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Crystalloid Isotonic Solution

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1. Crystalloid Isotonic Solution

Crystalloid Isotonic Solution Crystalloid Isotonic Solution Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Crystalloid Isotonic (...) Solution Crystalloid Isotonic Solution Aka: Crystalloid Isotonic Solution , Normal Saline , Lactated Ringers , Balanced Crystalloid , Isotonic Solutions II. Types Lactated Ringers Normal Saline III. Advantages Inexpensive and readily available Does not result in s IV. Disadvantages Only transiently expand the intravascular volume Only 25% remains in intravascular space Requires infusion of 4-5x the deficit May result in pulmonary edema in critically ill V. Preparations: Basic Saline Normal Saline (0.9

2018 FP Notebook

2. Effect of incubation with crystalloid solutions or medications on packed red blood cells. (Abstract)

Effect of incubation with crystalloid solutions or medications on packed red blood cells. American Association of Blood Banks (AABB) guidelines suggest that packed red blood cells (PRBCs) be administered through a dedicated intravenous (IV) catheter. Literature supporting this broad-scope declaration are scarce. Obtaining additional IV access is painful, costly, and an infectious risk. We evaluated the effect of co-incubating PRBCs with crystalloids and medications on PRBC hemolysis, membrane (...) , and trended lower when co-incubated with epi, norepi, or dopa. Medication concentrations were between those predicted by distribution only in plasma and distribution through the entire intra- and extracellular space.Our data suggest that 5 minutes of PRBC incubation with isotonic crystalloids or catecholamines does not deleteriously alter PRBC hemolysis, membrane deformability, or aggregation. Co-incubation with D5W likely increases hemolysis. Propofol may promote hemolysis.© 2019 AABB.

2019 Transfusion

3. Lactate versus acetate buffered crystalloid solutions: Protocol for a scoping review. Full Text available with Trip Pro

Lactate versus acetate buffered crystalloid solutions: Protocol for a scoping review. Intravenous (IV) fluid therapy has become a ubiquitous intervention in everyday clinical practice. Several types of fluid are available including isotonic crystalloid fluids. Among crystalloid fluids, buffered solutions (derivatives of the original Hartmann's and Ringer's solutions) are increasingly recommended as first-line resuscitation fluids. However, the choice between different buffered solutions appears (...) to be difficult with limited data to support the use of lactate vs. acetate buffered solutions. Accordingly, we aim at systematically describing the body of evidence on the use of the different types of buffered crystalloid solutions in hospitalised patients.We will conduct a scoping review of all study designs (i.e. no study design will per se be excluded from the proposed review) in accordance with the Preferred Reporting Items for Systematic reviews and Meta Analyses (PRISMA) statement.We will provide

2019 Acta Anaesthesiologica Scandinavica

4. Colloids versus crystalloids for fluid resuscitation in critically ill people. Full Text available with Trip Pro

Colloids versus crystalloids for fluid resuscitation in critically ill people. Critically ill people may lose fluid because of serious conditions, infections (e.g. sepsis), trauma, or burns, and need additional fluids urgently to prevent dehydration or kidney failure. Colloid or crystalloid solutions may be used for this purpose. Crystalloids have small molecules, are cheap, easy to use, and provide immediate fluid resuscitation, but may increase oedema. Colloids have larger molecules, cost (...) CENTRAL, MEDLINE, Embase and two other databases on 23 February 2018. We also searched clinical trials registers.We included randomised controlled trials (RCTs) and quasi-RCTs of critically ill people who required fluid volume replacement in hospital or emergency out-of-hospital settings. Participants had trauma, burns, or medical conditions such as sepsis. We excluded neonates, elective surgery and caesarean section. We compared a colloid (suspended in any crystalloid solution) versus a crystalloid

2018 Cochrane

5. Effect of Intravenously Administered Crystalloid Solutions on Acid‐Base Balance in Domestic Animals Full Text available with Trip Pro

Effect of Intravenously Administered Crystalloid Solutions on Acid‐Base Balance in Domestic Animals Intravenous fluid therapy can alter plasma acid-base balance. The Stewart approach to acid-base balance is uniquely suited to identify and quantify the effects of the cationic and anionic constituents of crystalloid solutions on plasma pH. The plasma strong ion difference (SID) and weak acid concentrations are similar to those of the administered fluid, more so at higher administration rates (...) and with larger volumes. A crystalloid's in vivo effects on plasma pH are described by 3 general rules: SID > [HCO3-] increases plasma pH (alkalosis); SID < [HCO3-] decreases plasma pH (alkalosis); and SID = [HCO3-] yields no change in plasma pH. The in vitro pH of commercially prepared crystalloid solutions has little to no effect on plasma pH because of their low titratable acidity. Appreciation of IV fluid composition and an understanding of basic physicochemical principles provide therapeutically valuable

