's solution, saline and compound sodium chloride injection was not statistically significant in patients with septic shock.展开更多
Twenty patients undergoing open-heart valve replacement were divided randomly into two groups in this study; intermittent perfusion of cold crystalloid (St. Thomas Hospital solution) with hypothermic cardiopulmonary b...Twenty patients undergoing open-heart valve replacement were divided randomly into two groups in this study; intermittent perfusion of cold crystalloid (St. Thomas Hospital solution) with hypothermic cardiopulmonary bypass (CPB) (hypothermic group) and continuous administration of warm blood cardioplegia with normothermic CPB (normothermic group) respectively. Tissue samples were taken from the right atrium before weaning from CPB and from the right appendage 30 minutes after removal of the cross-clamp. The results of pathological study in these two groups were as follows: the structural alterations were most severe during the ischemic period in the hypothermic group. Damages of the myocardial展开更多
Fluid therapy/resuscitation is mandatory in acute pancreatitis due to the pathophysiology of fluid loss as a consequence of the inflammatory process.For many years,without clear evidence,early and aggressive fluid res...Fluid therapy/resuscitation is mandatory in acute pancreatitis due to the pathophysiology of fluid loss as a consequence of the inflammatory process.For many years,without clear evidence,early and aggressive fluid resuscitation with crystalloid solutions(normal saline solution or Ringer lactate solution)was recommended.Recently,many randomized control trials and meta-analyses on fluid therapy have revealed that high fluid rate infusion is associated with increased mortality and severe adverse events compared to those resulting from moderate fluid rates,and this has triggered a paradigm shift in fluid management strategies.Meanwhile,there is evidence to show that Ringer lactate solution is superior to normal saline solutions in this context.The purpose of this review is to provide an update on the strategies for intravenous fluid treatment in acute pancreatitis,including the type,optimal amount,rate of infusion,and monitoring guides.Recommendations from recent guidelines are critically evaluated for this review in order to reach the authors'recommendations based on the available evidence.展开更多
基金Hainan provincial health and family planning industry research project(1801032061A2004)
文摘Objective: To explore the effect of clinically available crystalloids on lactate clearance in patients with septic shock Methods: Sixty-eight patients with septic shock who were treated in our hospital from January 2017 to January 2019 were enrolled in the study. The selected patients were randomly divided into three groups: sodium lactate Ringer's solution group (LR group), saline group (NS group) and compound sodium chloride injection group (RS group), each group received the corresponding crystal liquid for fluid resuscitation, compare three groups Heart rate (HR), mean arterial pressure (MAP), cardiac output, procalcitonin (PCT), and C-reactive protein (CRP) before and after treatment, compared with the treatment of 24 hours of lactate clearance and APACHE II scores, and the overall hospitalization time and mortality rate of the three groups of patients were statistically compared;Results: (1) The difference of HR, MAP and cardiac output between the three groups before treatment was not statistically significant (P>0.05), treatment for 24h The HR of the post-Lactate Ringer's solution group was lower than that of the control group, and the MAP and cardiac output were higher than the control group (P<0.05). (2) The difference of PCT, CRP and BNP levels between the three groups before and after treatment was not statistically significant. (P>0.05);(3) Compared with the results, there was no statistically significant difference in the clearance rate of lactate clearance between the three groups (P>0.05). Three groups before and after treatment APACHE II score was not statistically significant difference comparison (P> 0.05). (4) Three groups The overall hospitalization time and mortality rate of the patients were not statistically significant (P>0.05). Conclusion: Lactate Ringer's solution can better maintain the circulation capacity and blood pressure, which can alleviate the clinical symptoms of patients with septic shock, but no obvious effect on lactic acid clearance. The effect of resuscitation with clinically available crystalloid sodium lactate Ringer's solution, saline and compound sodium chloride injection was not statistically significant in patients with septic shock.
文摘Twenty patients undergoing open-heart valve replacement were divided randomly into two groups in this study; intermittent perfusion of cold crystalloid (St. Thomas Hospital solution) with hypothermic cardiopulmonary bypass (CPB) (hypothermic group) and continuous administration of warm blood cardioplegia with normothermic CPB (normothermic group) respectively. Tissue samples were taken from the right atrium before weaning from CPB and from the right appendage 30 minutes after removal of the cross-clamp. The results of pathological study in these two groups were as follows: the structural alterations were most severe during the ischemic period in the hypothermic group. Damages of the myocardial
文摘Fluid therapy/resuscitation is mandatory in acute pancreatitis due to the pathophysiology of fluid loss as a consequence of the inflammatory process.For many years,without clear evidence,early and aggressive fluid resuscitation with crystalloid solutions(normal saline solution or Ringer lactate solution)was recommended.Recently,many randomized control trials and meta-analyses on fluid therapy have revealed that high fluid rate infusion is associated with increased mortality and severe adverse events compared to those resulting from moderate fluid rates,and this has triggered a paradigm shift in fluid management strategies.Meanwhile,there is evidence to show that Ringer lactate solution is superior to normal saline solutions in this context.The purpose of this review is to provide an update on the strategies for intravenous fluid treatment in acute pancreatitis,including the type,optimal amount,rate of infusion,and monitoring guides.Recommendations from recent guidelines are critically evaluated for this review in order to reach the authors'recommendations based on the available evidence.