2017 Journal of Veterinary Internal Medicine

6. Isotonic crystalloid solutions: a structured review of the literature. Full Text available with Trip Pro

Isotonic crystalloid solutions: a structured review of the literature. Several different crystalloid solutions are available for i.v. fluid administration but there is little information about their specific advantages and disadvantages.We performed a systematic search of MEDLINE, EMBASE, and CENTRAL up until May 17, 2012, selecting all prospective human studies that directly compared any near-isotonic crystalloids and reported any outcome.From the 5060 articles retrieved in the search, only 28 (...) met the selection criteria. There was considerable heterogeneity among the studies. Several articles reported an increased incidence of hyperchloraemic acidosis with the use of normal saline, and others an increase in blood lactate levels when large amounts of Ringer's lactate solutions were infused. From the limited data available, normal saline administration appears to be associated with increased blood loss and greater red blood cell transfusion volumes in high-risk populations compared

2014 British Journal of Anaesthesia

7. Crystalloid Isotonic Solution

Crystalloid Isotonic Solution Crystalloid Isotonic Solution Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Crystalloid Isotonic (...) Solution Crystalloid Isotonic Solution Aka: Crystalloid Isotonic Solution , Normal Saline , Lactated Ringers , Balanced Crystalloid , Isotonic Solutions II. Types Lactated Ringers Normal Saline III. Advantages Inexpensive and readily available Does not result in s IV. Disadvantages Only transiently expand the intravascular volume Only 25% remains in intravascular space Requires infusion of 4-5x the deficit May result in pulmonary edema in critically ill V. Preparations: Basic Saline Normal Saline (0.9

2015 FP Notebook

8. Balanced Crystalloids Versus Saline in Sepsis: A Secondary Analysis of the SMART Trial. Full Text available with Trip Pro

Balanced Crystalloids Versus Saline in Sepsis: A Secondary Analysis of the SMART Trial. Administration of intravenous crystalloid solutions is a fundamental therapy for sepsis, but the effect of crystalloid composition on patient outcomes remains unknown.To compare the effect of balanced crystalloids versus saline on 30-day in-hospital mortality among critically ill adults with sepsis.Secondary analysis of patients from the Isotonic Solutions and Major Adverse Renal Events Trial (SMART (...) ) admitted to the medical intensive care unit with an ICD-10-CM code for sepsis, using multivariable regression to control for potential confounders.Of 15,802 patients enrolled in SMART, 1,641 patients were admitted to the medical intensive care unit with a diagnosis of sepsis. A total of 217 patients (26.3%) in the balanced crystalloids group experienced 30-day in-hospital morality, compared with 255 patients (31.2%) in the saline group (adjusted odds ratio, 0.74; 95% confidence interval, 0.59 - 0.93; P

2019 American journal of respiratory and critical care medicine Controlled trial quality: predicted high

9. Isotonic Solutions and Major Adverse Renal Events Trial in the Non-Medical Intensive Care Unit (SMART-SURG)

, 2015 Last Update Posted : September 14, 2017 Sponsor: Vanderbilt University Information provided by (Responsible Party): Todd Rice, Vanderbilt University Study Details Study Description Go to Brief Summary: The administration of intravenous fluids is ubiquitous in the care of the critically ill. Commonly available isotonic crystalloid solutions contain a broad spectrum electrolyte compositions including a range chloride concentrations. Recent studies have associated solutions with supraphysiologic (...) Isotonic Solutions and Major Adverse Renal Events Trial in the Non-Medical Intensive Care Unit (SMART-SURG) Isotonic Solutions and Major Adverse Renal Events Trial in the Non-Medical Intensive Care Unit (SMART-SURG) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies

2015 Clinical Trials

10. Isotonic Solutions and Major Adverse Renal Events Trial in the Medical Intensive Care Unit

: Vanderbilt University Information provided by (Responsible Party): Todd Rice, Vanderbilt University Study Details Study Description Go to Brief Summary: The administration of intravenous fluids is ubiquitous in the care of the critically ill. Commonly available isotonic crystalloid solutions contain a broad spectrum electrolyte compositions including a range chloride concentrations. Recent studies have associated solutions with supraphysiologic chloride content with hyperchloremia, metabolic acidosis (...) Isotonic Solutions and Major Adverse Renal Events Trial in the Medical Intensive Care Unit Isotonic Solutions and Major Adverse Renal Events Trial in the Medical Intensive Care Unit - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more

2015 Clinical Trials

11. Isotonic Solution Administration Logistical Testing

Isotonic Solution Administration Logistical Testing Isotonic Solution Administration Logistical Testing - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Isotonic Solution Administration Logistical Testing (...) Description Go to Brief Summary: The administration of intravenous crystalloids is ubiquitous in the care of the critically ill. Commonly available crystalloid solutions contain a broad spectrum of electrolyte compositions including a range of chloride concentrations. Recent studies of associated higher fluid chloride content with acute kidney injury and mortality but no large, randomized trials have been conducted. In preparation for a large, cluster-randomized, multiple-crossover trial comparing 0.9

2015 Clinical Trials

12. Effects of vasoactive drugs on crystalloid fluid kinetics in septic sheep. Full Text available with Trip Pro

Effects of vasoactive drugs on crystalloid fluid kinetics in septic sheep. Crystalloid fluid and vasoactive drugs are used in the early treatment of sepsis. The purpose of the present study was to examine how these drugs alter plasma volume expansion, peripheral edema, and urinary excretion.Twenty-five anesthetized sheep were made septic by cecal puncture and a short infusion of lipopolysaccharide. After 50 min, a slow infusion of isotonic saline was initiated: the saline either contained (...) no drug, norepinephrine (1 μg/kg/min), phenylephrine (3 μg/kg/min), dopamine (50 μg/kg/min), or esmolol (50 μg/kg/min). Ten min later, 20 mL/kg Ringer´s lactate solution was given over 30 min. Central hemodynamics, acid-base balance, and the urinary excretion were monitored. Frequent measurements of the blood hemoglobin concentration were used as input in a kinetic analysis, using a mixed effects modeling software.The fluid kinetic analysis showed slow distribution and elimination of Ringer´s lactate

2017 PLoS ONE

13. Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis

and protocol initiation, and enroll a maximum of 2320 patients with suspected sepsis-induced hypotension. All patients will receive at least 1 liter of fluids prior to meeting study inclusion criteria (and no more than 3 liters prior to randomization). Patients will be enrolled within 4 hours of meeting study inclusion criteria Any type of isotonic crystalloid (normal saline, ringers lactate, or a balanced solution such as plasmalyte) is permitted. Restrictive Fluids (Early Vasopressors) Group (...) of acute volume overload, or if other predefined rescue criteria are met. Any type of isotonic crystalloid (normal saline, ringers lactate, balanced solution such as plasmalyte) is permitted. Outcome Measures Go to Primary Outcome Measures : All-cause mortality prior to discharge home [ Time Frame: 90 days after randomization ] Vital status of the patient at day 90 will be determined using any of the following methods: medical record review, phone calls to patient, proxy or healthcare facility, review

2018 Clinical Trials

14. Which fluid (colloids or crystalloids) is better in initial resuscitation of severe sepsis?

et al 1999 Canada Adult patients (814) requiring fluid resuscitation in 17 trials. Systematic review of randomized trials Mortality No apparent difference between isotonic crystalloid and colloid resuscitation Power of aggregated data was insufficient. Methodological limitations of primary studies, including blinding, were noted. Only 3 included critically ill non-trauma patients including sepsis. Rivers E et al 2001 USA 263 patients with severe sepsis/ septic shock presenting to an urban ED (...) to be addressed regarding fluid choice. The choice of crystalloid is commonly between 0.9% sodium chloride and the more balanced salt solution Hartmann's. There are several different colloid solutions (starch, gelatine, dextran and albumin). Colloids may also be suspended in 0.9% sodium chloride or in a balanced salt solution. Furthermore, administration of hydroxyethyl starch may increase the risk of acute renal failure in patients with sepsis (Schortgen et al). The best choice from these options requires

2012 BestBETS

15. A Comparison of Crystalloid Alone Versus Crystalloid Plus Colloid in Shock Resuscitation

: May 25, 2016 Last Update Posted : May 25, 2016 Sponsor: Mahidol University Collaborator: Siriraj Hospital Information provided by (Responsible Party): Surat Tongyoo, Mahidol University Study Details Study Description Go to Brief Summary: Fluid resuscitation is the most effective treatment of shock. Isotonic crystalloid solution is the current recommended initial fluid resuscitation. However, this kind of fluid has high volume of distribution and may require large volume administration before (...) /treatment Phase Hypotension and Shock Drug: Isotonic crystalloid solution resuscitation Drug: Colloid solution resuscitation Not Applicable Detailed Description: Fluid resuscitation is the most effective treatment of shock. Isotonic crystalloid solution is the current recommended initial fluid resuscitation. However, this kind of fluid has high volume of distribution and may require large volume administration before achieve therapeutic goal of shock reversal. There are rising concern about the delay

2016 Clinical Trials

16. Balanced crystalloids versus saline in the intensive care unit: study protocol for a cluster-randomized, multiple-crossover trial. Full Text available with Trip Pro

Balanced crystalloids versus saline in the intensive care unit: study protocol for a cluster-randomized, multiple-crossover trial. Saline, the intravenous fluid most commonly administered to critically ill adults, contains a high chloride content, which may be associated with acute kidney injury and death. Whether using balanced crystalloids rather than saline decreases the risk of acute kidney injury and death among critically ill adults remains unknown.The Isotonic Solutions and Major Adverse (...) Renal Events Trial (SMART) is a pragmatic, cluster-level allocation, cluster-level crossover trial being conducted between 1 June 2015 and 30 April 2017 in five intensive care units at Vanderbilt University Medical Center in Nashville, TN, USA. SMART compares saline (0.9% sodium chloride) with balanced crystalloids (clinician's choice of lactated Ringer's solution or Plasma-Lyte A®). Each intensive care unit is assigned to provide either saline or balanced crystalloids each month, with the assigned

2017 Trials Controlled trial quality: predicted high

17. Saline versus balanced crystalloids for intravenous fluid therapy in the emergency department: study protocol for a cluster-randomized, multiple-crossover trial Full Text available with Trip Pro

receiving at least 500 mL of isotonic crystalloid solution during usual clinical care and subsequently hospitalized outside the intensive care unit are included. Treatment allocation of 0.9% saline versus balanced crystalloids is assigned by calendar month, with study patients treated during the same month assigned to the same fluid type. The first month (January 2016) was randomly assigned to balanced crystalloids, with each subsequent month alternating between 0.9% saline and balanced crystalloids (...) Saline versus balanced crystalloids for intravenous fluid therapy in the emergency department: study protocol for a cluster-randomized, multiple-crossover trial Prior studies in critically ill patients suggest the supra-physiologic chloride concentration of 0.9% ("normal") saline may be associated with higher risk of renal failure and death compared to physiologically balanced crystalloids. However, the comparative effects of 0.9% saline and balanced fluids are largely unexamined among patients

2017 Trials Controlled trial quality: predicted high

18. A novel balanced isotonic sodium solution vs normal saline during major surgery in children up to 36 months: a multicenter RCT. (Abstract)

A novel balanced isotonic sodium solution vs normal saline during major surgery in children up to 36 months: a multicenter RCT. The use of isotonic electrolytic solutions for the intraoperative fluid management in children is largely recognized, but the exact composition still needs to be defined.The primary objective of this randomized controlled open trial was to compare the changes in chloride plasma concentration using two intraoperative isotonic fluid regimens (Sterofundin vs. normal (...) was comparable between the two study groups. Relative risk of hyperchloremia was significantly higher when large volumes were infused (over than 46.7 ml·kg(-1) ), regardless of type of crystalloid infused. Hypoglycemia occurred in two of 229 patients.Sterofundin is safer than normal saline in protecting young children undergoing major surgery against the risk of increasing plasma chlorides and the subsequent metabolic acidosis.© 2014 John Wiley & Sons Ltd.

2014 Paediatric anaesthesia Controlled trial quality: uncertain

19. Colloids versus crystalloids for fluid resuscitation in critically ill patients. Full Text available with Trip Pro

Colloids versus crystalloids for fluid resuscitation in critically ill patients. Colloid solutions are widely used in fluid resuscitation of critically ill patients. There are several choices of colloid and there is ongoing debate about the relative effectiveness of colloids compared to crystalloid fluids.To assess the effects of colloids compared to crystalloids for fluid resuscitation in critically ill patients.We searched the Cochrane Injuries Group Specialised Register, CENTRAL (...) replacement. We excluded cross-over trials and trials in pregnant women and neonates.Two authors independently extracted data and rated quality of allocation concealment. We analysed trials with a 'double-intervention', such as those comparing colloid in hypertonic crystalloid to isotonic crystalloid, separately. We stratified the analysis according to colloid type and quality of allocation concealment.We identified 65 eligible trials; 56 of these presented mortality data.Colloids compared

2011 Cochrane

20. Balanced Solutions and Plasma Electrolytes

Description Go to Brief Summary: The administration of intravenous fluids is ubiquitous in the care of the critically ill. Commonly available isotonic crystalloid solutions contain a broad spectrum electrolyte compositions including a range chloride concentrations. Recent prospective, randomized trials have shown improved patient outcomes with the use of balanced crystalloids compared to saline. There have not been large randomized studies comparing acetate buffered balanced crystalloids to non-acetate (...) Library of Medicine available for: Arms and Interventions Go to Arm Intervention/treatment Active Comparator: Lactated Ringer's Patients in a MICU block randomized to lactated Ringer's will receive lactated Ringer's whenever isotonic intravenous fluid administration is ordered by the treating provider. Drug: Lactated Ringer's Lactated Ringer's will be used whenever an isotonic crystalloid is ordered Other Names: Ringer's lactate Non-acetate buffered solution Active Comparator: Normosol Patients

2018 Clinical Trials

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